How does C the Signs work?

A new study presented at the ASCO Care Quality Symposium 2025 and published in the Journal of Clinical Oncology (JCO Oncology Practice) has shown that C the Signs, an artificial intelligence (AI) platform supporting earlier cancer diagnosis, has delivered an 808% return on investment (ROI) for the NHS.

Commissioned by Health Innovation East, the independent evaluation found that implementation of C the Signs across Suffolk and North East Essex Integrated Care Board (ICB) was associated with 272 patients being diagnosed earlier and £1.5 million in annual cost savings - demonstrating how AI can help improve patient outcomes and optimise NHS resources.

By helping GPs identify patients at risk of cancer sooner and reduce unnecessary urgent suspected cancer (USC) referrals, the platform has also eased system pressures and released valuable clinical capacity across the region.

“This study provides clear evidence that AI can make a measurable impact on cancer care,” saidDr Miles Payling, Chief Scientific Officer at C the Signs. He went on to say:

"An 800% return on investment means we’re improving early diagnosis and helping the NHS use its resources more efficiently. It’s a practical example of innovation making care better for both patients and clinicians.”

The study builds on earlier research, also published in JCO Oncology Practice and presented at ASCO, which found that GP practices using C the Signs achieved a 12% increase in cancer detection rates - from 58.7% to 66.0% - without increasing referral activity.

Together, these studies show that C the Signs helps detect more cancers at an earlier stage while maintaining stable referral volumes - supporting NHS priorities around early diagnosis, productivity, and elective recovery.

“Early diagnosis gives patients the best chance of successful treatment,” said Dr Seema Dadhania, Clinical Oncologist at Imperial College London and author of the study. Dr Dadhania further stated:

“C the Signs is helping primary care clinicians identify those subtle cancer presentations that can otherwise be missed - improving detection while reducing unnecessary referrals. It’s a model for sustainable early diagnosis.”

Scaling Across the East of England

Following the success in Suffolk and North East Essex, Health Innovation East has supported the expansion of C the Signs across Norfolk and Waveney ICB, with further rollouts planned across the East of England.

Piers Ricketts, Chief Executive at Health Innovation East said:‍

“This work is a strong example of technology delivering measurable benefit. C the Signs has shown that AI can help clinicians find cancer earlier.

He continued: "This is of obvious benefits to patients whilst also easing the pressure on NHS services, in particular on primary care. The results from Suffolk and North East Essex are a real success story for innovation in the NHS and show how the service can progress towards its goal of increasing early detection rates from 50% to 75% by 2028.”

‍Dr Peter Holloway, GP Partner at Mendlesham Practice, Cancer Lead for Suffolk and North East Essex ICB, Chair of the Primary Care Group for the East of England Cancer Alliance, and Cancer Research UK GP for the East of England said:

“The NHS has set an ambitious target to achieve 75 percent early stage cancer diagnoses by 2028. To reach this, we must strengthen primary care’s ability to recognise early symptoms of cancer and ensure timely investigation and referral. C the Signs – a clinical decision support system integrated seamlessly within GP IT systems – helps deliver on these objectives.

Shedding further light on the impact, Dr Holloway said: "Research has shown a 12 percent increase in cancer detection rates in Ipswich and East Suffolk following its implementation. Moreover, it demonstrates a strong return on investment: by ensuring patients are quickly directed to the right pathway, the system effectively pays for itself and reinforces the value of a digital first approach.”

Actor James Pickens Jr., known to millions for his role as Dr Richard Webber on Grey’s Anatomy, has shared his personal experience with prostate cancer - a decision he hopes will encourage more men, especially Black men, to understand their risk and speak to a health professional sooner.

Pickens, now 73, was diagnosed after his annual physical in 2024. For him, the news was not entirely unexpected. Prostate cancer has affected many men in his family across generations. That family history meant he was diligent about monitoring his health - something that ultimately made all the difference.

“My urologist said it worked in my favour,” he shared.

“Because I was so consistent with my testing, they were able to catch it early.”

During his check-up, elevated PSA levels led to a referral to a urologist. A biopsy confirmed a tumour, and a PET scan showed it hadn’t spread. Given his early diagnosis, Pickens was able to choose between radiation or surgery. He opted for a robotic prostatectomy, supported by a team who kept a close eye on a rare cancer variant found during testing.

