The UK has national screening programmes for breast, bowel and cervix cancer. There is an ongoing need for evaluation and improvement of these, and for research on new potential cancer screening interventions. The Unit’s research in this area includes:
Case-control evaluation of the national breast screening programme.
This includes estimation of the programme’s effect in terms of breast cancer mortality, stage of disease and overdiagnosis. It also incorporates evaluation of the combined effects of screening, pathological features of the cancer, and treatment. We have already published results from the London pilot of the study (http://cebp.aacrjournals.org/content/25/3/455.long) and are currently processing the nationwide data. If you have any interest in or concerns about this study, you are welcome to contact the PRU (using the 'contact us' page on this website). A similar evaluation is at the planning stage for the bowel screening programme.
Use of routine screening data to research issues relevant to policy.
This includes analysis of screening and interval cancer data in the national breast screening programme to assess the effects of changes to the programme such as the introduction of two-view mammography, and to investigate the value of detection and treatment of ductal carcinoma in situ.
Major reviews of cancer screening strategies
We are currently working on a systematic review of the use of ultrasound in addition to X-ray mammography in screening women with dense breast tissue.
Studies of interventions to improve access to and participation in screening
We have found that GP endorsement improves participation in bowel cancer screening, that the offer to change to an evening appointment, postal reminders and second timed appointments for non-attenders, all increase participation in breast screening. Further trials of interventions to improve delivery of and participation in screening are under way.
The Unit is also involved in a number of major collaborative studies. These include studies of new technology such as breast tomosynthesis and automated ultrasound in breast screening; tactical issues such as faecal immunochemical thresholds for further investigation, and studies of new screening interventions such as CT screening for lung cancer.