Early Detection and Prevention - Screening Group
Current Research Topics:
The projects include large-scale, long-term cluster randomized controlled trials to evaluate various screening methods for breast, cervical, and oral cancers; cost-effectiveness studies; evaluation of national screening programmes; evaluation of the efficacy of treatment of cervical and colorectal precancerous lesions; studies to assess the accuracy and reproducibility of various low- and high-technology screening tests; the assessment of methods for evaluating test characteristics; studies on the natural history of cancer; the development of educational materials, information systems, and quality assurance strategies; conducting training courses on screening; and the development and implementation of information systems to support the monitoring.
Examples of major on-going studies are given below:
Cervical cancer prevention and screening
- Multicentre cluster randomized trial involving 20 000 girls aged 10-18 years in 9 locations in India to evaluate the comparative efficacy of 2 versus 3 doses of human papillomavirus (HPV) vaccine in preventing HPV infection, cervical intraepithelial neoplasia, and cervical cancer
- A cluster randomized trial involving 50 000 women aged 30-69 years in Osmanabad district, India, to evaluate the utility and impact of conventional Pap smear triage of HPV screen-positive women on detection rates of cervical cancer precursor lesions and in reducing colposcopy referrals/biopsy rates/unnecessary treatments, in collaboration with the Nargis Dutt Memorial Cancer Hospital, Barshi, India.
- Cluster randomized controlled trial involving 140 000 women to evaluate the long-term efficacy and cost-effectiveness of a single round of visual, cytology, and HPV screening in reducing cervical cancer incidence and mortality in Osmanabad district, India, in collaboration with the Tata Memorial Hospital, Mumbai and the Nargis Dutt Memorial Cancer Hospital, Barshi, India.
- Cluster randomized controlled trial involving 80 000 women to evaluate the long-term efficacy and cost-effectiveness of a single round of visual screening in reducing cervical cancer incidence and mortality in Dindigul district, India, in collaboration with the Christian Fellowship Community Health Centre, Ambilikkai and the Cancer Institute (WIA), Chennai, India.
- Evaluation of different cervical screening approaches in HIV-infected women in India and Zambia.
- Evaluation of the feasibility, acceptability, efficacy, and safety of field-based treatment of cervical cancer precursor lesions using thermocoagulation.
- Evaluation of cost-effectiveness of visual screening and HPV screening.
- Studies assessing the determinants of participation in screening.
- The performance of visual screening in routine health care settings in Bangladesh, India, Angola, Mali, Guinea, Republic of the Congo, and Zambia.
- Development of printed and digital learning resources for cytology, visual screening, histology, colposcopy, and treatment of cervical intraepithelial neoplasia (CIN) using cryotherapy, cold coagulation, and loop electrosurgical excision procedure (LEEP).
- Evaluation of national cervical screening programmes in Bangladesh, Thailand, and Tamil Nadu state, India.
- Technical assistance to visual screening programmes in Angola, Bangladesh, Guinea, India, Mali, Nepal, Republic of the Congo, United Republic of Tanzania, and Zambia.
Oral cancer screening
- Cluster randomized controlled trial involving 180 000 people to evaluate the effectiveness of oral visual screening in reducing oral cancer mortality in Trivandrum district, India, in collaboration with the Regional Cancer Centre, Trivandrum, India.
- Natural history studies of oral precancerous lesions.
- Operational research in implementing oral cancer screening in routine health services.
- Development of educational materials to facilitate the prevention and early detection of oral cancers.
Breast cancer screening
- Cluster randomized controlled trial involving 120 000 women to evaluate the role of an interventions “package” consisting of breast awareness and clinical breast examination (CBE) in reducing breast cancer mortality, in collaboration with the Regional Cancer Centre, Trivandrum, India.
- Evaluation of test characteristics of near-infrared transillumination breast imaging in the early detection of breast lumps and breast cancer, in collaboration with the Cancer Institute of the Chinese Academy of Medical Sciences (CICAMS), Beijing, China and the Cancer Institute (WIA), Chennai, India.
- Development of educational materials to facilitate the early detection of breast cancers.
- Evaluation of breast awareness in the early detection and control of breast cancer, in collaboration with Bhabha Atomic Research Centre Hospital, Mumbai, the Cancer Institute (WIA), Chennai, and the Cancer Control Foundation of India, Pollachi, India.
Colorectal cancer screening
- Implementation research in piloting and phased national scaling up of colorectal cancer screening using the immunochemical faecal occult blood test (iFOBT) and colonoscopy triage through government health services in Thailand, in collaboration with the National Cancer Institute (NCI), Bangkok, Thailand.
- Evaluation of the negative predictive value of 5-yearly colorectal cancer screening.
- Development of educational materials for training in colonoscopy.
Reporting on implementation of cancer screening in the European Union
- The preparation of the first report on Implementation of Cancer Screening in the European Union was coordinated by QAS, and it was published in 2008 (von Karsa et al., 2008). The second report is being prepared in a project co-financed by the EU Health Programme. Key collaborators include participants in the European Cancer Network and staff at the Department of Cancer Screening and Unit of Cancer Epidemiology, CPO Piemonte and AO City of Health and Science of Turin, Italy.