Risk stratified approaches to cancer prevention are of increasing interest at all levels of clinical care. Funded by Cancer Research UK, we are exploring the use of genetic, epidemiological, lifestyle, hormonal and imaging for predicting the likelihood of a person developing cancer, and whether knowledge of their risk will affect their behaviour. The main objective of the CanRisk programme is to develop and validate quantitative tools for cancer risk-stratification and prevention that take advantage of discoveries in both cancer genomics and epidemiology.
CanRisk aims to address the following specific research questions:
- What improvement can be achieved in individualised risk prediction for breast, ovarian and prostate cancer, by combining data on all genetic, lifestyle/hormonal, clinical and imaging risk factors?
- What is the accuracy of individualised breast and ovarian cancer risks for women with high risk mutations in the BRCA1 and BRCA2 genes on the basis of genetic and other risk modifying factors?
- What user-friendly risk prediction tools can be developed based on the results from objectives 1 and 2 which best enable primary, secondary and tertiary care health professionals to obtain future cancer risks?
The primary focus of questions 1 and 2, led by scientists within the Centre for Cancer Genetic Epidemiology, is on the analytical work and the development of the necessary methodologies and technologies for developing breast, ovarian and prostate cancer risk prediction models.
The third workstream aims to develop easy to use tools that implement the risk prediction models from questions 1 and 2 and provide cancer-risk estimates to clinicians at all healthcare levels. This work is carried out jointly with researchers from the Primary Care Unit and the Department of Medical Genetics. We are engaging with stakeholders through workshops and mixed methods research among tertiary, secondary and primary healthcare users. The main objective will be to assess the barriers and facilitators to implementation among each group. We aim to characterize the usability and usefulness of the prototypes across the groups and the development of the tool will be determined through an iterative process of consulting with these clinical investigators.
The CanRisk cancer risk assessment tool is being designed to assist clinicians during a consultation with the collection of risk information from patients. This information is used to calculate a cancer risk estimate which will be linked to management recommendations (e.g. screening, preventive medication). The risk prediction will be presented using a range of visual recommendations based on current best evidence from risk communication research.