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Centre for Research into Cancer Prevention and Screening (CRiPS) Ongoing and Recently Completed Work 2007-2011 Division of Clinical & Population Sciences & Education Level 7, Mailbox 7 Ninewells Hospital and Medical School Dundee DD1 9SY Tel: +44 (0)1382 496443 Fax: +44 (0)1382 496452 CRiPs Contacts: Professor Annie S. Anderson BSc SRD PhD [email protected] Professor Robert JC. Steele MD FRCS [email protected] Updated June 2011 Contents Centre for Research Into Cancer Prevention and Screening (CRiPS) ................................. 4 CRiPS Research Staff and Associates ................................................................................. 5 UK Academic Co-Investigators ................................................................................................................................. 8 International Academic Co-Investigators ................................................................................................................... 8 NGO Co-investigators .............................................................................................................................................. 9 Sources of Funding ................................................................................................................................................. 9 1. CRiPS Research Projects .............................................................................................. 10 I) Cancer Risk Awareness ................................................................................................ 10 Obesity and lifestyle interventions in colorectal cancer survivors - how well are clinicians prepared? ............................. 10 Response to being informed of weight status and body fat composition. Understandings, reactions and motivation to achieve a healthy weight. ...................................................................................................................................... 10 Lifestyle issues for colorectal cancer survivors – perceived needs, beliefs and opportunities. ........................................ 10 II) Interventions for Cancer Risk Reduction ................................................................... 11 BeWEL: the impact of a BodyWEight and physicaL activity intervention on adults at risk of developing colorectal adenomas 11 LIVEWELL- Development and feasibility of an intensive lifestyle intervention programme for the secondary prevention of colorectal cancer. .............................................................................................................................................. 12 Review of lifestyle interventions used in successful disease prevention programmes ................................................... 12 Bowel Health to Better Health: The development and evaluation of a family based intervention aimed at changing diet and physical activity in people at moderate to high risk of colo-rectal cancer .............................................................. 12 ENJOY- a Colorectal Cancer Patient Programme ...................................................................................................... 12 Breast Cancer Campaign: Breast – Activity & Healthy Eating after Diagnosis B-AHEAD ................................................ 12 Cancer as a Catalyst for Change? Predictors of changes in diet, alcohol, physical activity and tobacco use after colorectal cancer diagnosis among patients and their partners .................................................................................. 13 5 Year Follow Up of Breast Cancer Survivors in RCT ................................................................................................. 13 III) Understanding Cancer Related Health Behaviours ................................................... 13 Secondary Analysis of the Expenditure and Food Survey – comparison of household and eating out with the Scottish dietary targets and by area of residence ................................................................................................................. 13 Understanding food culture in Scotland and its comparison in an international context: implications for policy development 13 Can a gender-sensitised weight management programme delivered by Scottish Premier League football clubs help men lose weight? A feasibility study for a randomised controlled trial ....................................................................... 13 Football Fans in Training (FFIT): a randomised controlled trial of a gender-sensitive weight loss and healthy living programme delivered to men aged 35-65 by Scottish Premier League Football clubs .................................................. 13 The Effect of Adherence to Adjuvant Endocrine Therapy on Breast Cancer Outcomes ................................................. 14 IV) Screening and Early Detection ................................................................................... 15 Bowel Screening Research Unit .............................................................................................................................. 15 Results from the First Three Rounds of the Scottish Demonstration Pilot of FOBT Screening for Colorectal Cancer ......... 15 Effect of Gender, Age and Deprivation on Key Performance Indicators in an FOBT Based Colorectal Screening Programme 16 Clinico-pathological Characteristics and Outcome of Screen Detected Cancers ............................................................ 16 Interval Cancers and the “Certificate of Health” Effect .............................................................................................. 16 Prevalence and Incidence Screening ....................................................................................................................... 17 Adenoma Follow-up .............................................................................................................................................. 17 Effect of Colorectal Cancer Screening on Disease Specific Mortality ........................................................................... 17 Economic Impact of Screening ............................................................................................................................... 18 Faecal Immunological Testing ................................................................................................................................ 18 The Psychological Effect of Interval Cancers ............................................................................................................ 18 The Utility of DNA Mutations in Colorectal Cancer Screening ..................................................................................... 18 The Utility of Proteomics in Colorectal Cancer Screening........................................................................................... 19 Investigate the Diagnosis of Colorectal Polyps using Optical Projection Tomography ................................................... 19 Investigate the Utility of Quantitative Immunological Faecal Occult Blood Testing in Symptomatic Patients ................... 19 2 Evaluate Faecal Immunological Testing as a First-line Colorectal Screening Test in the Scottish Population ................... 19 2. CRiPS Publications 2007 - 2011 (original research) ..................................................... 20 3. Translating and Facilitating Research to Policy and Practice ....................................... 25 Current Government Advisory work (including UK Departments of Health and Research Councils) ................................ 25 Advisory Work for NGOs and Other Agencies ........................................................................................................... 26 Selected International/National Invited presentations for Scientific Professional Groups (since 2007)............................ 28 Publications for professional groups (excluding research findings) ............................................................................. 30 4. Public Understanding of Science and Advocacy in support of cancer prevention and early detection ................................................................................................................. 31 Communications for General Public ........................................................................................................................ 31 5. CRiPS – Visits from International Scholars .................................................................. 