In the report "Convergence: The Future of Health," academics from the Massachusetts Institute of Technology (MIT) and other top U.S. universities collaborated to outline the potential impact of the Convergence in Healthcare movement. In this white paper, Convergence in Healthcare is defined as the intersection of the life sciences, physical sciences, chemistry, mathematics, computing and engineering sectors for the purpose of revolutionizing conventional research methods. Through a deeply integrative approach to science, these leading academics believe healthcare in the U.S. and around the world could be improved, leading to more effective diagnosis, treatment and prevention.

To demonstrate the power Convergence in Healthcare has to radically change the medical sector, the white paper’s authors highlighted several examples of convergent research with potentially wide-reaching impacts on human health. One of the most exciting of these is a new method for early detection of cancer developed at MIT: a paper-based urine test.

Why a paper-based urine test for cancer is important

Cancer research is the most highly funded area of research by the National Institutes of Health (NIH). It is the second-leading cause of death in the United States, and every year brings an untold amount of emotional anguish to the people who live with it as well as those who love them. The ideal solution would be an infallible cure, but unfortunately, finding a cure-all for cancer is much more difficult than it may seem to the average person.

The term "cancer" refers to a collection of more than 200 different diseases with thousands of different subtypes, each of which requires its own specific type of treatment. While scientists work to find cures for cancer in its many forms, early detection remains one of the most important factors in treatment today. Discovering a cancerous growth early, before it has metastasized and spread throughout the body, greatly increases the likelihood of the patient’s survival. This is why a paper-based urine test for cancer holds so much promise: as an efficient, uncomplicated, affordable method of detection, the tool could catch cases earlier, giving people more time to seek treatment.

How the test works

The paper test functions through the convergence of life science, engineering and nanotechnology. Scientists first engineered nanoparticles capable of containing synthetic biomarkers and coated them with a material designed to interact with matrix metalloproteinases (MMPs) — a type of protein found in tumors. The nanoparticles are injected into the body, where they gravitate toward the tumor site. When the MMPs in the tumor encounter the coated nanoparticles, they cut the nanoparticle as they would a peptide, releasing the synthetic biomarkers into the body.

The biomarkers are eventually excreted from the body in urine. The patient’s urine is then placed on a nitrocellulose paper strip that has been coated with peptide-capturing antibodies, which react to the presence of synthetic biomarkers by displaying lines along the paper strip. In this respect, the test functions similarly to a home pregnancy test. Researchers were able to use the strip to identify the presence of colorectal cancer in animal models.

The potential impact on the developing world

While easy-to-use, early methods of cancer detection benefit everyone, this paper strip urine test holds particular promise for people in developing countries, where access to modern healthcare can be limited. According to the MIT scientist who developed the test, Sangeeta Bhatia, MD, PhD, as much as 70 percent of the world’s cases of preventable cancer will occur in the developing world by 2020.

Apart from being more affordable than other methods of cancer detection, the paper test is noted on the MIT website to be "as easy to read as a pregnancy test," meaning it would not have to be administered by an experienced physician. Secondly, the test does not require electricity — a significant benefit since many people in the developing world lack access to reliable power. Ideally, health care workers could administer the tests and photograph the results with a smartphone. The picture could be uploaded to a secure database to be analyzed or sent directly to a qualified physician for an accurate diagnosis.

The future of the paper test

Since the first iteration of the test was announced in 2014, researchers have advanced the technology behind it. Most notably, in 2017, Bhatia and her team announced that the same technology had been reengineered with sensors about 15 times more sensitive than the original model, and the test was now able to detect miniscule, 2 millimeter-wide ovarian cancer tumors in mice. The team believes the technology may allow the medical community to diagnose ovarian cancer up to five months earlier than currently possible through blood tests.

The paper-based cancer test is just one fascinating example of the new technologies and methods produced by convergent research. With more such research, humankind is likely to see the development of even more affordable and efficient methods of early diagnosis, treatment and prevention of the world’s deadliest diseases.