The cancer group is involved in projects which investigate diagnosis and follow up of cancer in primary care.

The group comprises Peter Rose, Nada Khan (who undertakes the work on cancer survivors) and Siân Harrison.

The group are supported by Alice Fuller who runs the FACS trial, Alison Ward who contributes health psychology expertise to the projects and Rafael Perera who provides statistical support. There are also collaborations with Professor Eila Watson, Professor of Supportive Cancer Care at Brookes University.

Research

Studies in Diagnosis of Cancer

A completed pilot study on the use of an algorithm to identify patients who should be referred for investigation for possible colorectal cancer has been completed and funding for a full trial (in collaboration with the NCRI primary care group) is being sought. A study to identify the clinical features of metastatic cancer and factors in delay in diagnosis of metastatic spread has been funded by the National School of Primary Care (in collaboration with Dr Willie Hamilton, University of Bristol). This study is awaiting ethical approval.

Studies in Follow up of Cancer

Three studies investigate various aspects of follow up of cancer in primary care. A CRUK funded study is investigating the primary care needs of long term adult survivors of breast, colorectal and prostate cancer. The study has three parts. A database analysis of patients from the General Practice Research Database, a questionnaire survey of long term survivors (including a survey of their partners/carers by colleagues at Brookes) and a qualitative interview study of individual patients. Health care needs of cancer survivors were highlighted in the 2007 Cancer Reform Strategy and this work is helping to inform the national debate. Results of this work are being used nationally to develop services for cancer survivors as part of the Cancer Reform strategy (2007).

A second study is looking at the primary care role in follow up of patients with prostate cancer after diagnosis and initial treatment. It is funded by CRUK and is a collaboration between Oxford and the Universities of Edinburgh and Cardiff. The work comprises a literature and guideline review, a GP medical record audit, and a questionnaire survey of health professionals. The Oxford work undertaken by Rosaleen O’Brien involves a qualitative interview study of health professionals (which will inform the survey) and a qualitative interview study of patients.

The Follow up After Colorectal Cancer (FACS) study has been running for several years and is nearing completion of recruitment. The study, in collaboration with Southampton University, is a factorial trial comparing intensive follow up in hospital versus no follow up and CEA monitoring in primary care versus no monitoring.

Cancer Screening

Over the years the Cancer Screen group has conducted many studies, most of which have focused on screening for cancer. Future plans involve the development of the cancer survivors work, looking at the possibility of joining the GPRD database to the national cancer registry data and the Hospital Episode Statistic data to provide a powerful database to describe the whole patient journey in cancer. In addition we would like to devise an intervention to address the needs of these patients that could be tested in a trial. The prostate cancer follow up group is currently devising an intervention to be tested in a trial.

Staff

Prof David Mant
Dr Peter Rose
Dr Siân Harrison
Nada Khan
Dr Rafael Perera
Dr Alison Ward