31 3 Centre for Research Into Cancer Prevention and Screening (CRiPS) The aims of the centre are to: • Undertake research on: o cancer risk awareness o lifestyle modifications related to cancer development and recurrence o cancer related health behaviours and health inequalities o methodologies to improve early detection of cancer • Facilitate the translation of behavioural and screening research into policy and practice • Increase Public Understanding of Science related to cancer prevention and screening and gain support for cancer control policies Background Globally, each year, around 11 million people are diagnosed with cancer and almost 8 million people die. Cancers cause one in four of all deaths in the UK and it is estimated that around one third of all cancer cases could be avoided if nobody was exposed to tobacco. Obesity is now recognised as the major cancer risk factor in non-smokers. Recent preventability estimates suggest that 42% of breast cancer and 43% of colorectal cancer could be avoided with changes in body fatness, alcohol and physical activity (and in the case of colorectal cancer increase in dietary fibre and decreases in red and processed meat). However, increasing knowledge about the relationship between risk factors and cancer will not in itself reduce the disease. Increasingly the role of health inequalities has been recognised as a major contributor to ill health. Research is urgently needed to identify effective routes to decrease cancer risk through improved action on diet and physical activity, environmental approaches that will facilitate changes in lifestyle by vulnerable groups and increase early diagnosis of cancer at treatable stages. In turn, findings need to be translated into policy and practice. The major behavioural challenge to cancer reduction in non smokers is obesity, caused by an imbalance between energy intake and energy expenditure. Health departments, funding councils and research agencies are exploring many opportunities for addressing this balance from new pharmacological approaches, strategies for tackling the built environment and sustainable energy initiatives. However, the fundamental challenge remains that of controlling energy intake (food, soft drinks and alcohol) and utilisation of energy (physical activity and sedentary behaviours). Understanding dietary (including alcohol) and physical activity behaviours and effective routes for intervention are high on the cancer prevention agenda and the main focus for behavioural modification research in CRiPS. This research area is lead by Professor Annie S. Anderson (Director, Centre for Public Health Nutrition Research). Unlike cardio-vascular disease there are no simple blood tests that can help identify people at increased risk of cancer or with early disease symptoms. However, significant research efforts have helped to develop programmes of population- based screening and early detection of pre-cancerous lesions or early stage cancers. These programmes include breast and cervix screening and have been demonstrated to help avoid disease progression and improve chances of survival. Data from the Scottish Bowel screening pilot study has shown that for every 100,000 people invited for screening that around 100 cancers and 300 pre-cancerous lesions will be detected. The Scotland wide programme is estimated to reduce mortality rates by at least 15%. Faecal Occult Blood Test (FOBT) screening is being introduced throughout Scotland providing a unique opportunity to study colorectal screening and to intervene to improve the testing process and improve uptake. In addition, screening identifies many individuals with colorectal adenomas who require follow up and form an ideal cohort in which to study preventative strategies. A CSO funded research unit has been established in Tayside which has already reported on the key performance indicators for the first 3 biennial rounds of screening in Scotland and carried out preliminary work on faecal immunological testing (FIT). Research is also ongoing into developing improved strategies for increasing uptake across all socio-cultural population groups. This screening and early detection research area is lead by Professor Robert Steele (Director, Bowel Screening Research Unit). 4 CRiPS Research Staff and Associates (by area of expertise) Alcohol Professor Iain Crombie is head of the department of Public Health at the University of Dundee. His current research interests focus mainly on alcohol-related problems. He has previously worked on cancer epidemiology, chronic pain and the nature of public health policy. Dr J Kevin Dunbar is a Specialty Registrar in Public Health Medicine with an interest in liver disease and health behaviour interventions in hard to reach groups involving mobile phones and SMS messaging. Dr Linda Irvine is a research fellow in public health with specific research interest on the prevention of alcohol related-harm. Cancer Survivorship Dr Colin McCowan is a cancer epidemiologist Dr Mary Wells is senior lecturer in cancer nursing within the School of Nursing and Midwifery and leads a research programme on cancer care. Diet, Obesity, Physical activity Professor Annie S. Anderson is a Public Health Nutritionist with extensive experience in designing, implementing and evaluating lifestyle intervention trials. Mrs Karen Barton is a Research Nutritionist with expertise in diet survey methodology and assessment. Her major focus is on trends analysis on the Scottish diet, funded by the Food Standards Agency. Dr Anna Campbell is a lecturer in Sports Biomedicine Dr Stephen Caswell is a Research psychologist, with a particular interest in utilising behaviour change opportunities ('teachable moments') with both the colorectal cancer screening programme and colorectal cancer survivors. Miss Emma Cessford is a postgraduate student evaluating intervention work in the areas of material and infant nutrition. Dr Angela Craigie is a research nutritionist working on several behavioural intervention studies involving modifications of lifestyle (diet and physical activity) at various stages through the lifespan, and has recently been appointed as lecturer in Cancer Prevention within CRiPs. Miss Sheila Fettes is a clinical dietician with responsibility for developing nutrition teaching in the medical undergraduate curriculum. Dr Maureen Macleod is a research nurse with extensive experience in clinical trials including weight loss and lifestyle change. Dr Jacqui Sugden is a research nurse with expertise in lifestyle interventions Dr Wendy Wrieden is an honorary lecturer with expertise in dietary assessment and surveillance. BeWEL Project Team: Ms Erna Wilkie – Trial Manager Ms Louise Bleazard Ms Charlotte McEleney Mrs Jill Hampton Ms Fiona Robertson Ms Catherine Savage Ms Caron Leckie 5 Health Behaviours Professor Ruth Freeman is Director of the Oral Health and Health Services Research Programme which focuses on health and oral health promotion and inequality and understanding behaviour change. Oncology Professor Alastair Munro is Professor of Radiation oncology with research interests in rehabilitation, survivorship and social dimensions of health. Public Health NHS Tayside, Department of Public Health plays a key role in many of the centres research collaborations and supporting innovative health promotion practice notably in the area of health inequalities, smoking cessation, diet change and obesity. Mr Paul Ballard is deputy director of Public Health Ms Joyce Thompson is Consultant in Public Health Nutrition Dr Drew Walker is Director of Public Health Research methodology Dr Shaun Treweek is Assistant Director of the Tayside Clinical Trials Unit and is also a leading member of the Scottish Collaboration of Trialists. Screening and early detection (by cancer site) Breast cancer Professor Andy Evans, Professor of Breast Imaging Professor Alistair Thompson Professor of Surgical Oncology Colo-rectal cancer Professor Bob Steele is the Director of the Scottish Bowel Cancer Screening Programme and the Bowel Screening Research Unit. Professor Frank Carey is the Pathology Lead for Colorectal Cancer Screening in Scotland Ms Gillian Libby is the Research Statistician in the Bowel Screening Research Unit Ms Paula Macdonald is the Bowel Screening Laboratory Manager Professor Callum Fraser is the Director of the Scottish Bowel Screening Laboratory 6 Oral cancer Professor Graham Ogden is an expert on screening for oral cancer Tobacco control See UK Academic partners Support staff Dr Irene Allan is Research Manager for the group. Kathleen Fotheringham is Divisional Manager for the group Roz Taylor is research clerical assistant for the group 7 UK Academic Co-Investigators Centre for Tobacco Control Research, University of Stirling and Open University Professor Gerard Hastings OBE Food Ethics Council Dr Tom McMillan Gastro Intestinal Epidemiology, Imperial College London Professor Wendy Atkin General Practice Section, Division of Community Health Sciences, University of Edinburgh Professor David Weller Health Behaviour Research