The CASSOWARY Trial: A Randomised Controlled Trial of the clinical utility and cost-effectiveness of a multi-cancer polygenic risk score in general practice

The CASSOWARY (CAncer genomic riSk ScOres in primARY Care) trial is exploring whether a new DNA test collected via a saliva swab at a GP clinic could be a cost-effective and efficient way to identify a person’s cancer risk (see more here). This randomised controlled trial will evaluate the effect on risk-appropriate cancer screening of multi-cancer polygenic risk scores (PRS) and tailored screening advice in general practice. Participants in the intervention group in the trial will receive an individualised cancer risk report and tailored advice for risk-appropriate screening for melanoma, colorectal, breast and prostate cancer. This trial will test the effect of this genomic risk information and associated risk reports in general practice on whether participants complete the right cancer screening for their risk, meaning:

• If at increased risk, to commence screening prior to the standard age of commencement or undertaking more sensitive forms of screening, or

• If at average risk, to reduce inappropriate use of invasive screening tests or overuse of screening tests.

Herman Prof Jon Emery, Academic GP, University of Melbourne

Dr. Sibel Saya, Research Fellow/ Genetic Counsellor, University of Melbourne

Prof Mark Jenkins, Genetic Epidemiologist, University of Melbourne

A/Prof Patty Chondros, Biostatistician, University of Melbourne

Prof Ingrid Winship, Clinical Geneticist, Royal Melbourne Hospital and The University of Melbourne

Prof Finlay Macrae, Gastroenterologist, Royal Melbourne Hospital and The University of Melbourne

A/Prof Jennifer McIntosh, Implementation Scientist, University of Melbourne

Ms.  Jacki Laszczyk, Research Coordinator, University of Melbourne

Ms. Georgia Ramsay, Research Assistant, University of Melbourne

Mr. Matthew Thoenig, Research Officer, University of Melbourne

Ms. Madeline Luke, Research Assistant, University of Melbourne

A/Prof Julia Steinberg, Epidemiologist, University of Sydney

Prof Anne Cust, Cancer Epidemiologist, Daffodil Centre (University of Sydney and Cancer Council NSW)

Dr. Amelia Smit, Epidemiologist, University of Sydney

Prof Karen Canfell, Epidemiologist, The Daffodil Centre (University of Sydney and Cancer Council NSW)

Dr. Erika Spaeth Tuff, Genetic Scientist, Phenogen Sciences/Genetic Technologies

Prof Fiona Walter, Academic GP, Queen Mary University of London

Dr. Elizabeth Bancroft, Clinical Nurse Consultant, Royal Marsden NHS Foundation Trust and the Institute of Cancer Research