Reader/Principal Researcher in Primary Care Cancer Research

MA, MB BChir, DCH, DRCOG, MSc, MD, FRCGP

Honorary Clinical Associate Professor

General Practice & Primary Care Academic Centre, University of Melbourne, Victoria 3053, Australia

Email: fmw22@medschl.cam.ac.uk

Tel: 01223 762514

Background and Research Interests

I lead the Cancer Group in the Primary Care Unit, Department of Public Health and Primary Care, at the University of Cambridge. The Cancer Group’s objective is to deliver world-class research focusing on the cancer pathway, from prevention, screening, early detection and diagnostics to post-treatment care; we also focus on translating genetics advances into primary care. My research expertise lies across the primary care research spectrum and includes randomised controlled trials, cohort studies and systematic reviews; I have a particular interest in patient experiences and qualitative and mixed methods approaches.

I have won research grants totalling more than £25 million in the UK and AU$5 million in Australia, and published over 160 peer reviewed articles including in Nature, Lancet, BMJ and JAMA. I co-lead the CanTest Collaborative, Cancer Research UK’s first Catalyst award, aiming to accelerate progress towards improving cancer outcomes by focussing on the transformative implementation in primary care of tests to support early detection of cancer. I am also co-investigator on the £5m NIHR Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis, led by Prof Stephen Duffy (QMUL).

Current UK leadership roles include membership of Cancer Research UK’s Early Detection Committee and Cambridge Cancer Centre’s Early Detection Committee. My international work is marked by an honorary academic role at the University of Melbourne, Australia, where I contribute to parallel programmes of work on improving outcomes for cancer patients. I also co-lead research in South Africa and Uganda, and contribute to research in Europe (Denmark, the Netherlands) and the US. My educational and capacity building work is marked by the setting up and delivery of the CanTest International School in Cancer Detection Research in Primary Care, and my role as Training Lead for Cambridge in the NIHR School for Primary Care Research, and in the University of Cambridge MPhil in Primary Care Research with Prof Jonathan Mant.

Selected Recent Key Publications

Walter FM, Thompson MJ, Wellwood I, Abel GA, Hamilton W, Johnson M, Lyratzopoulos G, Messenger M, Neal R, Rubin G, Singh H, Spencer A, Sutton S, Vedsted P, Emery JD. The CanTest Framework for evaluating diagnostic strategies for early detection of cancer in primary care. BMC Cancer 2019, 19:586. doi: 10.1186/s12885-019-5746-6

Pannebakker MM, Mills K, Johnson M, Emery JD, Walter FM. Understanding implementation and usefulness of electronic clinical decision support (eCDS) for melanoma in English primary care: a qualitative investigation. Brit J Gen Pract Open 2019, 3 (1). doi: 10.3399/bjgpopen18X101635

Walter FM, Joannides A, Penfold C, Saji S, Johnson M, Watts C, Brodbelt A, Jenkinson MD, Price SJ, Hamilton W, Scott SE. Missed opportunities for diagnosing brain tumours in primary care? Findings from a qualitative study. Brit J Gen Pract 2019,. pii: bjgp19X701861. doi: 10.3399/bjgp19X701861

Barclay ME, Lyratzopoulos G, Walter FM, Jefferies S, Peake MD, Rintoul RC. Incidence of second and higher order smoking-related primary cancers following lung cancer: a population-based cohort study. Thorax 2019, pii: thoraxjnl-2018-212456. doi: 10.1136/thoraxjnl-2018-212456

Lee A, Mavaddat N, Wilcox AN, Cunningham A, Carver T, Hartley S, Babb de Villiers C, Izquierdo A, Simard J, Schmidt MK,  Walter FM, Garcia-Closas M, Tischkowitz M, Pharoah P, Easton DF, Antoniou AC. BOADICEA: a comprehensive breast cancer risk prediction model incorporating genetic and non-genetic risk factors. Genet Med 2019. doi: 10.1038/s41436-018-0406-9

Emery JD, Murray SR, Walter FM, Martin A, Goodall S, Campbell SC, Mazza D, Habgood E, Kutzer Y, Barnes D, Murchie P. The CHEST Australia Trial: a randomised controlled trial of an intervention to reduce time to consult with symptoms of lung cancer. Thorax 2019. thoraxjnl-2018-212506v1-thoraxjnl-2018-212506

Dinnes J, Deeks JJ, Chuchu N, Ferrante di Ruffano L, Matin RN, Thomson DR, Wong KY, Aldridge RB, Abbott R, Fawzy M, Bayliss SE, Grainge MJ, Takwoingi Y, Davenport C, Godfrey K, Walter FM, Williams HC, Cochrane Skin Cancer Diagnostic Test Accuracy Group. Dermoscopy, with and without visual inspection, for diagnosing melanoma in adults. Cochrane Database Syst Rev 2018, CD011902. doi: 10.1002/14651858.CD011902.pub2

Chuchu N, Takwoingi Y, Dinnes J, Matin RN, Bassett O, Moreau J, Bayliss SE, Davenport C, Godfrey K, Jain A, Walter FM, Deeks JJ, Williams HC, Cochrane Skin Cancer Diagnostic Test Accuracy Group. Smartphone applications for triaging adults with skin lesions that are suspicious for melanoma. Cochrane Database Syst Rev 2018, CD013192. doi: 10.1002/14651858.CD013192