Centre, UCL, London Professor Jane Wardle Dr Anne Miles Health Economics, University of Glasgow Dr Andrew Walker Health Economics Research Unit, University of Aberdeen Professor Anne Ludbrook Institute of Health & Well-being, University of Glasgow Professor Sally Wyke Institute for Social Marketing, University of Stirling and Open University Professor Gerard Hastings OBE Ms Martine Stead ISD Scotland Dr Roger Black Dr David Brewster Dr Paula McClements MRC Social and Public Health Sciences Unit, Glasgow Professor Kate Hunt NHS Cancer Screening Programmes, Sheffield Professor Julietta Patnick NMAPP, University of Stirling Professor Brian Williams Physical Activity for Health Research Group, University of Strathclyde Dr Alison Kirk International Academic Co-Investigators Centre for Behavioural Research in Cancer Control, Curtin University, Perth WA Professor Peter Howatt 8 Flinders Centre for Cancer Prevention and Control, Adelaide, Australia Professor Graham Young NGO Co-investigators Australian Heart Foundation Trevor Shilton Cancer Council, Western Australia Terry Slevin British Heart Foundation Andrew Carver Sources of Funding Bowel Cancer UK Bowel Disease Research Foundation Breast Cancer Research Scotland Cancer Research UK (CRUK) Chief Scientist Office (Scottish Government) Macmillan Medical Research Council National Prevention Research Initiative (MRC) New Opportunities Fund NHS Health Scotland NHS Tayside Endowment NIHR Randox Limited Scottish Cancer Foundation Tenovus World Cancer Research Fund (WCRF) 9 1. CRiPS Research Projects I) Cancer Risk Awareness Obesity and lifestyle interventions in colorectal cancer survivors - how well are clinicians prepared? Status: Complete Funding: Cancer Research UK Grant Holders: Anderson AS, Wells M, Steele RJC Research Aims: To explore clinicians’ views and educational needs in relation to obesity and lifestyle interventions for patients treated for colorectal cancer. Research Questions: • To identify current knowledge and understanding about the risks and benefits of weight management in cancer survivors • To assess clinicians’ views of current practice in relation to weight management • To examine perceived barriers to providing advice (written/verbal) on weight management to cancer survivors • To identify perceived training needs on weight management • To raise clinicians awareness of obesity management as a relevant issue for cancer survivors Response to being informed of weight status and body fat composition. Understandings, reactions and motivation to achieve a healthy weight. Status: Complete Funding: Cancer Research UK Investigators: Wyke S, Hunt K, Anderson AS Research Aims: To investigate response to the terms ‘overweight’ and ‘obese’ in relation to motivation to lose weight. Research Questions: • How are the terms ‘overweight’ and ‘obese’ interpreted and understood in relation to body image and health risk? • What is the response to being told one’s weight status in relation to self-image and motivation to lose weight if necessary? • Is response affected by information on one’s body fat composition? • How, if at all, do responses to these questions vary by gender and weight status? • What are the implications of the above findings for cancer prevention communications about obesity and risk Lifestyle issues for colorectal cancer survivors – perceived needs, beliefs and opportunities. Status: Complete Funding: Bowel Cancer UK Investigators: Anderson AS, Steele, RJC 10 II) Interventions for Cancer Risk Reduction BeWEL: the impact of a BodyWEight and physicaL activity intervention on adults at risk of developing colorectal adenomas Status: In progress Funding: National Prevention Research Inititiave (MRC) Supervisors: Anderson AS, Steele RJC, Belch JJF, Daly F, Kirk A, Ludbrook A, Rodger J, Stead M, Thompson J, Trewick S, Wardle J Summary Colorectal cancer (CRC) is a major public health problem and often co-exists with other disorders including obesity, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). The proposed work aims to evaluate the impact of the “BeWEL” intervention programme on body weight changes, cardiovascular risk factors, diet and physical activity in healthy individuals with excess body weight attending routine NHS clinics who have had pre-cancerous bowel polyps removed, but are at risk of developing future cancer and other obesity related conditions. Men from the poorest backgrounds have the highest rates of screen detected adenomas and the proposed work offers a rare opportunity to engage with a hard to reach group. The 3 year study will be a two-arm, multi-centre, randomised controlled trial of the BeWEL intervention against usual care. Participants will be men and women aged 50 to 74 years, with a BMI 25m/kg2, who have been treated for the removal of a colorectal adenoma. They will be recruited after discharge from follow-up clinics. The pre-trial development will take 6 months, participants will be recruited over a 12 month period and undertake the intervention and follow up for 12 months with a further 6 months for data collection, analysis and interpretation. The Intervention Group (IG) will receive the “BeWEL” personalised, multiple contact, intervention programme (based on the clinically successful US diabetes prevention programme), personal body weight scales and invitations to undertake supervised monthly body weight recordings. The impact of the programme will be assessed by quantitative, qualitative and economic analysis. The main outcomes measures will be physical activity, dietary intake and psychosocial variables as well as body weight, markers of insulin resistance and cardiovascular risk. The research will also provide information on what factors influence decisions to engage in the programme, the response to the intervention by deprivation category, patients’ experience of the intervention, and the NHS cost implications. The findings will be relevant to increasing understanding of how the NHS can deliver effective lifestyle interventions to people from diverse social backgrounds and has particular relevance for combining disease prevention strategies with early detection procedures. 11 LIVEWELL- Development and feasibility of an intensive lifestyle intervention programme for the secondary prevention of colorectal cancer. Status: Complete (Publication in Press Supportive Care in Cancer) Funding: World Cancer Research Fund Investigators: Anderson AS, Steele RJC, Wells M, Stead M The acceptability and feasibility of a 3 month personalised lifestyle (diet ,exercise and weight management) intervention in overweight adults who had completed curative treatment for colorectal cancer was assessed by qualitative interviews, quality of life questionnaires, and subjective and objective measures of diet and activity. Over a 4 month period, 28 of 37 (75%) patients met the inclusion criteria and 20 (71%) of the eligible patients agreed to participate in the study and 18 (90%) completed the 3 month study. Reported adherence related to tailored advice, personalised feedback and family support. Reported barriers included time following surgery, fatigue, having a stoma or chronic diarrhoea, and conflicting advice from clinicians. A weight change of -1.2 (±4.4) kg was achieved overall and -4.1(±3.7) kg in the ten who had lost weight. In Conclusion Colorectal cancer survivors will participate in a lifestyle change initiative. Interventions should be personalised to suit abilities, provide feedback on personal goals and encourage social support. Intervention timing and attaining greater support from clinicians should be explored prior to the development of an efficacy trial. Review of lifestyle interventions used in successful disease prevention programmes Status: Complete (See Publications) Funding: Scottish Cancer Foundation Investigators: Anderson AS, Steele RJC, Stead M Bowel Health to Better Health: The development and evaluation of a family based intervention aimed at changing diet and physical activity in people at moderate to high risk of colo-rectal cancer Status: Complete (See Publications) Funding: Cancer Research UK Investigators: Anderson AS and Steele RJC ENJOY- a Colorectal Cancer Patient Programme Status: Complete (Craig K (2007) Enjoy project. Evaluation of a lifestyle intervention programme for colorectal cancer patients in Tayside. MPH thesis, University of Dundee Funding: New Opportunities Fund Investigators: Kerrigan J, Anderson AS, Steele RJC, Wells M Breast Cancer Campaign: Breast – Activity & Healthy Eating after Diagnosis BAHEAD Status: Ongoing. A randomised comparison of 3 weight control programmes during adjuvant treatment for early breast cancer Funding: Breast Cancer Campaign Investigators: Harvie M, Howell T, Campbell A (Co-investigator) 12 Cancer as a Catalyst for Change? Predictors of changes in diet, alcohol, physical activity