Breast screening research at Warwick
Warwick Screening leads trials, observational research and evidence review of breast cancer screening. We use large observational studies and trials to increase statistical power, so we can measure impacts on women screened. We specialise in pragmatic integrated trials (sometimes called quality improvement trials) where parts of the trial are integrated into the screening programme.
The ATHENA-M (Observational study of Age, test THreshold and frequency on English NAtional Mammography screening outcomes) study explores the effects of patient age, test threshold and frequency of testing for breast cancer and impact on long term outcomes like cancer mortality. Find out more about the study
Changing case order to optimise patterns of Performance in Screening
The Changing case order to optimise patterns of Performance in Screening (CO-OPS) trial randomised reading order for 1.2 million women attending breast cancer screening in England. The study found that contrary to previous psychology literature suggesting a vigilance decrement with time on task, experts accuracy to detect cancer did not decrease, in fact overall accuracy increased with time on task, through increased specificity. This study is published here. The National Institute for Health Research funded this study, as a fellowship for Dr Sian Taylor-Phillips.
The POSTBOx (Patient Outcomes from Second film-readers and Test threshold relaxation in Breast screening: Observational evaluation) study links breast screening, cancer registry and mortality data in England. We are evaluating the impact of previous changes to the Breast Screening Programme on long term outcomes. Find out more about the study.
SLOANE collaboration
Warwick Screening are collaborating with the SLOANE project to analyse routine data on atypical hyperplasia detected at Breast cancer screening. This will guide national policy on monitoring strategy by atypia subtype. This project is led by Dr Sian Taylor-Phillips with David Jenkinson the lead statistician. Find out more about the study.
The two publications from the study can be found here and here.
Communicating benign biopsy results
The anxiety caused by false positive screening results are an important harm from breast cancer screening. Communicating these results is moving from in person to telephone at many English breast screening centres. In this ESRC funded PhD studentship, Sian Willamson has used a mixed methods approach to understanding the impact of communication method on women’s experience of screening, and resultant anxiety. The first publications are available here, here and here. The supervisors are Dr Sian Taylor-Phillips, Dr Harbinder Sandhu and Dr David Ellard.
Comparison of different mammography testing strategies in Breast Cancer Screening
This follow-on research from the CO-OPS trial examines how different implementations of breast cancer screening may impact on test accuracy. This includes analysis of the impact of two readers separately examining the mammograms for signs of cancer (as used in the UK) with a single reader (used in the US) published here, and analyses of the impact of blinding the readers to each others decisions, and of the arbitration process to resolve disagreements between mammography readers. We discuss some of the complexities in this research here.