Cancer Prevention & Risk Reduction

Through carefully co-ordinated clinical trials, our researchers are focused on cancer prevention and risk reduction, and work to deliver validated interventions for reducing the risk of cancer, meanwhile aiming to identify more accurately individuals at high risk of developing particular cancers.

Theme Leads: Professor Jack Cuzick, Professor Ranjit Manchanda

Key Cancer Types: breast, cervical, ovarian, prostate

Research Focus Key Achievements Key Publications

Research Focus

The main areas of focus are as follows:

Development of methods for preventing occurrence and recurrence of breast cancer
Development of strategies for improving ovarian cancer prevention
Development and validation of biomarkers for risk stratification and prevention of other cancers
Development of strategies for repurposing drugs (e.g. aspirin) for cancer prevention or adjuvant treatment of early disease
Research into population based genetic testing strategies for risk stratification and cancer prevention
Development and evaluation of strategies for enhancing genetic testing at cancer diagnosis for precision medicine and cancer prevention

Key Achievements

Obtaining a £5m Catalyst award from CRUK to understand the mechanisms and benefit risk of aspirin chemoprevention of cancer through population research.
Completing the feasibility study for the PROVENT trial. This is a clinical trial of men enrolled onto an active surveillance programme for the management of prostate cancer who participated in a randomised chemoprevention study of standard or low dose aspirin and/or Vitamin D. We are currently seeking funding for the main trial of 1,000 men to evaluate the reduction in progression of prostate cancer, associated with taking aspirin and/or Vitamin D daily for 3 years.
The development of a small pilot cohort study in high-risk ER positive breast cancer patients who have completed adjuvant endocrine treatment, which we hope to expand. This has a primary focus on identifying and validating biomarkers of late recurrence risk.
Undertaking the PROTECTOR study evaluating early salpingectomy and delayed oophorectomy for targeted ovarian cancer prevention in high risk women.
Undertaking a pilot study (PROMISE-FS) for population based panel germline testing for predicting ovarian cancer risk and targeted prevention.
Undertaking the SIGNPOST study evaluating panel germline and somatic tumour testing in ovarian cancer patients.

Key Publications

Comparison of the Performance of 6 Prognostic Signatures for Estrogen Receptor-Positive Breast Cancer: A Secondary Analysis of a Randomized Clinical Trial. Sestak I, Buus R, Cuzick J, Dubsky P, Kronenwett R, Denkert C, Ferree S, Sgroi D, Schnabel C, Baehner FL, Mallon E, Dowsett M. JAMA Oncol (2018) 4(4):545-553. PMID: 29450494

Cost-effectiveness of population-based BRCA1, BRCA2, RAD51C, RAD51D, BRIP1, PALB2 mutation-testing in unselected general-population women. Manchanda R, Patel S, Gordeev V, Antoniou AC, Smith S, Lee A, Hopper JL, MacInnis RJ, Turnbull C, Ramus SJ, Gayther SA, Pharoah PDP, Menon U, Jacobs I, Legood R. J Natl Cancer Inst (2018) 110(7):714-725. PMID: 29361001

Use of Single-Nucleotide Polymorphisms and Mammographic Density Plus Classic Risk Factors for Breast Cancer Risk Prediction. van Veen EM, Brentnall AR, Byers H, Harkness EF, Astley SM, Sampson S, Howell A, Newman WG, Cuzick J, Evans DGR. JAMA Oncol (2018) 4(4):476-482. PMID: 29346471

Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials. Early Breast Cancer Trialists’ Collaborative Group, et al., Cuzick J. Lancet (2015) 386(10001):1341-1352. PMID: 26211827

Tamoxifen for prevention of breast cancer: extended long-term follow-up of the IBIS-I breast cancer prevention trial. Cuzick J, Sestak I, Cawthorn S, Hamed H, Holli K, Howell A, Forbes JF, Investigators IBIS-I. Lancet Oncol (2015) 16(1):67-75. PMID: 25497694

Anastrozole for prevention of breast cancer in high-risk postmenopausal women (IBIS-II): an international, double-blind, randomised placebo-controlled trial. Cuzick J, Sestak I, Forbes JF, Dowsett M, Knox J, Cawthorn S, Saunders C, Roche N, Mansel RE, von Minckwitz G, Bonanni B, Palva T, Howell A; IBIS-II investigators. Lancet (2014) 383(9922):1041-1048. PMID: 24333009

Anastrozole versus tamoxifen for the prevention of locoregional and contralateral breast cancer in postmenopausal women with locally excised ductal carcinoma in situ (IBIS-II DCIS): a double-blind, randomised controlled trial. Forbes JF, Sestak I, Howell A, Bonanni B, Bundred N, Levy C, von Minckwitz G, Eiermann W, Neven P, Stierer M, Holcombe C, Coleman RE, Jones L, Ellis I, Cuzick J; IBIS-II investigators. Lancet (2016) 387(10021):866-873. PMID: 26686313

Tamoxifen-induced reduction in mammographic density and breast cancer risk reduction: a nested case-control study. Cuzick J, Warwick J, Pinney E, Duffy SW, Cawthorn S, Howell A, Forbes JF, Warren RM. J Natl Cancer Inst (2011) 103(9):744-752. PMID: 21483019

A 9-valent HPV vaccine against infection and intraepithelial neoplasia in women. Joura EA, Giuliano AR, Iversen OE, Bouchard C, Mao C, Mehlsen J, Moreira ED Jr, Ngan Y, Petersen LK, Lazcano-Ponce E, Pitisuttithum P, Restrepo JA, Stuart G, Woelber L, Yang YC, Cuzick J, Garland SM, Huh W, Kjaer SK, Bautista OM, Chan IS, Chen J, Gesser R, Moeller E, Ritter M, Vuocolo S, Luxembourg A; Broad Spectrum HPV Vaccine Study. N Engl J Med (2015) 372(8):711-723. PMID: 25693011

Cost-effectiveness of population screening for BRCA mutations in Ashkenazi Jewish women compared with family history-based testing. Manchanda R, Patel S, Gordeev VS, Antoniou AC, Smith S, Lee A, Hopper JL, MacInnis RJ, Turnbull C, Ramus SJ, Gayther SA, Pharoah PDP, Menon U, Jacobs I, Legood R. J Natl Cancer Inst (2015) 107(1):380. PMID: 25435542

Specifying the risk threshold of premenopausal risk reducing salpingo-oophorectomy for ovarian cancer prevention: a cost-effectiveness analysis. Manchanda R, Legood R, Antoniou C, Gordeev V, Menon U. J Med Genet (2016) 53(9):591-9. PMID: 27354448

Prognostic value of an RNA expression signature derived from cell cycle proliferation genes in patients with prostate cancer: a retrospective study. Cuzick J, Swanson GP, Fisher G, Brothman AR, Berney DM, Reid JE, Mesher D, Speights VO, Stankiewicz E, Foster CS, Møller H, Scardino P, Warren JD, Park J, Younus A, Flake DD 2nd, Wagner S, Gutin A, Lanchbury JS, Stone S; Transatlantic Prostate Group. Lancet Onc (2011) 12(3):245-255. PMID: 21310658

Key Senior Researchers:

Professor Stephen Duffy
Professor Trevor Graham

Professor Louise Jones
Professor Yong-Jie Lu
Dr Stuart McDonald

Operations Manager: Tracy Connelly