and tobacco use after colorectal cancer diagnosis among patients and their partners Status: Ongoing Funding: Chief Scientist Office Investigators: Hubbard G, Morrison D, Campbell A (Co-investigator) 5 Year Follow Up of Breast Cancer Survivors in RCT Status: Ongoing Funding: Macmillan Investigators: Mutrie N, Campbell A III) Understanding Cancer Related Health Behaviours Secondary Analysis of the Expenditure and Food Survey – comparison of household and eating out with the Scottish dietary targets and by area of residence Status: Ongoing Funding: Food Standards Agency Scotland Investigators: Wrieden W, Anderson AS Understanding food culture in Scotland and its comparison in an international context: implications for policy development Status: Complete Funding: NHS Health Scotland Investigators: McMillan T, Anderson AS, Dowler E Can a gender-sensitised weight management programme delivered by Scottish Premier League football clubs help men lose weight? A feasibility study for a randomised controlled trial Status: Complete Funding: Chief Scientist Office Investigators: Wyke S, Hunt K, Gray C, Anderson AS, Leishman J, Mutrie N, Treweek S Football Fans in Training (FFIT): a randomised controlled trial of a gendersensitive weight loss and healthy living programme delivered to men aged 3565 by Scottish Premier League Football clubs Status: Ongoing Funding: NIHR Public Health Research Programme Investigators: Wyke S, Hunt K, Gray C, Anderson AS, Mutrie N, Treweek S, Donnan P, White A, Fenwick E, Leishman J, MacPhee S 13 The Effect of Adherence to Adjuvant Endocrine Therapy on Breast Cancer Outcomes Status: Completed Funding: MRC (Personal Fellowship) & Breast Cancer Research Scotland Investigators: McCowan C, Thompson AM, Dewar JA, Donnan PT, Fahey T, Makubate B Increasing duration of adjuvant endocrine therapy improves survival in women with breast cancer but the impact of adherence to therapy on mortality and recurrence is unclear. Two linked studies investigated whether women prescribed endocrine therapy after surgery for breast cancer adhered to their prescription and whether adherence influenced survival. The first study looked solely at tamoxifen use between 1993 & 2002 and the second study also looked at aromatase inhibitor use over the period 1993-2008. Methods A retrospective cohort study of all women with incident breast cancer in the Tayside region of Scotland between 1993 and 2002 was linked to encashed prescription records to calculate adherence to endocrine therapy. A case note review was performed to ascertain breast cancer recurrence. Survival analysis was used to determine the effect of adherence on all-cause mortality and recurrence. Results 2080 patients formed the initial study cohort with 1633 (79%) prescribed tamoxifen. Longer duration was associated with better survival, the hazard ratio for mortality for duration at 2.4 years was 0.85, 95% CI 0.83-0.87. Median adherence to tamoxifen was 93% (interquartile range 84-100%). Adherence <80% was associated with poorer survival, hazard ratio 1.10, 95% CI 1.001-1.21. Persistence with tamoxifen was modest with only 49% continuing therapy for 5 years of those followed up for 5 years or more. The second study looked at 4,627 patients with 1530 (33%) deaths and 726 (16%) recurrences observed. 3,328 (72%) patients received endocrine therapy with median duration of use 3.24 years (inter-quartile range = 1.41 - 5.07). 1,415 (43%) women were treated for at least 5 years or until death. Median adherence to therapy remained high at 93% (IQR 73-100%), although 1,008 (30%) patients had low adherence <80%. In Conclusion A significant proportion of women have low adherence to endocrine therapy and published work for tamoxifen has shown they are at increased risk of death. Increased duration of endocrine therapy reduces the risk of death, although over one in two women do not complete the recommended 5-year course of treatment. 14 IV) Screening and Early Detection Bowel Screening Research Unit Status: Ongoing Funding: Chief Scientist Office (CSO) Investigators: Steele RJC, Brewster D, Black R, Walker A, Weller D, Fraser C Funded by a five year CSO programme grant, a screening research unit has been established within the Scottish Bowel Screening Centre with four basic aims:1. To utilise data collected from the demonstration pilot of colorectal cancer screening carried out in Scotland between 2000 2006 and the ongoing Scottish National Screening Programme to investigate changes in mortality, geographical and socio-economic variation in uptake, and programme performance across Scotland. 2. To develop rational management plans for screen detected cancers and polyp cancers. 3. To evaluate follow up strategies in screen detected adenomas. 4. To investigate the effect of the introduction of new screening technologies. Some of the screening projects listed below are funded entirely by the CSO programme grant. Others are supported by the screening research unit and others are independent of the screening research unit. Results from the First Three Rounds of the Scottish Demonstration Pilot of FOBT Screening for Colorectal Cancer Status: Complete (See Publications) Funding: Scottish Government Health Department Investigators: Steele RJC, McClements PL, Libby G, Black R, Morton C, Birrell J, Mowat NEG, Wilson JA, Kenicer M, Carey FA, Fraser GC A demonstration pilot programme was conducted in three Scottish NHS Boards between 2000 and 2006. Residents aged between 50-69 years, registered on the community health index, were included in the study. In the first round the uptake was 55%, the positivity rate was 2.07% and the cancer detection rate was 2.1 per thousand screened. In the second round these were 53.0%, 1.90% and 1.2 per thousand respectively and in the third round 55.3%, 1.16% and 0.7 per thousand respectively. In the first round the positive predictive value of the FOBT was 12.0% for cancer and 36.5% for adenoma; these fell to 7.0% and 30.3% in the second round and were maintained at 7.5% and 29.1% in the third round. The percentage of screen detected cancers diagnosed at Dukes’ Stage A was 49.2% in the first round and 40.1% in the second round and 36.3% in the third round. These results are compatible with those of previous randomised trials done in research settings demonstrating that population based colorectal cancer screening is feasible in Scotland and should lead to a comparable reduction in disease specific mortality. 15 Effect of Gender, Age and Deprivation on Key Performance Indicators in an FOBT Based Colorectal Screening Programme Status: Complete, presented at DDW 2009, Manuscript in preparation Funding: Chief Scientist Office (CSO) programme Investigators: Steele RJC, Kostourou I, McClements P, Watling C, Libby G, Weller D, Brewster D, Black R, Carey F, Fraser C The relevant populations from the Scottish demonstration pilot of FOBT Colorectal Screening were subdivided into four age categories and into five deprivation categories according to the Scottish Index of Multiple Deprivation (SIMD) and key performance indicators analysed within these groups. In all rounds, uptake of the FOBT decreased with increasing deprivation and increased with age in both sexes, although uptake in women was significantly higher than men in all SIMD and all age groups. In addition SIMD category correlated negatively with uptake of colonoscopy and those with a positive FOBT although this effect was stronger in men than in women. Positivity rates increased with increasing deprivation and age in both sexes in all rounds although they were higher in men than in women for all SIMD and age categories. Cancer and adenoma detection rates increased with age in both men and women were consistently higher in men than in women in all age and SIMD categories but were not consistently related to deprivation. The PPVs for cancer and adenoma increased with age and decreased with increasing deprivation in both sexes in all rounds and were consistently higher in men than in women in all age and SIMD categories. In this population based colorectal screening programme, age deprivation and gender had marked effects on key performance indicators and this has implications for both the evaluation of screening programmes and for strategies designed to reduce inequalities. Clinico-pathological Characteristics and Outcome of Screen Detected Cancers Status: Complete, presented at DDW 2009, Manuscript in preparation Funding: Chief Scientist Office (CSO) programme Investigators: Steele RJC, Libby G, Carey F Analysis of screen detected cancers clearly demonstrates that these are diagnosed at a much earlier stage than symptomatic cancers. There is a tendency for screening to under diagnose right-sided cancers and to over diagnose rectal cancers but even within these categories, stage at diagnosis is more favourable in