Cancer in Primary Care
Research Overview
The Primary Cancer Research Group was established at the University of Melbourne in 2013 and has become the biggest primary care cancer research team in the world. The team has accrued over $30,000,000 of funding and published over 160 publications since 2018. The research group has steadily grown and currently includes over 30 core team members working in three distinct areas:
- Data Connect – linking primary care data to hospital and clinical cancer registries to study the patterns of care and impacts on patient outcomes, as part of a Victorian Comprehensive Cancer Centre (VCCC) Alliance research program.
- Clinical trials – we are currently running nine randomized controlled trials (RCTs) in general practice testing novel interventions covering cancer prevention, risk-based screening, pharmacogenomics, and early cancer diagnosis in primary care.
- Primary care trial infrastructure and capacity building – the Primary Care Collaborative Cancer Clinical Trials Group (PC4) and PARTNER national trial networks.
The evolution and growth of the team reflects the success in obtaining competitive research funding through effective national and international collaboration, and development of effective teams to execute research.
At a local level, the Primary Care Cancer Research Group has built strong collaborations with researchers from the School of Population and Global Health (Mark Jenkins, John Hopper), the School of Medicine (Finlay Macrae, Ingrid Winship), and the Department of General Practice and Primary Care (Jo-Anne Manski-Nankervis, Dougie Boyle, Lena Sanci, Patty Chondros). These collaborations have been critical to build programs on cancer genomics and risk-based prevention, creation of critical data infrastructure for data linkage and trials, and development of decision support tools.
Nationally, we work closely with research teams at the University of Western Australia, University Technology Sydney, University of Queensland, University of Sydney, Flinders University, and others. Many of these collaborations have been built through the successful engagement and processes established by PC4 (see below).
Internationally, we have a long-standing collaboration with researchers at the University of Cambridge as part of our program on cancer risk assessment and early detection. This led to our group being the Australian lead on the £5 million Cancer Research UK Cantest program, creating opportunities for our team to attend international research schools on early cancer diagnosis and develop collaborations with groups in the UK (Cambridge, UCL, Exeter, Oxford), the US and Denmark. Jon Emery and PC4 were approached to help establish primary care cancer networks in SE Asia, led through a collaboration at NUS in Singapore. The SPRINT (Singapore) and Asia Pacific Primary Care Cancer Research Group have been established and have led to collaborations on several Australian and Asian grants involving early and mid-career researchers. This is supported through the Primary Care Collaborative Cancer Clinical Trials Group (PC4) of which Prof Jon Emery is Director.
Funding
Our research is funded by the National Health and Medical Research Council (NHMRC), Cancer Australia, Cancer Council Victoria, Department of Health Victoria, Medical Research Future Fund (MRFF), Victorian Cancer Agency, the VCCC Alliance, Cancer Research UK, Paul Ramsay Foundation and the BUPA Foundation.
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.
Data Connect
Data Connect is a collaboration between the VCCC Alliance, the University of Melbourne, hospitals and BioGrid Australia, that has enabled the linking of primary care and cancer research for the first time in Australia. Linked data enables research examining cancer across the patient’s whole journey – from pre-diagnosis to diagnosis and treatment, to post-treatment including survivorship and palliative care. The Data Connect team is conducting a range of research projects using primary care data from general practices linked to hospital and clinical registry data. These research projects include diagnostic pathways and diagnostic delay in cancer, risk prediction modelling, and post-treatment cancer care. The Data Connect website includes an infographic detailing the data that is available and how it is being used.
PARTNER
The PARTNER network is a national rural practice-based research network (PBRN) that connects rural Australians to potential clinical trials through their local GP. PARTNER creates an environment of research-ready GP practices that improves the efficiency and quality of trials conducted in primary care. PARTNER uses technology solutions to support identification of eligible patients for trials, for disease surveillance and trial follow-up.
