Reader/Principal Researcher in Primary Care Cancer Research

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

Honorary Clinical 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

Fiona leads 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. Her research expertise lies across the primary care research spectrum and includes randomised controlled trials, cohort studies and systematic reviews; she has a particular interest in patient experiences and qualitative and mixed methods approaches.

She has won research grants totalling more than £25 million in the UK and AU$5 million in Australia, and published over 180 peer reviewed articles including in Nature, Lancet, BMJ and JAMA. Fiona co-leads 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. She is 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. Her international work is marked by an honorary academic role at the University of Melbourne, Australia, where she contributes to parallel programmes of work on improving outcomes for cancer patients. She also co-leads research in South Africa and Uganda, and contribute to research in Europe (Denmark, the Netherlands) and the US. Her 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 her role as Training Lead for Cambridge in the NIHR School for Primary Care Research.

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