the screen detected cohort. In addition to this, survival analysis demonstrates that screen detected cancers have a more favourable prognosis stage for stage than symptomatic cancers indicating that there are subtle differences between screen detected and symptomatic cancers that are not detected by conventional staging techniques. Interval Cancers and the “Certificate of Health” Effect Status: Complete, presented at DDW 2009, Manuscript in preparation Funding: Chief Scientist Office (CSO) programme Investigators: Steele RJC, Libby G, McClements P, Carey F, Fraser C An interval cancer is a cancer that is diagnosed after a negative screening test and apparently in the Scottish Screening Programme approximately 30% of cancers that are diagnosed in the screen population are interval cancers. There is a concern that these cancers may have a particularly poor prognosis as a false negative test may persuade an individual to ignore symptoms. We have carried out a study in which the stage of interval cancers has been compared to both screen detected cancers and symptomatic cancers arising in non-screened health boards in Scotland. Although interval cancers present at a more advanced stage than screen detected cancers they do not present at a more advanced stage than symptomatic 16 cancers in non-screened areas indicating that there is no significant certificate of health effect. Prevalence and Incidence Screening Status: Complete, presented at DDW 2009, Manuscript in preparation Funding: Chief Scientist Office (CSO) programme Investigators: Steele RJC, Libby G, Carey F, Fraser C Prevalence screening is defined as the first screening episode for an individual whereas incidence screening is screening that is carried out in subsequent tests. It is important to determine the relative efficacy of prevalence and incidence screening as this provides the rationale for repeating invitations. In the Scottish demonstration pilot we have demonstrated that although uptake of prevalence screening is only 55% in the first round, follow up of this initial cohort demonstrates that prevalence screening goes up to 65% after three rounds. Similarly, repeated invitations for incidence screening increases uptake. It is also interesting to note that the proportion of individuals’ early stage disease declines from about 50% for prevalence screening to around 35% for second incidence screening indicating that incidence screens may be detecting cancers that had been missed on prevalence or previous incidence screens. The conclusion is that repeated invitation for both prevalence and incidence screening is worthwhile. Adenoma Follow-up Status: In progress Funding: NHS Tayside Endowment Investigators: Kostourou I, Steele RJC, Libby G, Carey F When an adenoma has been diagnosed and removed endoscopically, patients then enter an endoscopic surveillance programme. The evidence underlying the optimum surveillance interval is however, lacking. In this study all patients who have had a screen detected adenoma have been tracked and the results of any subsequent colonoscopies have been recorded. In this way we expect to determine the efficacy of different screening intervals and the data will inform a more rational endoscopic surveillance policy. Effect of Colorectal Cancer Screening on Disease Specific Mortality Status: In progress Funding: Chief Scientist Office (CSO) programme Investigators: Libby G, Brewster D, Steele RJC Although the randomised trials of colorectal cancer screening have consistently demonstrated reductions in disease specific mortality, it is not clear to what extent the national population based colorectal screening programme will have. The Scottish demonstration pilot of colorectal cancer screening provides an ideal opportunity to study this as, during the duration of the pilot, the rest of Scotland was not being screened. We are therefore carrying out a case control study where all individuals offered screening in the pilot health boards are being matched with individuals of similar age, gender and deprivation category in the non-screened health boards in order to determine the effect of population screening on colorectal cancer mortality. 17 Economic Impact of Screening Status: In progress Funding: Chief Scientist Office (CSO) programme Investigators: Walker A, Libby G, Steele RJC The true economic impact of screening is still uncertain. UK estimates of cost effectiveness have progressed from those based on the MRC (Nottingham) randomised trial to an evaluation alongside the UK pilot studies yet we do not have an estimate of “Real World” cost effectiveness. To achieve this, costs will be obtained for the various interventions from the screening centre and NHS boards and calculating cost per life-year saved overall and for different sub-groups defined by age, sex and deprivation. In addition projections will be used to calculate the cost saving created by reducing the need for adjuvant treatment and the treatment of advanced disease. Faecal Immunological Testing Status: Complete see publications Funding: Chief Scientist Office (CSO) programme Investigators: Fraser C, Carey F, Steele RJC For many years faecal occult blood testing has utilised the guaiac test which in an indirect measure of haemoglobin and therefore susceptible to dietary interference. In the initial pilot it was found that approximately 50% of all colonoscopies carried out for a positive FOBT detected no neoplastic pathology. For this reason a study was carried out in which individuals awaiting colonoscopy for a positive guaiac FOBT were offered Faecal Immunological Testing (FIT). It was found that 60% of those with a positive guaiac FOBT had a positive FIT. Of those with a negative FIT the yield of neoplastic pathology was negligible. It would therefore appear that the colonoscopy requirement could be reduced by 30% without adversely affecting the yield of pathology using a two tier reflex system whereby those who had a positive guaiac FOBT would go on to have an FIT and only have a colonoscopy if the FIT was positive. This strategy has been introduced into the national Scottish Bowel Screening Programme. The Psychological Effect of Interval Cancers Status: to commence 2010 Funding: Bowel Disease Research Foundation Investigators: Miles A (UCL), Steele RJC There is a concern that individuals who develop interval cancers may develop psychological morbidity. For this reason a qualitative study based on semi-structured interviews is planned to assess individuals’ reactions to developing an interval cancer. This study will be run from the Health Behaviour Research Centre, UCL, London but will be carried out in Tayside. The Utility of DNA Mutations in Colorectal Cancer Screening Status: Ongoing Funding: Randox Limited Investigators: Jenkinson F, Fraser C, Steele RJC 18 In recent years there has been great interest in detecting DNA mutations in the stool as a marker for early colorectal cancer. Randox Limited has developed a chip which can be used to detect 36 different mutations in four colorectal cancer associated genes. Currently we are engaged in a sensitivity study where this technology is being used in patients with known colorectal cancer and in individuals who have recently had a normal colonoscopy. Study is accumulating data after overcoming considerable technical difficulties. The Utility of Proteomics in Colorectal Cancer Screening Status: Ongoing Funding: Tenovus Investigators: Goodbrand S, Ferguson M, Steele RJC In an attempt to find plasma proteins that may be consistently associated with the presence of colorectal and neoplasia, a large scale proteomics screen is being carried out in collaboration with Professor Mike Ferguson of Life Sciences. This involves advanced proteomics technology which utilises mass spectrometry. When candidate proteins have been identified it is intended to develop simple assays for these proteins in order to test them prospectively in a screening environment. Investigate the Diagnosis of Colorectal Polyps using Optical Projection Tomography Status: Ongoing Funding: MRC T Investigators: Steele RJC, Weddell S, Carey F, Keogh R Investigate the Utility of Quantitative Immunological Faecal Occult Blood Testing in Symptomatic Patients Status: Ongoing Funding: Evelyn Ferris Mudie Charitable Trust Investigators: Steele, RJC Evaluate Faecal Immunological Testing as a First-line Colorectal Screening Test in the Scottish Population Status: Ongoing Funding: NHS Tayside Investigators: Steele RJC 19 2. CRiPS Publications 2007 - 2011 (original research) Anderson AS, Caswell S, MacAskill S, Steele RJC, Wells M (2009) "It makes you feel so full of life" LiveWell, a feasibility study of a personalised lifestyle programme for colorectal cancer survivors. Supportive Care in Cancer; 2009 18(4): 409-415 Anderson AS, Caswell S. Obesity management--an opportunity for cancer prevention. Surgeon. 