“They told me they hadn’t seen one detected as early as mine,” he said - a powerful reminder of what’s possible when cancer is identified in time.

Pickens has spoken openly about the stigma that often surrounds men’s health, especially conversations about prostate cancer. Many men delay seeking help, feel uncertain about what’s normal, or worry about “making a fuss”. These barriers are even more pronounced for Black men, who face a higher risk due to genetic and structural factors.

“One in eight men will be diagnosed with prostate cancer,” he said in a recent public message. “For Black men, the risk is even higher. His story reinforces a truth we hear across healthcare: the earlier prostate cancer is detected, the more options men have - and the better their outcomes can be.

"Early detection is key, and sometimes there are no noticeable symptoms.”

How do you know if you have prostate cancer?

Prostate cancer can be difficult to recognise in its early stages - not because people aren’t paying attention, but because the body often gives very few clues at the beginning. That’s why understanding your own baseline, your personal risk, and what feels normal for you is so important.

There isn’t one single sign to look out for. Instead, there are moments worth pausing on - small changes, shifts in how your body behaves, or a sense that something simply feels different.

You don’t need to be certain something is wrong before speaking to a doctor. You just need to notice a change.

For many men, that might look like:

• A change in the way you urinate - starting, stopping, or feeling different
• Going more often, especially at night
• A stream that feels weaker or slower than usual
• A lingering sense that your bladder hasn’t fully emptied
• Or simply a feeling that something isn’t quite your normal

These changes don’t automatically mean prostate cancer. They’re far more often caused by benign prostate enlargement - a common part of ageing. But they are still worth a conversation, because the earlier any prostate issue is understood, the more options you have.

Your risk also changes over time. Growing older, having Black heritage, or having a family history of prostate, breast or ovarian cancer can increase the chance of developing prostate cancer - which is why some people choose to check in sooner.

A doctor may talk to you about a PSA blood test - a simple blood test that measures the level of prostate-specific antigen - a protein made by the prostate. It isn’t a diagnosis, and it doesn’t give all the answers - but it can offer a helpful starting point if you want to understand your risk more clearly.

What matters most is listening to your body. You know when something feels different. And you deserve to be taken seriously, to ask questions freely, and to have the right support at the right time.

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For many people, conversations about cannabis and cancer come from a place of hope - a hope that something natural might ease symptoms or make treatment feel more manageable. For others, it’s a topic filled with uncertainty and mixed messages. With so much information circulating online, it can be difficult to know what’s fact, what’s theory, and what’s still being explored.

What is cannabis?

Cannabis is a plant that has been used for thousands of years, both recreationally and medicinally. The resin it produces contains cannabinoids, chemical compounds that can interact with the human body.

Two of the main cannabinoids are:

• Delta-9-tetrahydrocannabinol (THC) - the compound that causes a “high.”
• Cannabidiol (CBD) - which doesn’t cause a high and is legal in the UK when sold without THC.

The human body naturally produces its own cannabinoids, known as endocannabinoids, which help regulate processes such as appetite, mood and pain. This system is complex and continues to be studied, including how it may relate to certain diseases, cancer among them.

The legal status in the UK

Cannabis remains a Class B drug under UK law, meaning it’s illegal to possess or supply it. However, several prescribed medicines derived from cannabis are approved for use in the NHS, including:

• Nabilone, used to help control nausea and vomiting caused by chemotherapy.
• Epidyolex, used to treat certain types of severe epilepsy.

These are highly regulated medicines, prescribed only when other treatments haven’t worked.

CBD products, such as oils, drops, or gummies, are legal to buy in the UK if they contain no THC and are marketed as food supplements. They cannot legally claim to treat or prevent disease.

What about cannabis oil?

Cannabis oil products vary widely. Some contain only CBD, while others, often sold illegally, include THC. Pure CBD oil is legal to buy as a food supplement in the UK, but products sold online or in shops are not medicines and are not regulated for quality or content.

People living with cancer sometimes explore CBD oil to help with pain, anxiety or sleep. However, claims that CBD or cannabis oil can cure or shrink cancer are not supported by scientific evidence.