Our Collaborators
Prof Jon Emery and his team have long-standing collaborations with researchers around the world in primary care, cancer, psychiatry, genomics, and linked data. These include a program of work with Prof Fiona Walter now at Queen Mary University of London (Wolfson Institute of Population Health) and formerly at the Department of Public Health and Primary Care, University of Cambridge, Dr Chad Bousman at the University of Calgary on the PRESIDE trial, and Dr Juliet Usher-Smith at Cambridge on the CanRisk program. Additionally, The CanTest program, co-led by Prof Fiona Walter and Prof Willie Hamilton encompassed 42 collaborators from 11 institutions around the world with a focus on early cancer detection in primary care. Current studies within this collaboration include SCRIPT, CRISP, IC3, CanRisk and the Melatools programme.
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2023
Drosdowsky, A., Lamb, K. E., Bergin, R. J., Boyd, L., Milley, K., IJzerman, M. J., & Emery, J. D. (2023). A systematic review of methodological considerations in time to diagnosis and treatment in colorectal cancer research. Cancer Epidemiology, 83, 102323.
Emery, J., Jenkins, M. A., Saya, S., Chondros, P., Oberoi, J., Milton, S., ... & McIntosh, J. G. (2023). The CRISP Trial: RCT of a decision support tool for risk-stratified colorectal cancer screening. British Journal of General Practice.
Milley, K., Chima, S., Karnchanachari, N., McNamara, M., Druce, P., & Emery, J. (2023). General practice-based cancer research publications: a bibliometric analysis 2013–2019. British Journal of General Practice, 73(727), e133-e140.
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2022
Milley, K., Chima, S., Thornton-Benko, E., & Emery, J. (2022). Embedding primary healthcare professionals as consumers in cancer research development. Australian Journal of General Practice, 51(8), 565-566.
Ristanoski, G., Emery, J., Gutierrez, J. M., McCarthy, D., & Aickelin, U. (2022). AI based cancer detection models using primary care datasets. Journal of Advances in Information Technology Vol, 13(2).
Saya, S., Boyd, L., Chondros, P., McNamara, M., King, M., Milton, S., ... & Emery, J. (2022). The SCRIPT trial: study protocol for a randomised controlled trial of a polygenic risk score to tailor colorectal cancer screening in primary care. Trials, 23(1), 810.
Wood, A., Emery, J. D., Jenkins, M., Chondros, P., Campbell, T., Wenkart, E., ... & McIntosh, J. G. (2022). The SMARTscreen Trial: a randomised controlled trial investigating the efficacy of a GP-endorsed narrative SMS to increase participation in the Australian National Bowel Cancer Screening Program. Trials, 23(1), 1-14.
Zhang, J., IJzerman, M. J., Oberoi, J., Karnchanachari, N., Bergin, R. J., Franchini, F., ... & Emery, J. D. (2022). Time to diagnosis and treatment of lung cancer: A systematic overview of risk factors, interventions and impact on patient outcomes. Lung Cancer, 166, 27-39.
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2021
Milley, K., Chima, S., McIntosh, J. G., Ackland, E., & Emery, J. D. (2021). Long‐term consumer involvement in cancer research: Working towards partnership. Health Expectations, 24(4), 1263-1269.
Milton, S., McIntosh, J., Macrae, F., Chondros, P., Trevena, L., Jenkins, M., ... & Emery, J. (2021). An RCT of a decision aid to support informed choices about taking aspirin to prevent colorectal cancer and other chronic diseases: a study protocol for the SITA (Should I Take Aspirin?) trial. Trials, 22(1), 1-17.
Ristanoski, G., Emery, J., Martinez Gutierrez, J., McCarthy, D., & Aickelin, U. (2021, February). Handling uncertainty using features from pathology: opportunities in primary care data for developing high risk cancer survival methods. In 2021 Australasian Computer Science Week Multiconference (pp. 1-7).
Zhang, J., Oberoi, J., Karnchanachari, N., Druce, P., IJzerman, M. J., & Emery, J. D. (2021). The timeliness of lung cancer care: A systematic review of systematic/scoping reviews on time intervals and their impacts on cancer outcomes.
Explore the extensive body of work from the Cancer Research Group, encompassing over 220 publications since 2018.