Humphrys E, Burt J, Rubin G, Emery JD, Walter FM. The influence of health literacy on the timely diagnosis of symptomatic cancer: a systematic review. Euro J Cancer Care 2018, e12920. doi: 10.1111/ecc.12920

Wilson E, Usher-Smith J, Emery JD, Corrie P, Walter FM. A modelling study of the cost-effectiveness of a risk stratified screening programme for melanoma in the UK. Value Health 2018; 21:8:658-668. doi: 10.1016/j.jval.2017.11.009

Rubin G, Walter FM, Emery J, de Wit N. Re-imagining the diagnostic pathway for gastro-intestinal cancer. Nat Rev Gastro Hepat 2018, 5(3):181-188. doi: 10.1038/ nrgastro.2018.1

Emery JD, Gray V, Walter FM, Cheetham S, Croager EJ, Slevin T, Saunders C, Threlfall T, Auret K, Nowak AK, Geelhoed E, Bulsara M, Holman CDJ. The Improving Rural Cancer Outcomes (IRCO) Trial: a cluster-randomised controlled trial of a complex intervention to reduce time to diagnosis in rural cancer patients in Western Australia. Br J Cancer 2018, 118(6):e8. doi: 10.1038/ bjc.2017.457

Stewart TS, Moodley J, Walter FM. Population risk factors for late-stage presentation of cervical cancer in sub-Saharan Africa. Cancer Epidemiol 2018, 53:81-92. doi: 10.1016/j.canep.2018.01.014

Usher-Smith JA, Harshfield A, Saunders CL, Sharp SJ, Emery J, Walter FM, Muir K, Griffin SJ. External validation of risk prediction models for incident colorectal cancer using UK Biobank. Br J Cancer 2018, 118(5):750-759. doi: 10.1038/bjc.2017.463

Koo MM, Hamilton W, Walter FM, Rubin GP, Lyratzopoulos G. Symptom signatures and diagnostic timeliness in cancer patients: a review of current evidence. Neoplasia 2018, 20(2):165-174. doi: 10.1016/j.neo.2017.11.005

Zhou Y, Mendonca SC, Abel GA, Hamilton W, Walter FM, Johnson S, Shelton J, McPhail S, Elliss-Brookes L, Lyratzopoulos, G. Variation in ‘fast-track’ referrals for suspected cancer by patient characteristic and cancer diagnosis: evidence from 670,000 patients with cancers of 35 different sites. Br J Cancer 2018, 118(1):24-31. doi: 10.1038/bjc.2017.381

Emery JD, Gray V, Walter FM, et al. The Improving Rural Cancer Outcomes (IRCO) Trial: a cluster-randomised controlled trial of a complex intervention to reduce time to diagnosis in rural cancer patients in Western Australia. Br J Cancer 2017. doi: 10.1038/bjc.2017.310

Usher-Smith JA, Kassianos A, Emery JD, Abel GA, Teoh Z, Hall S, Neal RD, Murchie P, Walter FM. Identifying people at higher risk of melanoma across the UK: a primary care based electronic survey. Brit J Dermatol 2017, 176(4):939-948. doi: 10.1111/bjd.15181

Zhou Y, Abel GA, Hamilton W, Pritchard-Jones K, Gross CP, Walter FM, Renzi C, Johnson S, McPhail S, Elliss-Brookes L, Lyratzopoulos G. Diagnosis of cancer as an emergency: a critical review of current evidence. Nat Rev Clin Oncol 2017, 14(1):45-56. doi: 10.1038/nrclinonc.2016.155

Walter FM, Mills K, Mendonca S, Abel G, Basu B, Carroll N, Hamilton W, Rubin GP, Emery JD. Symptoms and patient factors associated with diagnostic intervals for pancreatic cancer (SYMPTOM pancreatic study): a prospective cohort study. Lancet Gastroenterol Hepatol 2016, (4):298-306. doi: 10.1016/S2468-1253(16)30079-6

Walter FM, Emery JD, Mendonca S, Hall N, Morris HC, Mills K, Dobson C, Bankhead C, Johnson M, Abel G,  Rutter M, Hamilton W, Rubin GP. Symptoms and patient factors associated with longer time to diagnosis for colorectal cancer: results from a prospective cohort study. Brit J Cancer 2016, 115(5):533-541. doi: 10.1038/bjc.2016.221

Hamilton W, Walter FM, Rubin G, Neal RD. Improving early diagnosis of symptomatic cancer. Nat Rev Clin Oncol 2016, 13(12):740-749. doi: 10.1038/nrclinonc.2016.109

Usher-Smith JA, Emery J, Hamilton W, Griffin S, Walter FM. Risk prediction tools for cancer in primary care. Br J Cancer 2015, 113(12):1645-50. doi: 10.1038/bjc.2015.409

Walter FM, Rubin G, Bankhead C, Morris HC, Hall N, Mills K, et al. First symptoms and other factors associated with time to presentation and diagnosis and stage at diagnosis of lung cancer: a prospective cohort study. Br J Cancer 2015; 112 Suppl:S6-S13. doi: 10.1038/bjc.2015.30

Rubin G, Berendsen A, Crawford SM, … Walter FM et al. The expanding role of primary care in cancer control. Lancet Oncol 2015, 16(12):1231-72. doi: 10.1016/S1470-2045(15)00205-3