In the UK, there are three national cancer screening programmes for bowel, breast and cervical cancer. Researchers in Manchester are aiming to improve screening techniques and investigating the use of personalised risk information alongside the screening programmes.

Screening for cancer is an important step in the early detection of the disease, aiming to diagnose the presence of cancer before the individual has even displayed symptoms. There are only three national screening programmes in the UK, as these programmes have to demonstrate that they can save lives with minimal risk.

Breast MRI scan with intravenous contrast medium, which shows a large tumour in the left breast. 
Photo courtesy of Dr Anthony Maxwell

Large scale screening studies have been conducted in Greater Manchester to help inform and improve the current national NHS screening programmes. Professor Henry Kitchener and his team’s pioneering Manchester-based research led to changes in the national cervical screening programme with screening samples now being tested for the human papilloma virus (HPV) first, which is found to produce more accurate results. Professor Kitchener has also led research into urine testing for HPV, which could be used as an alternative screening method for women who would otherwise not engage in screening. 

There has also been research into potential modifications in the current NHS breast screening programme. The PROCAS (Predicting Risk Of Cancer At Screening) study, led by Professor Gareth Evans, examined whether women’s personalised risk of breast cancer could be accurately predicted within the breast screening program, using risk information from individuals, mammographic density and genetic testing. These results could lead to more frequent screening for those who are in the high risk group, as well these women being provided personalised lifestyle advice to help lower their risk of breast cancer.

Dr Susan Astley

Dr Susan Astley

“Much of my current research aims to improve identification of those at increased risk of developing breast cancer by measuring the amount and pattern of dense tissue in mammograms. This will help personalise breast screening based on individual risk.  Dense tissue can also be assessed by different technologies which we are evaluating to see if they provide a safe alternative to mammography. 

There is some evidence that computer-aided detection (CAD) can aid early detection, but it requires further understanding of how inaccurate CAD prompts affect detection; we are looking into this by developing a computer game that mimics CAD although has a different detection task - finding bats in flocks of birds.”

For a screening programme to become available for other cancers there is a need for good quality research in order to develop an accurate test, which clearly demonstrates high benefit and low risk to the general population. Researchers in Greater Manchester are currently investigating the pragmatics of screening programmes for cancers such as lung, prostate, ovarian and endometrial. 

It is hoped that research into cancer screening can lead to more accurate tests for a wider range of cancers in the future. Screening research contributes to the overall aim of fewer late stage presentations from cancer patients and in turn better survival rates.