If a patient wishes to try CBD, they should always speak to their GP, pharmacist or cancer care team first - especially as CBD can interact with other prescribed medicines.

Cannabis and cancer: what the evidence shows

Researchers around the world have been studying cannabinoids and their potential role in cancer treatment. The results have been mixed and mostly early stage.

Some laboratory studies show that cannabinoids can:

• Trigger cancer cells to die (a process called apoptosis).
• Slow the growth of certain cancer cells.
• Prevent tumours from forming new blood vessels.

However, other studies have found that cannabinoids can:

• Damage healthy blood vessels.
• Sometimes promote cancer cell growth under certain conditions.

It’s also important to note that most of this research has been done in cells in the lab or in animals, not in people. What works in a petri dish doesn’t always translate into safe or effective treatments for patients.

As of 2025, there is no reliable clinical evidence that cannabis or cannabinoids can treat or cure cancer in humans.

What the research is exploring

Recent trials are beginning to look at cannabinoids in controlled, medical settings. These studies focus mainly on symptom control or exploring whether cannabinoids can be safely combined with standard treatment - not on replacing proven therapies.

Medicinal cannabis for symptom control in advanced cancer (2025)

A randomised, double-blind clinical trial tested a cannabis oil against placebo in patients with advanced cancer. The trial found no difference in overall symptom distress, though some patients reported a small reduction in pain. However, this came with higher rates of side effects such as dizziness and fatigue, highlighting the need for further research into safe dosing.
(Hardy et al., 2025). 

The ARISTOCRAT trial – UK, ongoing

The ARISTOCRAT trial, led by the University of Leeds and the University of Birmingham, is testing nabiximols (Sativex),  a balanced THC:CBD oral spray, alongside standard chemotherapy for people with recurrent glioblastoma. Early data suggests the treatment is well tolerated. The study aims to understand whether adding cannabinoids could improve survival.
(University of Leeds, 2021; The Brain Tumour Charity, 2023; BMC Cancer trial protocol, University of Birmingham, 2023)

Together, these studies show that research is progressing, but there is still no clear evidence that cannabinoids improve cancer outcomes.

What we still need to understand

There are still important questions to answer:

• Which cannabinoids (natural or synthetic) might be most effective?
• What doses are safe and meaningful?
• Which cancer types, if any, might respond?
• How do cannabinoids interact with existing treatments like chemotherapy or immunotherapy?

Until large, well-controlled clinical trials can answer these questions, cannabis cannot be recommended as a cancer treatment.

The bottom line

There’s currently no reliable evidence that cannabis or cannabis oil can treat or cure cancer.
Some cannabinoids may help manage symptoms such as pain, sickness or appetite loss, but always under clinical supervision.

For anyone considering CBD or cannabis-based products, the safest step is to talk to a GP or oncology specialist first. They can help review what’s evidence-based, what’s safe, and what may interfere with ongoing treatment.

Because every informed choice, and every early conversation,gives patients back control, confidence and clarity.

References

Hardy JR, Greer RM, Pelecanos A, et al. (2025). Medicinal cannabis for symptom control in advanced cancer: a double-blind, placebo-controlled, randomised clinical trial of 1:1 tetrahydrocannabinol and cannabidiol. Supportive Care in Cancer. DOI: 10.1007/s00520-025-09763-5

University of Leeds (2021). World-first trial tests cannabis-based drug on aggressive brain tumours. Leeds.ac.uk

The Brain Tumour Charity (2023). ARISTOCRAT: a pioneering trial using a cannabinoid-based drug to treat brain tumours. thebraintumourcharity.org

University of Birmingham (2023). A randomised phase II trial of temozolomide with or without cannabinoids in patients with recurrent glioblastoma (ARISTOCRAT). BMC Cancer protocol. birmingham.ac.uk

Cancer Research UK (2023). Cannabinoids and cancer: what we know. news.cancerresearchuk.org

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Earlier this month, Joe Powell, Member of Parliament for Kensington and Bayswater, visited Golborne Medical Centre to see how local GPs are using C the Signs.