2009 Oct;7(5):282-5. Anderson AS, Caswell S. Obesity and Cancer risk: a weighty problem in the 21st century. The Biologist. 2008;55(2):1005. Anderson AS. Nutrition interventions in women in low-income groups in the UK. Proc Nutr Soc. 2007 Feb;66(1):25-32. Anderson A, Dewar J, Marshall D, Cummins S, Taylor M, Dawson J, Sparks L. The development of a healthy eating indicator shopping basket tool (HEISB) for use in food access studies-identification of key food items. Public Health Nutr; 2007 Dec; 10(12):1440-7. Barton KL, Wrieden WL, Anderson AS. Validity and reliability of a short questionnaire for assessing the impact of cooking skills interventions. J Hum Nutr Diet; 2011 (In Press) Blaney J Lowe-Strong, Rankin A, Campbell J, Allen A, Gracey J. The Cancer Rehabilitation Journey: Barriers to and facilitators of exercise among patients with cancer-related fatigue. Physical Therapy, 2010 90 (8): 1135-1147 Bray SE, Paulin FE, Fong SC, Baker L, Carey FA, Levison DA, Steele RJ, Kernohan NM. Gene expression in colorectal neoplasia: modifications induced by tissue ischaemic time and tissue handling protocol. Histopathology. 2010 Jan; 56(2):240-50. Brewster DH, Clark DI, Stockton DL, Munro AJ, Steele RJC. Characteristics of patients dying within 30 days of diagnosis of breast or colorectal cancer in Scotland, 2003-2007. Br J Cancer 2011; 104: 60-67 Burke L, Jancey J, Howat P, Lee A, Kerr D, Shilton T, Hills A, Anderson A. Physical activity and nutrition program for seniors (PANS): protocol of a randomized controlled trial. BMC Public Health. 2010; 10:751. Campbell A, Mutrie N, Whyte F, Emslie C, Lee L, Ritchie D, McConnachie A, Kearney N. Short and long term physical and psychological benefits of a 12 week supervised group exercise programme during treatment for early stage breast cancer. EJC Supplements, 2007; 5 (4): 452-452 8151 Caswell S, Anderson AS, Steele RJC Diet and physical activity in patients with colorectal adenomas -directions for intervention programmes. J Hum Nutr Diet; 2008 21(5): 494-501 Caswell S, Anderson AS Steele RJC Bowel health to better health” A minimal contact lifestyle intervention for people at increased risk of colorectal cancer. Br J Nutr; 2009, 102: 1541-1546 Clarke P, Jack F, Carey FA, Steele RJC (2006) Medications with anticoagulant properties increase the likelihood of a negative colonoscopy in faecal occult blood population screening. Colorectal Disease; 8: 389-392 Craigie AM, Matthews JNS, Rugg-Gunn AJ,Lake AA, Mathers JC, Adamson AJ. Raised adolescent body mass index predicts the development of adiposity and a central distribution of body fat in adulthood: a longitudinal study. Obesity Facts; 2009 2(3): 157-165. Craigie AM, Caswell S, Paterson C, Treweek S, Belch JJ, Daly F, Rodger J, Thompson J, Kirk A, Ludbrook A, Stead M, Wardle J, Steele RJ, Anderson AS.(2011) Study protocol for BeWEl: the impact of a BodyWEight and physical L activity intervention on adults at risk of developing colorectal adenomas (2011) BMC Public Health. 2011 Mar 25;11(1):184 Craigie AM, Barton KL, MacLeod M, Williams B, van Teijlingen E, Belch JJ, Anderson AS : the Healthforce team. (2011) 20 A feasibility study of a personalised lifestyle programme (HealthForce) for individuals who have participated in cardiovascular risk screening. Prev Med Mar 16 52(5): 387-389 Craigie AM, Macleod M, Barton, KL, Treweek S, Anderson AS and the WeighWell team (2011) Supporting postpartum weight loss in women living in deprived communities - design implications for a randomised control trial. Eur J Clin Nutr (in press) Cummins S , Smith DM, Taylor M, Dawson JM, Marshall D, Sparks L Anderson AS (2010) Neighbourhood deprivation and the price and availability of fruit and vegetables in Scotland J Hum Nutr Diet 5:494-501 Cummins S, Smith DM, Taylor M, Dawson J, Marshall D, Sparks L, Anderson AS. Variations in fresh fruit and vegetable quality by store type, urban-rural setting and neighbourhood deprivation in Scotland. Public Health Nutr. 2009 Feb 26:1-7. Dawson JM, Marshall D, Taylor M, Cummins S, Sparks L, Anderson AS. Accessing Healthy Food: Availability and price of a healthy food basket in Scotland. Marketing Management. 2008;24(9/10):893-913. Donnelly CM, Lowe-Strong A, Rankin JP, Campbell A, Allen JM, Gracey JH. Physiotherapy management of cancerrelated fatigue: a survey of UK current practice. Supportive Care in Cancer, 2010 July, 18 (7):817-825 Emslie C, Whyte F, Campbell A, Mutrie N, Lee L, Ritchie D, Kearney N. “I wouldn’t have been interested in just sitting round a table talking about cancer”; exploring the experiences of women with breast cancer in a group exercise trial. Health Education Research 2007 Foster E, Adamson AJ, Anderson AS, Barton KL, Wrieden WL. Estimation of portion size in children's dietary assessment: lessons learnt. Eur J Clin Nutr. 2009 Feb;63 Suppl 1:S45-9. Foster E, Matthews JN, Lloyd J, Marshall L, Mathers JC, Nelson M, Barton KL, Wrieden WL, Cornelissen P, Harris J, Adamson AJ. Children's estimates of food portion size: the development and evaluation of three portion size assessment tools for use with children. Br J Nutr. 2008 Jan;99(1):175-84. Foster E, O'Keeffe M, Matthews JN, Mathers JC, Nelson M, Barton KL, Wrieden WL, Adamson AJ. Children's estimates of food portion size: the effect of timing of dietary interview on the accuracy of children's portion size estimates. Br J Nutr. 2008 Jan;99(1):185-90. Fraser CG, Matthew CM, Mowat NAG, Wilson JA, Carey FA, Steele RJC Evaluation of a card collection based faecal immunochemical test in screening for colorectal cancer using a two-tier reflex approach. Gut; 2007, 56: 1415-1418 Fraser CG, Matthew CM, McKay K, Carey FA, Steele RJC Automated immunochemical quantitation of haemoglobin in faeces collected on cards for screening for colorectal cancer. Gut; 2008, 57: 1256-1260 Fraser CG, McDonald PJ, Colford L, Irvine A, Kenicer M, Morton C, Birrell J, Steele RJC. Experience with a wipe guaiacbased FOBT as an alternative test in a bowel screening programme. J Med Screening 2010; 17: 211-213 Goodbrand SA, Steele RJ. An overview of colorectal cancer screening. Scott Med J. 2008 Nov;53(4):31-7. Gray C, Anderson AS, Dalziel A, Hunt K, Leishman J, Wyke S. Addressing Male Obesity: An evaluation of a group-based weight management intervention for Scottish men. Journal of Men's Health. 2009;6(1):70-81 Haleem MA, Barton KL, Borges G, Crozier A, Anderson AS. Increasing antioxidant intake from fruits and vegetables: practical strategies for the Scottish population. J Hum Nutr Diet. 2008 Dec;21(6):539-46 Jenkinson F, Steele RJ. Colorectal cancer screening - Methodology. Surgeon. 2010 Jun;8(3):164-71 21 Kapur G, Windsor PM, McCowan C. The Effect of Aerobic Exercise on Treatment Related Acute Toxicity in Men Receiving Radical External Beam Radiotherapy for Localised Prostate Cancer. EJCC 2010 19 (5): 643-647 Lake AA, Adamson AJ, Craigie AM, Rugg-Gunn AJ, Mathers JC. Tracking of Dietary Intake and Factors Associated with Dietary Change from Early Adolescence to Adulthood: The ASH30 Study. Obesity Facts; 2009 2(3): 150-156 Lawrence JM, Devlin E, Macaskill S, Kelly M, Chinouya M, Raats MM, Barton KL, Wrieden WL, Shepherd R. Factors that affect the food choices made by girls and young women, from minority ethnic groups, living in the UK. J Hum Nutr Diet. 2007 Aug;20(4):311-9 Libby G, Bray, J, Champion J, Colford L, Birrell J, Gorman D, Crighton E, Fraser C, Steele RJC. Pre-notification increases uptake of colorectal cancer screening in all demographic groups: a randomised controlled trial. J Med Screening 2011; 18: 24-29 Lorimer K , Gray CM, Hunt K, Wyke S, Anderson AS Benzeval M (2011) Response to written feedback of clinical data within a longitudinal study: a qualitative study exploring the ethical implicationsBMC Medical Research Methodology BMC Medical Research Methodology in press Mackison D, Wrieden WL, Anderson AS. Making an informed choice in the catering environment: what do consumers want to know? J Hum Nutr Diet. 2009 Dec;22(6):567-73. Mackison D, Wrieden WL, Anderson AS. Validity and reliability testing of a short questionnaire developed to assess consumers' use, understanding and perception of food labels. Eur J Clin Nutr. 2009 Nov 11. Maynard MJ, Baker G, Rawlins E, Anderson A, Harding S. Developing obesity prevention interventions among minority ethnic children in schools and places of worship: The DEAL (DiEt and Active Living) study. BMC Public Health. 