Professor of Primary Care Cancer Research

MA, MD, FRCGP

Honorary Senior Visiting Fellow

The Primary Care Unit, Department of Public Health and Primary Care

Email: fmw22@medschl.cam.ac.uk

Twitter: @fmw22

Background and Research Interests

Professor Fiona Walter is Director of the Wolfson Institute of Population Health at Queen Mary University of London and Professor of Primary Care Cancer Research. She joined in April 2021 after serving as Reader in Primary Care Cancer Research in the Primary Care Unit, Department of Public Health and Primary Care at the University of Cambridge, and she continues to work with the Cancer Group as a Honorary Senior Visiting Fellow. Our work is focused on primary care oncology and the patient pathway, using a wide range of approaches including mixed methods and trials set in general practice.

Fiona also co-leads the CanTest Collaborative, an international collaborative programme funded by Cancer Research UK, 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.

Fiona is a member of the NIHR-Department of Health’s Policy Research Unit for cancer awareness, screening and early diagnosis. She also has a portfolio of global cancer research, including studies on cancer prevention and early detection in Australia; on improving outcomes for women with breast and cervical cancer in sub-Saharan Africa – AWACAN; and on symptomatic lung cancer outcomes in the US.

Fiona has been a member of Cancer Research UK’s Early Detection and Diagnosis Research Committee since inception. She is also a member of the NCRI Screening, Prevention and Early Diagnosis (SPED) group, and ex-chair of the NCRI Primary Care Clinical Studies Group’s Early Diagnosis group.

Selected Recent Key Publications

1. Calanzani N, Druce P, Snudden C, et al. Identifying novel biomarkers ready for evaluation in low-prevalence populations for the early detection of upper gastrointestinal cancers: a systematic review. Adv Ther 2020. doi: 10.1007/s12325-020-01571-z
2. Funston G, Hamilton W, Abel GAA, Crosbie EJ, Rous B, Walter FM. The diagnostic performance of CA125 for the detection of ovarian and non-ovarian cancer in primary care: A population-based cohort study. PLoS Med 2020. doi: 10.1371/journal.pmed.1003295
3. Moodley J, Constant D, Mwaka AD, Scott SE, Walter FM. Mapping awareness of breast and cervical cancer risk factors, symptoms and lay beliefs in Uganda and South Africa. PLoS One 2020. doi: 10.1371/journal.pone.0240788
4. Fitzgerald RC, di Pietro M, O’Donovan M, et al. Cytosponge-trefoil factor 3 versus usual care to identify Barrett’s oesophagus in a primary care setting: a multicentre, pragmatic, randomised controlled trial. The Lancet 2020. doi: 10.1016/S0140-6736(20)31099-0
5. Helsper CW, Campbell C, Emery J, et al. Cancer has not gone away: A primary care perspective to support a balanced approach for timely cancer diagnosis during COVID‐19. Euro J Cancer Care 2020. doi: 10.1111/ecc.13290
6. Zhou Y, Abel GA, Hamilton W, Singh H, Walter FM, Lyratzopoulos G. Imaging activity possibly signalling missed diagnostic opportunities in bladder and kidney cancer: A longitudinal data-linkage study using primary care electronic health records. Cancer Epidemiol 2020. doi: 10.1016/j.canep.2020.101703
7. Archer S, Babb de Villiers C, Scheibl F, et al. Evaluating clinician acceptability of the prototype CanRisk tool for predicting risk of breast and ovarian cancer: a multi-methods study. PLOS One 2020. doi: 10.1371/journal.pone.0229999
8. Walter FM, Pannebakker MP, Barclay ME, et al. Effect of a Skin Self-monitoring Smartphone Application on Time to Physician Consultation Among Patients With Possible Melanoma: A Phase 2 Randomized Clinical Trial. JAMA Netw Open 2020. doi: 10.1001/jamanetworkopen.2020.0001
9. Freeman K, Dinnes J, Chuchu N, et al. Algorithm based smartphone apps to assess risk of skin cancer in adults: systematic review of diagnostic accuracy studies. Brit Med J 2020. doi: 10.1136/bmj.m127
10. Renzi C, Kaushal A, Emery J, et al. Comorbid chronic diseases and cancer diagnosis: disease-specific effects and underlying mechanisms. Nat Rev Clin Oncol 2019. doi: 10.1038/s41571-019-0249-6
11. Walter FM, Thompson MJ, Wellwood I, et al. Evaluating diagnostic strategies for early detection of cancer: the CanTest framework. BMC Cancer 2019. doi: 10.1186/s12885-019-5746-6
12. Walter FM, Joannides A, Penfold C, et al. Missed opportunities for diagnosing brain tumours in primary care? Findings from a qualitative study. Brit J Gen Pract 2019. doi: 10.3399/bjgp19X701861
13. Lee A, Mavaddat N, Wilcox AN, et al. 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
14. Emery JD, Murray SR, Walter FM, et al. The CHEST Australia Trial: a randomised controlled trial of an intervention to reduce time to consult with symptoms of lung cancer. Thorax 2019. doi: 10.1136/thoraxjnl-2018-212506
15. Rubin G, Walter FM, Emery J, de Wit N. Re-imagining the diagnostic pathway for gastro-intestinal cancer. Nat Rev Gastro Hepat 2018. doi: 10.1038/ nrgastro.2018.1
16. Zhou Y, Mendonca SC, Abel GA, et al. 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. doi: 10.1038/bjc.2017.381
17. 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
18. Usher-Smith JA, Kassianos A, Emery JD, et al. Identifying people at higher risk of melanoma across the UK: a primary care based electronic survey. Brit J Dermatol 2017. doi: 10.1111/bjd.15181
19. Zhou Y, Abel GA, Hamilton W, et al. 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
20. Walter FM, Mills K, Mendonca S, et al. Symptoms and patient factors associated with diagnostic intervals for pancreatic cancer (SYMPTOM pancreatic study): a prospective cohort study. Lancet Gastroenterol Hepatol 2016. doi: 10.1016/S2468-1253(16)30079-6
21. Walter FM, Emery JD, Mendonca S, et al. Symptoms and patient factors associated with longer time to diagnosis for colorectal cancer: results from a prospective cohort study. Brit J Cancer 2016. doi: 10.1038/bjc.2016.221
22. Hamilton W, Walter FM, Rubin G, Neal RD. Improving early diagnosis of symptomatic cancer. Nat Rev Clin Oncol 2016. doi: 10.1038/nrclinonc.2016.109
23. Usher-Smith JA, Emery J, Hamilton W, Griffin S, Walter FM. Risk prediction tools for cancer in primary care. Br J Cancer 2015. doi: 10.1038/bjc.2015.409
24. Walter FM, Rubin G, Bankhead C, 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. doi: 10.1038/bjc.2015.30
25. Rubin G, Berendsen A, Crawford SM, et al. The expanding role of primary care in cancer control. Lancet Oncol 2015. doi: 10.1016/S1470-2045(15)00205-3