Hosted by Dr Meena Nathan and Dr Thushara Goonewardene, the visit brought together community clinicians, C the Signs Co-Founder Dr Miles Payling, and local leaders to explore how innovation, teamwork, and community engagement are transforming early diagnosis in one of London’s most diverse communities.

Transforming Early Diagnosis in Primary Care

Inside the busy surgery, clinicians demonstrated how C the Signs supports decision-making in real time - analysing patient records, symptoms, and risk factors to surface hidden indicators of cancer during routine appointments.

“We’re still early in the rollout, but already it’s helping us prioritise patients who might otherwise slip through the cracks,” one clinician shared.

C the Signs’ AI models - validated across more than 500,000 patient records - have achieved 99% sensitivity for cancer detection and 94% accuracy in predicting tumour origin. In real-world NHS evaluations, practices using C the Signs have seen a 50% reduction in emergency cancer diagnoses and a 20–50% improvement in time to diagnosis.

Discussions during the visit focused on addressing barriers such as low screening uptake and under-detection in harder-to-spot cancers like pancreatic and lung - areas where C the Signs’ AI-driven case finding is already being deployed across the NHS.

Community, Compassion and Continuity

Beyond technology, clinicians emphasised the human side of early diagnosis. One GP described how her team intervened when a patient’s surgery was nearly cancelled due to language barriers:

“She came in completely distraught. We stepped in, made the calls, got her rebooked. That kind of support takes time - but it changes everything.”

The Golborne team highlighted how community partnerships and culturally sensitive communication remain critical to ensuring that early diagnosis reaches every patient.

“It all starts with education,” said another clinician. “We saw what community groups achieved during the pandemic - those links still exist, but time is our biggest limitation.”

Facing the Pressures in Primary Care

The visit also revealed the realities of delivering proactive, preventative care in a high-demand urban setting. With limited space, the team frequently repurposes rooms - even corridors - to ensure every patient is seen. Expansion plans are already underway to increase clinical capacity next year. Despite these pressures, Golborne’s clinicians continue to innovate, integrating mental health support, opportunistic health checks, and early-diagnosis prompts into every consultation.

“Our patients work with us,” said a member of the Golborne team. “They know we’re doing our best - and they appreciate that.”

Partnership Beyond the Practice

Speaking after the visit, Joe Powell MP emphasised the importance of collaboration between community, technology, and health services:

“What’s happening here in Golborne - between GPs, community groups, and innovators like C the Signs - is exactly the kind of joined-up approach we need to deliver earlier diagnosis and better care.”

He also called for stronger links across the Integrated Care Board (ICB) and better alignment between voluntary and statutory services to tackle the wider determinants of health - from housing to mental wellbeing.

Dr Miles Payling, Co-Founder and Chief Scientific Officer at C the Signs, added:

“Early diagnosis begins in communities - in everyday conversations between GPs and patients, supported by technology that empowers those moments. Every 22 minutes, C the Signs helps detect another patient with cancer. What’s happening in Golborne shows how innovation can give patients back the one thing cancer takes away: time.”

Why It Matters

C the Signs was built by NHS doctors to work within existing systems and integrate seamlessly with primary-care workflows. Today, it is commissioned in over 1,500 GP practices, covering more than 10 million patient lives across the UK.

By enabling faster, more accurate triage and supporting clinicians at the point of care, the platform is redefining how cancer is detected - turning complex data into actionable insight and giving every patient a better chance of being seen in time.

Cancer affects almost every family, but one thing shapes outcomes more than anything else: how early it’s found. When cancer is diagnosed sooner, treatment is usually simpler, options are greater, and people have a much better chance of living longer, healthier lives.

Early diagnosis gives people time - and that time can change everything.

Why it can be hard to spot early signs

The first signs of cancer are often subtle. Tiredness, a lingering cough, changes in appetite or digestion - symptoms that are incredibly common and usually caused by something minor. With so many possibilities, it can be difficult to know what needs attention and what can wait.

Primary care clinicians are often the first people patients turn to. They see a huge range of symptoms every day, often with limited time to explore them fully. It’s a challenging balance: being thorough, being reassuring, and making sure no early clue is overlooked.

This isn’t a reflection of ability.