2009;9:480 McCowan C, Shearer J, Donnan PT, Dewar JA, Crilly M, Thompson AM, Fahey T P. Cohort study examining tamoxifen adherence and its relationship to mortality in women with breast cancer. BJC 2008 99 1763-68 McCowan C, Donnan PT, Dewar JA, Thompson AM, Fahey T P. Identifying suspected breast cancer: development and validation of a clinical prediction rule. Br J Gen Prac 2010 61 327-328 Mutrie N, Campbell AM, Whyte F, McConnachie A, Emslie C, Lee L, Kearney N, Walker A, Ritchie D. What are the benefits of a supervised group exercise programme for women undergoing treatment for early stage breast cancer? A randomised controlled trial. British Medical Journal, 2007, 334: 517 Northwood EL, Elliott F, Forman D, Barrett JH, Wilkie MJ, Carey FA, Steele RJ, Wolf R, Bishop T, Smith G. Polymorphisms in xenobiotic metabolizing enzymes and diet influence colorectal adenoma risk. Pharmacogenet Genomics. 2010 May;20(5):315-26 Olde Bekkink M, McCowan C, Falk G, Teljeur C, Van de Laar F, Fahey T. Diagnostic accuracy systematic review of rectal bleeding in combination with other symptoms, signs and tests in relation to colorectal cancer. BJC 2009 102 48-58 Orbell S, O’Sullivan I, Parker R, Steele RJC, Campbell C, Weller D Illness representations and coping following an abnormal colorectal cancer screening result. Soc Sci Med 2008; 67: 1465-1474 Quyn AJ, Appleton PL, Carey FA, Steele RJ, Barker N, Clevers H, Ridgway RA, Sansom OJ, Nathke IS. Spindle orientation bias in gut epithelial stem cell compartments is lost in precancerous tissue. Cell Stem Cell. 2010 Feb 5;6(2):175-81 Quirke P, Steele R, Monson J, Grieve R, Khanna S, Couture J, O'Callaghan C, Myint AS, Bessell E, Thompson LC, Parmar M, Stephens RJ, Sebag-Montefiore D. Effect of the plane of surgery achieved on local recurrence in patients with operable rectal cancer: a prospective study using data from the MRC CR07 and NCIC-CTG CO16 randomised clinical trial. Lancet. 2009 Mar 7;373(9666):821-8 22 Roger J, Steele RJC Telephone assessment increases uptake of colonoscopy in a FOBT colorectal cancer screening programme. J Med Screening; 2008 15: 105-107 Sebag-Montefiore D, Stephens RJ, Steele R, Monson J, Grieve R, Khanna S, Quirke P, Couture J, de Metz C, Myint AS, Bessell E, Griffiths G, Thompson LC, Parmar M. Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomised trial. Lancet. 2009 Mar 7;373(9666):811-20. Smith G, Bounds R, Wolf H, Steele RJ, Carey FA, Wolf CR. Activating K-Ras mutations outwith 'hotspot' codons in sporadic colorectal tumours - implications for personalised cancer medicine. Br J Cancer. 2010 Feb 16;102(4):693-703 Smith DM, Cummins S, Taylor M, Dawson J, Marshall D, Sparks L, Anderson AS. Neighbourhood food environment and area deprivation: spatial accessibility to grocery stores selling fresh fruit and vegetables in urban and rural settings. Int J Epidemiol. 2009 Feb;39(1):277-84. Steele RJC (2006) Faecal occult blood test screening in the United Kingdom. Am J Gastroenterology; 101: 1-3 Steele RJC (2008) Colorectal cancer screening in Scotland. Z Gastroenterol; 46(S1): 33-35 Steele RJC, McClements PL, Libby G, Black R, Morton C, Birrell J, Mowat NAG, Wilson JA, Kenicer M, Carey FA, Fraser CG (2009) Results from the first three rounds of the Scottish Demonstration Pilot of FOBT Screening for Colorectal Cancer. Gut; 58: 530-535 Steele RJ, Kostourou I, McClements P, Watling C, Libby G, Weller D, Brewster DH, Black R, Carey FA, Fraser C. Effect of repeated invitations on uptake of colorectal cancer screening using faecal occult blood testing: analysis of prevalence and incidence screening. BMJ. 2010;341:c5531. Abridged print version : Br Med J 2010; 341: 977 Steele RJ, Kostourou I, McClements P, Watling C, Libby G, Weller D, Brewster DH, Black R, Carey FA, Fraser C. Effect of gender, age and deprivation on key performance indicators in a FOBT-based colorectal screening programme. J Med Screen. 2010 Jun;17(2):68-74. Steele RJ. Colorectal cancer surgery: a specialty in evolution. Surgeon. 2010 Jun;8(3):125-6. Stephens RJ, Thompson LC, Quirke P, Steele R, Grieve R, Couture J, Griffiths GO, Sebag-Montefiore D. Impact of shortcourse preoperative radiotherapy for rectal cancer on patients' quality of life: data from the Medical Research Council CR07/National Cancer Institute of Canada Clinical Trials Group C016 randomized clinical trial. J Clin Oncol. 2010 Sep 20;28(27):4233-9 Thaha MA, Campbell KL, Kazmi SA, Irvine LA, Khalil A, Binnie NR, Hendry WS, Walker A, Staines HJ, Steele RJ. Prospective randomised multi-centre trial comparing the clinical efficacy, safety and patient acceptability of circular stapled anopexy with closed diathermy haemorrhoidectomy. Gut. 2009 May;58(5):668-78 Vossenaar M, Solomons N, Valdés-Ramos R, Anderson AS Evaluating concordance with the 1997 World Cancer Research Fund/American Institute of Cancer Research cancer prevention guidelines- challenges for the research community Nutrition Research Reviews 2008 21, 189-206 Vossenaar M, Solomons NW, Valdés-Ramos R Anderson AS Concordance with dietary and lifestyle population goals for cancer prevention in Dutch, Scottish, Mexican and Guatemalan population samples Nutrition 2009 26(1): 40-52 Vossenaar M, Mayorga E, Soto-Méndez MJ, Medina-Monchez SB, Campos R, Anderson AS, Solomons NW (2009) The positive deviance approach can be used to create culturally appropriate eating guides compatible with reduced cancer risk. J Nutr 139(4): 755-762 Vossenaar M, Solomons NW, Valdes-Ramos R, Anderson AS. Evaluating concordance with the 1997 World Cancer 23 Research Fund/American Institute of Cancer Research cancer prevention guidelines: challenges for the research community. Nutr Res Rev. 2008 Dec;21(2):189-206 West NP, Anderin C, Smith KJ, Holm T, Quirke P, Steele R. Multicentre experience with extralevator abdominoperineal excision for low rectal cancer. Br J Surg. 2010 Apr;97(4):588-99 Weidlich S, Walsh K, Crowther D, Burczynski ME, Fuerstein G, Carey FA, Steele RJC, Wolf CR, Miele G, Smith G. Pyrosequencing-based methods reveal marked inter-individual differences in oncogene mutation burden in human colorectal tumours. Br J Cancer (in press) Windsor PM, Potter J, McAdam K, McCowan C. Evaluation of a Fatigue Initiative: Information on Exercise for Patients Receiving Cancer Treatment. Clin Oncol (R Coll Radiol). 2009 Feb 24 Wrieden WL, Anderson AS. Measurement of food and alcohol intake in relation to chronic liver disease. Stat Methods Med Res. 2009 Jun;18(3):285-301 Wrieden WL, Anderson AS, Longbottom PJ, Valentine K, Stead M, Caraher M, Lang T, Gray B, Dowler E. The impact of a community-based food skills intervention on cooking confidence, food preparation methods and dietary choices - an exploratory trial. Public Health Nutr. 2007 Feb;10(2):203-11 Wrieden WL, Longbottom PJ, Adamson AJ, Ogston SA, Payne A, Haleem MA, Barton KL. Estimation of typical food portion sizes for children of different ages in Great Britain. Br J Nutr. 2008 Jun;99(6):1344-53 24 3. Translating and Facilitating Research to Policy and Practice Current Government Advisory work (including UK Departments of Health and Research Councils) Anderson AS NCRI/MRC – National Prevention Research Initiative (NPRI), Deputy Chair, Scientific committee UK Depts. of Health & Food Standards Agency Scientific Advisory Committee on Nutrition (SACN), (Ministerial appointment), 2001 to 2011 NCRI Screening Prevention Colorectal cancer Sub Group, Member Food Standards Agency, Expert advisor, research review panel (as part of international group) NICE Public Health Initiatives Advisory Committee, Co-opted member Scottish Government, Food Research Committee (REERAD), Expert Advisor Scottish Government: Workstream Lead on Health and sustainability for National Food and Drink policy (launched 2009), (Ministerial appointment) Steele RJC Director, Scottish Government Scottish Bowel Screening Programme Chair of the Programme Board Chair, UK Depts. of Health Colorectal Cancer Screening Executive Group Chair, Colorectal Subgroup of NHS Quality Improvement Scotland Chair, Colorectal Screening Subgroup of NHS Quality Improvement Scotland Chair, Colorectal Cancer Guideline Group, Scottish Intercollegiate Guidelines Network Member, Colorectal Clinical Studies Group of the National Cancer Research Institute (NCRI) Chair, Screening and prevention subgroup of the National Cancer Research Institute (NCRI) Member, NHS Advisory Group on Colorectal Cancer Member, MRC College of Experts, Health Services and Public Health Research Board Member, Data Monitoring Committee for SIGGAR Chair, Colorectal Subgroup of the National Core Data Set Development Group (NCDDP) Member, Panel of Peer Reviewers, National Institute for Health Research, Health Technology Assessment Programme Member, Health Services Research Committee, Chief Scientist Office, Scottish Executive Health Department 25 Advisory Work for NGOs and Other Agencies Anderson AS Healthway, Western Australia Visiting Professor, Centre for Behavioural Research in Cancer Control, Division of Health Sciences Curtin University, Perth, Western Australia (2007 Healthway Visiting Research Fellow) Scottish Cancer Foundation (SCF) Member, Board of Directors - Conference co-organiser and speaker: Cancer Prevention: