Cancer in Primary Care

Research Overview

Our Cancer in Primary Care Research Group conducts research covering the role of primary care across the cancer continuum (see Figure).

The role of primary care across the cancer continuum. From Emery JD et al Nature Reviews Clinical Oncology 2013

This includes studies on cancer screening, cancer diagnosis and survivorship care. We are interested in the application of risk stratification and risk assessment tools to support more tailored and specific care across the cancer continuum. This includes, for example, our work in colorectal cancer screening and the implementation of fast track pathways for suspected cancer using risk assessment tools in general practice. Our work also examines potential causes of poorer cancer outcomes in specific populations including rural and culturally and lingually diverse communities.  We have recently completed an RCT testing a model of shared care for men with prostate cancer and are developing similar models for other common cancers. We are a highly collaborative group having formed strong collaborations with several local, national and international research groups who share our interests in primary care oncology. This is supported through the Primary Care Collaborative Cancer Clinical Trials Group (PC4) of which Prof Jon Emery is the Director.

PC4- The Primary Care Collaborative Cancer Clinical Trials Group

PC4 is funded by Cancer Australia to support the development of high quality cancer research in primary care. Our Group provides an infrastructure to foster collaboration between researchers, health care practitioners, policy makers and consumers. We provide access to expert advice and resources through our Support Services, and build research capacity with our Training Awards, Workshops and Mentoring Programs. Further information about becoming a member of PC4 and learning more about ways to support your research is provided on the trial group’s website.

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Collaborators

Prof Jon Emery has a long-standing collaboration with Dr Fiona Walter at the Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge. Together they lead a joint research programme between Melbourne and Cambridge with a focus on cancer risk assessment and early diagnosis – The CamMel Collaboration. Current studies within this collaboration include: The CHEST Trial, CRISP, CanRisk and the Melatools programme.

Our other collaborators include:

• Department of Health Victoria
• Cancer Council of Australia
• Victorian Comprehensive Cancer Centre
• Health and Biomedical Informatics Centre, University of Melbourne
• Centre for Epidemiology and Biostatistics, University of Melbourne
• Royal Melbourne Hospital
• Western Health
• Peter MacCallum Cancer Centre
• Department of Public Health and Primary Care, University of Cambridge
• Department of General Practice, University of Sydney
• Department of General Practice, Monash University
• General Practice, UWA
• Department of General Practice, Durham University

Funding

Our research is funded by the National Health and Medical Research Council (NHMRC), Cancer Australia, Cancer Council Victoria, Department of Health Victoria and the BUPA foundation.

Research Publications

2017

Walker JG, Bickerstaffe A, Hewabandu N, Maddumarachchi S, Dowty JG, Jenkins M, Pirotta M, Walter FM, Emery JD. (2017). The CRISP colorectal cancer risk prediction tool: an exploratory study using simulated consultations in Australian primary care. BMC Medical Informatics and Decision Making, 17(1), 1-11. DOI: 10.1186/s12911-017-0407-7

Emery J, Saya S. (2017). Applying genomics to tailor colorectal cancer screening. EuroDigest, 1(4) 20-21

2016

van Die MD, Bone KM, Emery J, Williams SG, Pirotta MV, Paller CJ. Phytotherapeutic interventions in the management of biochemically recurrent prostate cancer: A systematic review of randomised trials. BJU Int. 2016 April; 117 (4):17-34.

Usher-Smith JA, Walter FM, Emery JD, Win AK, Griffin SJ. Risk Prediction Models for Colorectal Cancer: A Systematic Review. Cancer Prevention Research. 2016 Jan; 9(1):13-26.

Rubin G,  Berendsen A, Crawford SM, Dommett R, Earle C, Emery J, [...]  de Wit N, Zimmermann C. The expanding role of primary care in cancer control. The Lancet Oncology. 2015 Sep; 16(12):1231-1272.

Usher-Smith J, Emery J, Hamilton W, Griffin SJ, Walter FM. Risk prediction tools for cancer in primary care. British Journal of Cancer. 2015 Dec; 113(12):1645-1650.

Chiang PP-C, Glance D, Walker J, Walter FM, Emery JD. Implementing a QCancer risk tool into general practice consultations: an exploratory study using simulated consultations with Australian general practitioners. British Journal of Cancer. 2015 Mar; 112:S77-S83.

Neal RD, Tharmanathan P, France B, Din NU, Cotton S, Fallon-Ferguson J, Hamilton W, Hendry A, Hendry M, Lewis R, et al. Is increased time to diagnosis and treatment in symptomatic cancer associated with poorer outcomes? Systematic review. British Journal of Cancer. 2015 Mar; 112:S92-S107.

Walker JG, Licqurish S, Chiang PPC, Pirotta M, Emery JD. Cancer Risk Assessment Tools in Primary Care: A Systematic Review of Randomized Controlled Trials. Annals of Family Medicine. 2015 Sep; 13(5):480-489.

Murray SR, Murchie P, Campbell N, Walter FM, Mazza D, Habgood E, Kutzer Y, Martin A, Goodall S, Barnes DJ, et al. Protocol for the CHEST Australia Trial: a phase II randomised controlled trial of an intervention to reduce time-to-consult with symptoms of lung cancer. BMJ OPEN. 2015; 5(5):7.

Usher-Smith J, Emery J, Kassianos A, Walter F. Risk Prediction Models for Melanoma: A Systematic Review.  Cancer Epidemiol Biomarkers Prev. 2014 Aug; 23:1450-1463.

Emery JD, Shaw K, Williams B, Mazza D, Fallon-Ferguson J, Varlow M, Trevena LJ. The role of primary care in early detection and follow-up of cancer. Nature Reviews Clinical Oncology. 2014 Nov; 11: 38-4