Blood test may improve survival of childhood cancer in Africa
UNDER EMBARGO UNTIL 19 March 2026 at 10:00 (London time), 19 March 2026 at 06:00 (US Eastern Time)..
Burkitt lymphoma is an aggressive cancer affecting children in sub-Saharan Africa If treated early, over 90% survive but currently, slow diagnosis results in fewer than 50% of children surviving A new, highly accurate blood test has been shown to cut diagnosis time from 46.8 days (using current methods) to 6.5 days and increases detection rate from 40% to 93.3% This approach could help ensure that children with Burkitt lymphoma begin life-saving treatment sooner This research is an output of the National Institute for Health and Care Research (NIHR)-funded AI-REAL consortium In a study published today in Nature Medicine, researchers from the University of Oxford and the Muhimbili University of Health and Allied Sciences (MUHAS) in Dar es salaam, Tanzania have shown that a minimally invasive “liquid biopsy” test can diagnose Burkitt lymphoma rapidly and accurately in sub-Saharan Africa, where delays in traditional testing often prove fatal.
Despite its aggressive nature, Burkitt lymphoma is often curable when treated quickly, with survival rates over 90%. Treatment is widely available and free-of-charge in most sub-Saharan countries, however current diagnostic tests demand specialist expertise and laboratory equipment that are often unavailable in resource-limited settings. Due to this, most children either remain undiagnosed or are diagnosed too late. In much of the region, survival rates can fall below 50%.
“There is an urgent need for new diagnostic methods that are practical and effective in the under-resourced settings where Burkitt lymphoma is most common”, said Anna Schuh, Professor of Molecular Diagnostics at the University of Oxford and lead researcher on the study. “This is a highly treatable cancer, yet too many children and young adults are not diagnosed in time. As a minimally invasive and precise approach, liquid biopsy tests have enormous potential to transform diagnosis in sub-Saharan Africa and significantly improve outcomes.”
Liquid biopsies detect tiny amounts of DNA released by cancer cells into the blood. Using a simple blood sample, scientists can identify specific genetic changes that are characteristic of Burkitt lymphoma and distinguish them from DNA from healthy cells or other tumour types.
Prof. Anna Schuh and her team in Oxford, working in collaboration with researchers at MUHAS in Tanzania, the Central Public Health Laboratory in Kampala, Uganda and 4 study sites in these countries have developed a minimally invasive liquid biopsy test for the rapid and precise detection of Burkitt lymphoma. This is the first indication that liquid biopsies might play a big role in diagnosing other cancers in sub-Saharan Africa.
The international research team evaluated the liquid biopsy test in a large group of children and young adults who presented with clinical signs of lymphoma across four hospitals in Uganda and Tanzania. Its performance was compared to a tissue biopsy-based approach that used diagnostic tests accessible in limited-resource settings.
High accuracy and faster results
The blood test demonstrated strong ability to distinguish Burkitt lymphoma from other conditions, achieving an overall accuracy of 98%. Among 81 patients with a confirmed tissue-based diagnosis of Burkitt lymphoma, 86.4% were correctly identified via liquid biopsy.
Importantly, the blood test dramatically reduced the time needed to reach a diagnosis. A liquid biopsy diagnosis was 40.3 days faster on average, compared to tissue biopsy diagnosis.
To understand how the test would perform in real-world clinical practice, the team held weekly multidisciplinary team (MDT) meetings to review cases in real time.
Clara Chamba, Head of Haematology at MUHAS and study author said:
“Introducing liquid biopsy into our multidisciplinary meetings transformed how quickly we could start treating our patients. With liquid biopsy, 93% of cases were diagnosed within the first week of sample collection, compared to just 40% when we relied on tissue biopsy alone. For a cancer that progresses as quickly as Burkitt lymphoma, that time can be life-saving.”
While further work is needed to understand how to scale the test for clinical use, this study shows that liquid biopsy could serve as a complementary and timely diagnostic tool, especially where tissue biopsy access is limited or delayed. By increasing diagnostic yield and dramatically shortening time to diagnosis, this approach could help ensure that children with Burkitt lymphoma begin life-saving treatment sooner.
Prof. Bruno Sunguya, Deputy Vice Chancellor, Research and Consultancy, MUHAS, Tanzania, said:
“The successful implementation and analytical work conducted in Tanzania and Uganda demonstrates that precision medicine research can and should be led from within low- and middle-income countries. Beyond lymphoma, this work opens new opportunities to apply genomic and liquid biopsy technologies to strengthen cancer diagnosis and improve outcomes more broadly across the region. This collaboration reaffirms our commitment to advancing innovation, accelerating timely diagnosis, and improving survival for children and adults affected by cancer.”
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Notes to Editors
This project (NIHR200133) was funded through the NIHR Research on Interventions for Global Health Transformation (RIGHT) programme. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK government.
For further information or interviews with the researchers, please contact:
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University of Oxford
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Christopher.mcintyre@admin.ox.ac.uk
About The AI-REAL consortium
Funded by the National Institute for Health and Care Research (NIHR), AI-REAL (Aggressive Infection-Related East Africa Lymphoma) aims to improve the early detection and outcomes of childhood lymphoma in Uganda and Tanzania by increasing the speed and precision of diagnosis. The programme is led by Professor Anna Schuh (University of Oxford), with research teams in Tanzania and Uganda. The AI-REAL study developed and tested two simple, low-cost tools that can operate outside traditional laboratory environments:
a liquid biopsy test that detects cancer DNA from a blood sample
mobile whole-slide imaging which involves scanning entire histological tissue slides using a mobile camera that can be attached to any microscope, to enable remote pathology review.
The study paired these innovations with bioinformatics training, health economic evaluation and policy engagement to assess technical feasibility, affordability and pathways for scale-up. By combining research with local capacity strengthening, it sought to demonstrate how molecular and digital tools can transform cancer care in low- and middle-income countries.
About Burkitt lymphoma
Burkitt lymphoma is a highly aggressive cancer that grows very quickly. It can affect the jaw, central nervous system, bowel, kidneys, ovaries, and other organs. In sub-Saharan Africa, 95% of cases are associated with infection by the Epstein-Barr virus (EBV).
An accurate diagnosis of Burkitt lymphoma is made by identifying specific genetic and molecular changes in tumour samples. These tests demand specialist expertise and laboratory equipment that are often unavailable in resource-limited settings. As a result, many hospitals struggle with delays, misdiagnoses, and limited access to specialist pathology services.
About the NIHR
The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research.
We do this by:
funding high quality, timely research that benefits the NHS, public health and social care
investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services
partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research
attracting, training and supporting the best researchers to tackle complex health and social care challenges
collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system
funding applied global health research and training to meet the needs of the poorest people in low and middle income countries
NIHR is funded by the Department of Health and Social Care. Our work in low and middle income countries is principally funded through UK international development funding from the UK government.
About the University of Oxford
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