Evidence to Action: Food, Nutrition and Physical Activity. Royal College of Surgeons, Edinburgh (June, 2008) - Conference co-organiser and speaker: Enhancing Cancer Prevention in Scotland Royal College of Physicians, Edinburgh, August 2009 - Survey of Cancer prevention activities by cancer agencies in Scotland (August, 2009) - SCF supports The Scottish Cancer Prevention Network (SCPN). Inititiated in 2009 to assist professionals and NGOs to communicate research evidence, information and education approaches and support advocacy work for practical action related to cancer prevention and early detection. Anderson and Steele were founding members. UICC (International Union against Cancer) - Observer – (On behalf of UICC) WCRF/AICR Review Food, Nutrtition, Physical Activity and the prevention of Cancer (2005-2009) Bowel Cancer UK Member, expert advisory group 26 Steele RJC Bowel Disease Research Foundation Trustee Bowel Cancer UK Member, Advisory Committee. Melville Trust Member, Scientific Advisory Committee. Scottish Cancer Foundation Chair, Board of Directors Invited speaker, The patient journey and how to avoid it. Cancer Prevention: Evidence to Action: Food, Nutrition and Physical Activity, Edinburgh 2008 UICC Invited Speaker/workshop organiser The Scottish National Colorectal Cancer Screening Programme - Lessons from the First Two Rounds UICC World Cancer Congress 2006 (Washington 2006) Cancer screening – an opportunity for prevention? UICC World Cancer Congress 2008, Geneva 2008 WHO International Association for Cancer Research (IARC) Member, Committee for Quality Assurance in Colorectal Screening Australian, Republic of Ireland, Netherlands, Portuguese and Spanish Government Health Departments Advisor, colorectal screening 27 Selected International/National Invited presentations for Scientific Professional Groups (since 2007) Anderson AS • Recommendation for cancer prevention - theory to practice th 8 National Nutrition and Health Conference, London Nov 2007 • Energy balance - an opportunity for cancer reduction Military Hospital, Muscat, Oman, Feb 2008 • Legga Italiana Per La Lotta contro I Tumori (Italian Cancer League) Food, nutrition and physical activity: the latest evidence for cancer prevention, invited presentation, Rome 2008 • Food, Nutrition and Physical activity and the prevention of cancer British Dietetic Association national conference, Liverpool June 2008 • Colorectal cancer: optimising screening and prevention NCRI cancer Conference, Birmingham, Oct 2009 • UNESCO Nutrition interventions in low-income groups: Dearth of research on effective interventions. June 2009, Paris • CSIRO Food and drink policy in Scotland, 2009, Adelaide, South Australia • College of Surgeons of Hong Kong Cancer Prevention – Global solutions to a global problem, 2010, Hong Kong • World Cancer Research Fund International Nutrition, Physical Activity and Cancer Prevention: Current Challenges, New Horizons Policy and Practice in Scotland, 2010, London • UICC 6th World Cancer Congress Screening – a missed opportunity for weight management, 2008, Geneva • European Gastro-Enterology Foundation Colorectal cancer prevention: is lifestyle modification achievable? 2010, Barcelona Steele RJC • Increasing uptake of colon cancer screening by invitation schemes European Conference on Colon Cancer Prevention, Brussels 2007 • Effective Screening for Rectal Cancer Colorectal Cancer Congress, St Gallen, Switzerland, 2007 • Bowel Screening Today: A UK Perspective Meeting organised by the Scottish Bowel Screening Programme, Edinburgh 2008 • Evidence from an established screening programme based on FOBT 28 Colorectal Cancer Screening Meeting. Norwegian Directorate of Health, Oslo 2008 • Effective screening for colorectal cancer (Bo F Holmström Lecturer) Colorectal Surgery Symposium and Workshop at the Karolinska Institute, Stockholm 2008 • Colorectal Screening in the United Kingdom Screening and Management of Colorectal Cancer in Europe. Meeting Organised by ICDA (International Digestive Cancer Alliance), Prague 2008 • Keynote Lecture - Colorectal Cancer Screening Joint Scientific Meeting of the College of Surgeons of Hong Kong and the Royal College of Surgeons of Edinburgh, Hong Kong 2008 • How to improve participation and adherence in a colorectal cancer screening programme Moving forward to Colorectal Cancer Screening in Spain, Santa Cruz de Tenerife 2008 • Setting up a national colorectal cancer screening programme in the United Kingdom Visit to the Centre for Cancer Screening and Prevention Research, National Cancer Centre, Tokyo, Japan, 2009 • Age and other influences on screening KPIs in Scotland OMED Colorectal Cancer Screening Meeting, DDW, Chicago, 2009 • Indications for elective surgery in Diverticular Disease, Impact of screening on rectal cancer surgery 10th Colorectal Surgery Symposium and Workshop, Karolinska Instituet, Stockholm, Sweden, 2009 • Implementation of colorectal cancer screening. Presentation of a successful experience Discussion group on colorectal cancer screening organised by the Portuguese Health Department and the Portuguese Gastrointestinal Cancer Association, Lisbon 2010 • Interval cancers in population screening for colorectal cancer European Multidisciplinary Colorectal Cancer Congress, Nice, France 2010 • Evidence based colorectal cancer screening United European Gastroenterology Week (UEGW) Cochrane Symposium, Barcelona, Spain 2010 • Characteristics of interval cancers in the Scottish Colorectal Cancer Screening Programme OMED Colorectal Cancer Screening meeting, DDW, Chicago, USA 2011 29 Publications for professional groups (excluding research findings) Anderson AS (2004) Evidence based dietary behaviour strategies to reduce cancer risk in Sancho-Garnier, H, Biedermaan A, Slama K, Anderson AS, Lynge E (Editors). Evidence-based Cancer Prevention Strategies for NGOs A Handbook for Europe UICC, Geneva Anderson AS (2004) Evaluating cancer prevention activities in Sancho-Garnier H, Biedermaan A, Slama K, Anderson AS, Lynge E (Editors). Evidence-based Cancer Prevention Strategies for NGOs, A Handbook for Europe UICC, Geneva Anderson AS (2008) Obesity and cancer should not be ignored Scottish Primary Care 79 p14-15 Anderson AS & Caswell S (2008) Obesity and Cancer risk: a weighty problem in the 21st century. The Biologist 55:2 100-105 Anderson AS & Caswell S. (2009) Obesity management – an opportunity for cancer prevention The Surgeon (in press) Goodbrand SA, Steele RJC. An overview of colorectal cancer screening. Scot Med J 2008; 53: 31-37 Henderson NA, Steele RJC. SELDI-TOF proteomic analysis and cancer detection. Surgeon 2005; 1: 383-390 Sancho-Garnier H, Biedermaan A, Slama K, Anderson AS, Lynge E (Editors) (2004) Evidence-based Cancer Prevention Strategies for NGOs, A Handbook for Europe UICC, Geneva Steele RJC. Implications of screening for colorectal cancer. Practice Nursing 2005: 16: 124-126 Slevin T, Anderson AS, Doyle C, Bull F, Pratt S, and Mohandas Mallath (2009) A Healthy, Active Childhood.UICCGenevahttp://www.worldcancercampaign.org/templates/wcc/images/pdf/2009WCC_PDFs /Scientific%20Report/scientific%20report.pdf See Also: Scottish Cancer Prevention Network Newsletter edited by Anderson AS, Steele SJC; 2010 Vol. 1-4, 2011 Vol. 5-6 http://www.sitemantra.co.uk/cancerpreventionscotland/index.php?page=newsletters 30 4. Public Understanding of Science and Advocacy in support of cancer prevention and early detection Communications for General Public Anderson AS Dispelling the myths about foods that fight cancer, invited presentation, Perth WA, July 2007 Organised by Cancer Council of Western Australia st Anderson AS Healthy eating in the 21 century, invited presentation Montrose, Sep 2007 Scottish Women’s Rural Institute (national conference) Anderson AS At last – Proof that we can all cut cancer risk. Invited article The Scotsman Nov 2007 Anderson AS Diet and cancer prevention, invited presentation, Dundee April, 2008 Café Science, Dundee Steele RJC and Anderson AS Prevention of colo-rectal cancer, invited presentation, Dundee Jan 2008 Organised by British Association, Dundee Steele RJC Bowel Cancer Screening in Scotland - stakeholder meetings Dundee, Elgin and Glasgow 5. CRiPS – Visits from International Scholars Professor Graeme Young, Flinders Centre for Cancer Prevention and Control, Adelaide. Oct 2009 Dr Cliona Ni Mhurchu, Clinical Trials Research Unit, University of Auckland. June 2010 Professor Peter Howatt, Centre for Behavioural Research in Cancer Control, Perth, Auckland. April 2011 31 CRiPS Contacts: Annie Anderson [email protected] Mary Wells [email protected] Robert Steele [email protected] CRiPS Contact Professor Annie S. Anderson Division of Clinical and Population Sciences and Education Ninewells Hospital and Medical School Dundee DD1 9SY Tel: 01382 496442 [email protected] An affiliate of the 32