It’s simply the nature of early cancer symptoms - they’re easy to miss, even when clinicians are doing everything right.

Where technology can make a meaningful difference

As cancer becomes more complex, clinicians need support that helps them make sense of subtle symptoms quickly and confidently.

Modern technology - including AI designed for early cancer detection - can help by:

• recognising patterns that may not be obvious at first glance
• supporting consistent, evidence-based decision-making
• helping clinicians identify when further checks might be needed
• making sure patients at risk don’t slip through the cracks
  

The goal isn’t to replace clinical judgement. It’s to strengthen it - and lighten the load on the people who carry so much responsibility.

The impact of finding cancer sooner

When cancer is identified earlier:

• people start treatment sooner
• recovery can be quicker
• treatment is often less invasive
• survival rates increase
• families gain more time together
  

Early diagnosis isn’t just a clinical milestone - it’s a moment that can change the course of a life.

Diagnosing cancer early is one of the most complex and emotionally demanding responsibilities placed on primary care clinicians. It’s in primary care - the first place most people turn when something doesn’t feel right - where the earliest clues of cancer often appear. These signs are rarely clear, rarely dramatic, and rarely easy to separate from everyday illnesses.

And yet, this is where early detection begins. At the very first conversation. In the very first appointment. With the clinicians who know their patients best. This is why the demands placed on primary care clinicians are so great - and why they deserve systems designed to support them.

Seeing the small signs that can be easy to miss

In primary care, symptoms rarely arrive in neat, textbook patterns. Fatigue, a persistent cough, subtle abdominal discomfort, a quiet change in weight - these common concerns can be signs of countless conditions, most of them benign. But occasionally, they are the earliest indication of cancer.

Recognising these signals within a short consultation, often with partial information, is a profound clinical challenge.

Primary care clinicians must balance:

• large and growing patient caseloads
• time-limited appointments
• complex and evolving cancer guidelines
• administrative responsibilities such as referral coordination, documentation and safety-netting
• rising patient expectations and system pressure
  

And they must do so while ensuring every patient feels heard, reassured, and supported.

These pressures don’t simply affect workflows — they affect wellbeing. The emotional weight of worrying about a missed diagnosis can stay with clinicians long after their day ends.

Turning uncertainty into early action

Our platform analyses symptoms, risk factors, demographics, and clinical information in seconds - highlighting when a patient may be at risk and guiding the clinician toward the right next step.

It integrates within the systems clinicians already use, supporting healthcare teams across many regions, whether through EMIS, SystmOne or local electronic medical record systems.

This helps clinicians:

• Cross-check symptoms against validated cancer pathways
• Recognise rare or non-specific presentations earlier
• Refer or investigate patients with greater clarity and confidence

Every earlier investigation gives patients something invaluable: time to act, time to treat, and time to live the moments that matter.

Strengthening clinical judgment - not replacing it

Our platform is built to work with clinicians, never instead of them. It unites the best available evidence, national and international guidelines, and AI-powered insight in one clear, supportive view.

This leads to:

• Less diagnostic uncertainty
• More consistent, evidence-based decisions
• Improved patient safety and continuity of care

As one clinician shared:

“C the Signs helps me confirm when my instincts are right — and sometimes, when they’re not.

It ensures that no patient slips through the net.”

— GP, North West England

A global movement towards earlier diagnosis

Healthcare systems around the world share the same goal: to find cancer earlier and give patients the best possible chance.

Clinicians using C the Signs are already seeing meaningful change - with earlier referrals, faster diagnostic timelines, and improved identification of patients with cancer.

Behind every statistic is a person whose story is changed by earlier clarity. A family kept whole. A future rewritten.

Platforms like C the Signs - used across more than 1,500 practices and supporting over 10 million patient lives - help clinicians detect a patient with cancer every 22 minutes. Each one represents time given back.

More than technology - a partnership for better care

Technology alone doesn’t transform early cancer detection. People do.

Our platform is shaped hand-in-hand with clinicians across the world, grounded in their experience and continually refined through their insights.

Together, we’re helping shift early cancer detection from a reactive moment to a proactive standard of care - where every symptom is seen, every risk understood, and every patient given the best possible chance.

Image Credit: iStock