A collaborative programme of primary care cancer research for Scotland
Introduction
To optimise the delivery of care to people with cancer, Scottish Primary Care must address challenges in key areas of patient experience: prevention and screening; early diagnosis of symptomatic disease; treatment and follow-up and providing palliative and supportive care. This programme of cancer research, led by Aberdeen and Edinburgh Universities, but involving collaboration throughout Scotland, has the express aims of addressing these priority areas through a collaborative programme of internationally competitive research. We seek to build capacity for primary cancer research, by creating a comprehensive network of researchers from all primary care disciplines and developing key national and international primary cancer care collaborations.
Aims
The aims of this programme are:
- To build on current strengths to deliver in Scotland over 5 years a funded and collaborative programme of internationally competitive cancer research. A major focus of our work will be on attracting new research investment for our programmes (including programme and project funding) from agencies including the CSO, MRC, and Cancer Research UK.
- To increase capacity and create a comprehensive network of cancer researchers from all primary care disciplines and inclusive of all Scottish School of Primary Care institutions, underpinned by a strong user involvement strategy. This network is well-placed to build on our existing strong links with secondary care/biomedical cancer researchers (through groups including the Scottish Cancer Research Network, the NCRI and major cancer treatment centres in Glasgow and Edinburgh).
- To develop key national and international primary care cancer collaborations
Research team
Professor David Weller (University of Edinburgh) and Dr Neil Campbell (University of Aberdeen) are the Principal Investigators on this funded programme.
Other grantholders are:
- Professor Christine Bond University of Aberdeen
- Dr Christine Campbell University of Edinburgh
- Professor Phil Hannaford University of Aberdeen
- Dr Peter Murchie University of Aberdeen
- Professor Scott Murray University of Edinburgh
Key Collaborators
- Dr Una MacLeod University of Glasgow
- Professor Sally Wyke University of Stirling
As projects develop we envisage engaging with other primary care colleagues across Scotland
Activity streams within the programme
Prevention and Screening
A detailed research plan for a programme examining the role of primary care in cancer screening, focusing on, but not limited to, the newly established bowel cancer screening programme in Scotland is being developed. This programme will build on relevant international literature as well as previous studies including the Evaluations of the Bowel Cancer Screening Pilots, qualitative interviews with participants and non-participants in the Pilots, ongoing pilot studies, and other recent projects.
Several strands of this programme are envisaged, including:
- Further work on the role of primary care in addressing the needs of low uptake groups
- Substantive qualitative work in the early stages of an ongoing pilot study has raised issues of profound health literacy, and literacy, issues in some invitees to the screening programme: working with the Communications team of the National Programme, we will develop and test alternative means of information provision
- Examining the involvement of primary care in engaging with non-participants, and in dealing with symptomatic presentation in screen-negative participants.
- Rurality building on the expertise and previous work in Aberdeen on cancer and issues of rurality, and working with David Heaney (Inverness)
Early Diagnosis
PM has been tasked with producing a detailed ,action plan for a programme of research around early diagnosis of cancer in primary care.
Upper GI cancer generally has a poor prognosis, often due to its late presentation. Many of its early symptoms mimic benign functional disorders of the upper digestive tract, leading to late presentation by patients, perhaps compounded by late referral from primary care. A programme of work with the overarching aim of expediting the diagnosis of upper GI cancer is timely.
Such a programme will contain several strands: the formation of a cohort of newly presenting patients with upper GI symptoms; the detailed description of the diagnostic and treatment pathway of upper GI in Scotland; a detailed investigation of how GPs managed symptoms of upper GI origin; a detailed understanding of how elements within the health service may best interact to ensure the most timely possible diagnosis of upper GI cancer. These strands will form the basis of the programme.
Cancer survivorship planning and advance care planning
A research programme on cancer survivorship planning, under the direction of Professor Scott Murray is being developed: this work will be informed by evolving work in Advance Care Planning in Edinburgh, and work on integrated primary and secondary cancer care in Aberdeen, and will benefit from input from and ongoing research by our key collaborators in Glasgow and Stirling.
The hypothesis is that some patients with cancer want an opportunity to talk about the future with health professions and plan their care, and secondly that this process improves outcomes for patients. This is of course culturally dependant, but we seek to answer this in the UK context, to inform the juggernaut of new policies around cancer registers and palliative care registers. We will draw on relevant theory from various disciplines and the international literature, and our previous studies including
- Longitudinal qualitative studies of people with lung cancer
- Serial focus groups to understand how cancer patients wish to be care for in primary care
- Training and evaluating GPs in ACP
- Serial interviews with patients and palliative care nurse specialists who are carrying out ACP
- Care planning care home staff and GPs
Leadership of the Cancer Programme
The programme is jointly led by Dr Peter Murchie (University of Aberdeen) and Dr Christine Campbell (University of Edinburgh)
Dr Christine Campbell
Senior Research Fellow,
General Practice
Portfolio Coordinator
NCRI Primary Care Clinical Studies Development Group
General Practice,
Community Health Sciences
The University of Edinburgh
20 West Richmond Street
Edinburgh, EH8 9DX
Scotland, UK
Tel: +44 (0)131 650 9252
Fax: +44 (0)131 650 9119
Email University of Edinburgh profile
Dr Peter Murchie
GP and Senior Clinical Lecturer
University of Aberdeen
Foresterhill Health Centre
Westburn Road
Aberdeen, AB25 2AY
Scotland, UK
Tel: +44 (0)1224 553972
Fax: +44 (0)1224 550683
