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Cancer

A open, collaborative, and multidisciplinary group working with clinicians, researchers, and patients to improve pathways to cancer diagnosis.

A major focus of the group is building interdisciplinary teams to deliver projects to improve cancer control in primary care with impact and direct patient benefit.

To do this the cancer research theme works closely with patients, primary care professionals, cancer charities, researchers from other disciplines and institutions, NHS commissioners, diagnostics services and companies, and cancer care in the hospital setting.

This multidisciplinary approach enables the team to use the most appropriate research methodologies to address pressing research questions that have arisen out of direct clinical care.

Our work is organised into four themes: health records data, clinical studies, implementation science, and diagnostic reasoning.  

Theme leads:

Cancer Sub Themes

Health Records Data brings together patient data from large scale research studies and clinical practice. Health Records Data is made up of anonymised patient medical records pulled automatically from electronic health records systems compiled into various databases. Some Health Records databases are nationwide, containing information collected over the entire country. They contain, for example, primary care electronic health records from GP systems, data from hospital activity, data about tests used in the NHS, and data about death and cancer diagnosis registrations. Health Records Data facilitate large scale longitudinal research studies that may not be possible to conduct prospectively on millions of UK patients. Health Records Data can improve precision of evidence in health care. We work with other groups in the university, like the Big Data Institute and the Department of Engineering, on Health Records research.

Health Records Data

Implementation research explores how to translate what we have learnt through research into changes in practice that benefit everyone affected by cancer. An important part of research is understanding how we put what we have learnt into practice. In our cancer work, as well as developing evidence about new tests and technologies of cancer detection, we are also exploring how to make it easy for health care professionals and patients to use and understand them. We are focusing on: • How to make sure that new ways of detecting cancer are available to everyone • How new tests and technologies change the work of detecting cancer in primary care • How to avoid unintended consequences of new technologies • How to share best practice and keep positive changes going We work with other groups in the university, like Medical Sociology and Health Experiences Research Group on Implementation research.

Implementation

Studying diagnostic reasoning helps us understand how clinicians suspect cancer and what support they need to diagnose cancer. Diagnostic reasoning is the thinking process that clinicians use to work out what is causing their patient’s symptoms. We study the ways that clinicians think about their patients’ symptoms when they clearly suggest cancer and when cancer is harder to suspect. We do this by speaking to clinicians about how they think, make decisions, and follow-up with patients. We analyse the effect diagnostic reasoning has on the time it takes for a patient to get their diagnosis. We speak to patients about how they would prefer their doctor or nurse to communicate about cancer. We work with other groups in the university, like Medical Sociology and Health Experiences Research Group, to investigate Diagnostic Reasoning.

Diagnostic Reasoning

Clinical Studies allow us to build knowledge and evidence for the best ways of providing health care for patients who may have, or have already been diagnosed with, cancer. Clinical Studies can take different forms. Some are ‘randomised control trials’ where participants are allocated to different groups and others are ‘observational cohort studies’ where similar participants are followed over time. Often clinical studies involve assessing if a new approach to care, such as a type of scan or blood test, or combinations of these, work as well or better than the current standard NHS care. Clinical Studies can also be used to evaluate how effectively therapies prevent or treat cancer. We work with other groups in the university, like the Primary Care Clinical Trials Unit and the Oncology Clinical Trial Office, to conduct Clinical Studies.

Clinical Studies

Our Team

Latest publications

Blog posts

Man in blue scrubs with black stethescope around his neck talks to a lady with a purple headscarf on.

Bridging the Gap: Primary Care Clinical Trials Unit and Cancer theme join OCTO in CRUK Collaboration

In the UK today 1000 people will be diagnosed with cancer. The earlier a cancer is caught the more treatment options are available. A core strategy within the NHS Long Term Plan is to diagnose 75% of cancers at an early stage by 2028. Primary care plays an essential role in meeting this target with the majority of patients diagnosed with cancer first presenting to their GP with symptoms.

The Future of Diagnosis: Navigating Uncertainty

Claire Friedemann Smith, Brian Nicholson and Georgia Black reflect on their visit to the first in-person Society to Improve Diagnosis in Medicine (SIDM) conference since Covid-19 in Utrecht, the Netherlands.

Building interdisciplinary research networks to improve cancer control

The BLOTTED study has established a network of researchers at various career stages interested in blood test trend for cancer detection. Blood test trend might tell GPs more information than single blood test results. A small change from a steady trend could be more useful for identifying patients at risk of undiagnosed cancer than waiting for a blood test value to fall outside a fixed “normal” range.

Non-specific symptom pathways: How are they working and where are they going?

When it comes to diagnosing and treating non-specific symptoms (NSS) in cancer patients, a holistic approach is essential. However, the implementation of non-specific symptom pathways and national policies promoting holistic care can vary greatly among healthcare providers. In our workshop presented at the Cancer in Primary Care conference at Worcester College, Oxford, we discussed key challenges and future directions for research in providing comprehensive care to those with NSS.

If you're interested in working with us and would like to discuss how we might work together, please contact us on:

cancer@phc.ox.ac.uk.