Using GP data to improve cancer survival rates

Julia Hippisley–Cox is Professor of Clinical Epidemiology and General Practice based in the Nuffield Department of Primary Healthcare. Julia trained in Medicine at Sheffield University and held a number of academic positions before being appointed full professor at the University of Nottingham moving to Oxford in 2019. Julia’s research interests include large-scale clinical epidemiology, drug safety and the development of risk prediction algorithms using electronic databases from general practices. She is the co-founder of the QResearch database which is one of the largest clinical research databases worldwide.

The UK has one of the poorest survival rates for cancer in Europe. This is thought to be partly related to late presentation, and delays in diagnosis and treatment. Earlier diagnosis could improve with more targeted investigation of symptomatic patients and increased public awareness of symptoms. It has been estimated that such an approach may save 5000 lives a year without any new medical advances. Current screening programs tend to prioritise patients for cancer screening based on very simple measure (e.g. those in a particular age band) rather than those people at highest risk of developing a cancer for whom interventions might be more beneficial. QCancer aims to address these shortcomings in screening, early detection, and disease.

QCancer® is an evolving set of prediction models developed using the QResearch database linked to cancer registry, mortality and hospital data. Broadly the prediction models are designed to (1) quantify the absolute risk that a patient has an existing cancer based on combinations of readily available risk factors and symptoms, (2) estimate future risk of major cancers over the next 10 years to improve the evidence base for screening and targeting interventions to those at highest risk, and (3) estimate survival among those with an existing cancer taking into account information about their tumour (type, stage, grade) as well as information on risk factors and treatments.

Such information is essential to ensure that patients are fully informed so they can make appropriate choices regarding their treatment. Using very large linked electronic health datasets, prediction models are being developed which can improve the information available to patients.

In Oxford, Julia collaborates with Brian Nicholson and Eric O’Neil. She also works with Juliet Usher Smith (Cambridge), Carol Coupland (Nottingham), Rosie Loftus (Macmillan), the NHS England and CRUK ACE program, EMIS Health, Pancreatic Cancer UK. The QCancer tool was highlighted by the All Party Parliamentary Working Group on Pancreatic Cancer in their report, The Need for Speed. Julia is also medical director of ClinRisk Ltd, a software company that develops open and closed sourced software to implement risk prediction tools into clinical systems.

Julia’s latest funding comes from the PCUK ADEPTS trial which has begun in Oxford to look at improving earlier diagnosis of pancreatic cancer.

Find out more below

Image from an endoscopy video with the detected artefacts highlighted with coloured boxes.

AI endoscopy enables 3D surface measurements of pre-cancerous conditions in oesophagus

Clinicians and engineers in Oxford have begun using artificial intelligence alongside endoscopy to get more accurate readings of the pre-cancerous condition Barrett’s oesophagus and so determine patients most at risk of developing cancer.

New prostate cancer risk tool

A new calculator has been developed by Professors Julia Hippisley-Cox and Carol Coupland to help GPs prioritise patients at high risk of prostate cancer.
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New clinical prediction tools for myeloma

Dr Constantinos Koshiaris has developed clinical prediction models for use in primary care with the aim of accelerating myeloma diagnoses.
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Higher testosterone levels in men linked to greater melanoma risk

New research from Dr Eleanor Watts at the Nuffield Department of Population Health has found this association for the first time

Funding to improve childhood, teenage and young adult cancer detection

Dr Defne Saatci and Professor Julia Hippisley-Cox will develop risk prediction tools using the QResearch database to support the earlier detection of childhood, teenage and young adult cancer

New partnership enables access to state-of-the-art radiotherapy machine

University of Oxford, OUH and GenesisCare have partnered to provide access to a new ViewRay MRIdian machine. It is the first of its kind in the UK and will help to improve challenging cancer treatment through faster, tailored radiotherapy.

Drinking alcohol regularly increases cancer risk in Chinese populations

New research from the Nuffield Department of Population Health shows that reducing alcohol consumption in China could be an important cancer prevention strategy

New Oxford technology assesses cancer patient vulnerability to COVID-19

New research from Prof Julia Hippisley-Cox has resulted in thousands of cancer patients being given prioritised access to the COVID-19 vaccine.

Bowel cancer patients going undiagnosed due to COVID distruption

A new study led by the University of Oxford has found that since the first coronavirus lockdown the number of people diagnosed with bowel cancer in England has fallen sharply, with a deficit persisting up to October 2020