Cancer Screening
We have major collaborations with industry and with other Policy Research Units in breast cancer screening, including evaluation of artificial intelligence for mammogram reading and modelling different modes of risk adapted breast screening. We are actively evaluating the effects of the NHS Breast Screening Programme on patient outcomes, and assessing potential innovations to the programme, such as:
- Quantitative breast density analysis to predict interval and node-positive cancers in pursuit of improved screening protocols: a case-control study
- A case-control study to evaluate the impact of the breast screening programme on mortality in England
- Association between Screening Mammography Recall Rate and Interval Cancers in the UK Breast Cancer Service Screening Program: A Cohort Study
In bowel cancer screening, we are investigating different strategies of use of faecal haemoglobin levels determined by the immunochemical bowel screening test. We are researching different combinations of haemoglobin thresholds, actions on exceeding thresholds and frequency of testing. See our papers:
- Faecal immunochemical testing in bowel cancer screening: Estimating outcomes for different diagnostic policies
- Impact of changing from a guaiac faecal occult blood test to a faecal immunochemical test in a national screening programme: Results from a pilot study within the national bowel cancer screening programme in England
Our long-term collaboration with the Liverpool Lung Project and the UK Lung Screening Trial has recently yielded interesting results, in particular improving estimation of individual lung cancer risk and further demonstrating the benefits of low dose CT screening in reducing mortality from lung cancer:
- Liverpool Lung Project lung cancer risk stratification model: calibration and prospective validation
- Lung cancer mortality reduction by LDCT screening: UKLS randomised trial results and international meta-analysis
In addition, we maintain a substantial strand of behavioural research to promote participation in screening, particularly among underserved populations. Recent findings include a modest increase in uptake of bowel cancer screening with primary care endorsement, including in deprived populations, a preference for virtual colonoscopy over colonoscopy for further investigation of bowel screen positive results, and that an information film significantly improved objective knowledge of lung cancer screening with low dose CT.