Cancer Screening & Early Diagnosis

By investigating new approaches to cancer screening and continuously evaluating current methods available, we are dedicated to developing newer and more effective tests for early cancer detection, particularly for lethal cancers of unmet clinical need, including pancreatic and oesophageal malignancies.

Theme Leads: Professor Stephen Duffy, Professor Hemant Kocher

Key Cancer Types: pancreatic, lung, colorectal, breast, cervical, prostate, ovarian

Research Focus Key Achievements Key Publications

Research Focus

The CRUK Barts Centre is at the forefront of research into screening and early detection of cancer. The main areas of focus are as follows:

Development of strategies for refining and improving existing cancer screening programmes and developing new forms of cancer screening
Evaluation of interventions to promote early presentation and facilitate prompt diagnosis of cancer
Evaluation of risk models and interventions to prevent or downstage cancer in high-risk individuals.

Key Achievements

Identification of a three-biomarker panel of urinary markers for pancreatic cancer.
Establishment of improved cancer screening uptake with postal and telephone reminders, primary care endorsement and, for breast cancer, second timed appointments for non-attenders and the offer of out-of-hours appointments.
Discovery that increased screen-detection of ductal carcinoma in situ of the breast is associated with reduced subsequent incidence of invasive cancers.
Demonstration of substantially increased specificity of breast cancer screening with digital breast tomosynthesis.
Demonstration of long term efficacy of flexible sigmoidoscopy screening in prevention of colorectal cancer incidence and mortality.
Development of methylation classifiers for detection of precancerous cervical lesions and aggressive prostate cancer.
Quantification of potential for increased detection of colorectal cancer and advanced adenomas with faecal immunochemical testing and of the cost in calls on endoscopy services.
Demonstration of feasibility of low dose CT screening for lung cancer in the UK.

Key Publications

Identification of a Three-Biomarker Panel in Urine for Early Detection of Pancreatic Adenocarcinoma. Radon et al., Lemoine N, Crnogorac-Jurcevic T. Clin Cancer Res (2015) 21(15):3512-3521. PMID: 26240291

UK Lung Cancer RCT Pilot Screening Trial: baseline findings from the screening arm provide evidence for the potential implementation of lung cancer screening. Field JK, Duffy SW et al. Thorax (2016) 71(2):161-170. PMID: 26645413

Increased uptake and improved outcomes of bowel cancer screening with a faecal immunochemical test - results from a pilot study within the national screening programme in England. Moss S, Mathews C, Day TJ, Smith S, Seaman, HE, Snowball J, Halloran SP. Gut (2016) 66(9):1631-1644. PMID: 27267903

Effects of evidence-based strategies to reduce the socioeconomic gradient of uptake in the English NHS Bowel Cancer Screening Programme (ASCEND): four cluster-randomised controlled trials. Wardle J et al., Duffy SW, Moss S. Lancet (2016) 387(10020):751-759. PMID: 26680217

Effect of mammographic screening from age 40 years on breast cancer mortality in the UK Age trial at 17 years’ follow-up: a randomised controlled trial. Moss S, Wale C, Smith R, Evans A, Cuckle H, Duffy SW. Lancet Oncol (2015) 16(9):1123-1132. PMID: 26206144

Screen detection of ductal carcinoma in situ and subsequent incidence of invasive interval breast cancers: a retrospective population-based study. Duffy SW et al. Lancet Oncol (2016) 17(1):109-114. PMID: 26655422

Long term effects of once-only flexible sigmoidoscopy screening after 17 years of follow-up: the UK Flexible Sigmoidoscopy Screening randomised controlled trial. Atkin W, Wooldrage K, Parkin DM, Kralj-Hans I, MacRae E, Shah U, Duffy S, Cross AJ. Lancet (2017) 389(10076):1299-1311. PMID: 28236467

Accuracy of Digital Breast Tomosynthesis for Depicting Breast Cancer Subgroups in a UK Retrospective Reading Study (TOMMY Trial). Gilbert FJ, Tucker L, Gillan MG, Willsher P, Cooke J, Duncan KA, Michell MJ, Dobson HM, Lim YY, Suaris T, Astley SM, Morrish O, Young KC, Duffy SW. Radiology(2015) 277(3):697-706. PMID: 26176654

Results of annual screening in phase I of the United Kingdom familial ovarian cancer screening study highlight the need for strict adherence to screening schedule. Rosenthal AN, Fraser L, Manchanda R, et al. J Clin Oncol (2013) 31(1):49-57. PMID: 23213100

Population testing for cancer predisposing BRCA1/BRCA2 mutations in the Ashkenazi-Jewish community: a randomized controlled trial. Manchanda R et al. J Natl Cancer Inst (2015) 107(1):379. PMID: 25435541