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Exploring cancer detection and inequality: a forward focus through behavioural science

Kate Brain, Professor of Heath Psychology at Cardiff University and Theme 6 Cancer Research Strategy (CReSt) lead, sheds light on the evolving landscape of cancer early detection within the UK’s NHS and the challenges posed by inequalities, emphasising the critical need to evaluate public acceptance and impact through multidisciplinary research collaboration.

“The NHS has set an ambitious goal to detect 3 in 4 cancers at an early stage by 2028, a leap from the current 1 in 2. A myriad of novel technologies aims to meet this target, from rapid diagnostic centres to risk-stratified screening. One revolutionary aspect is multi-cancer early detection tests (MCEDs), hailed as potential game-changers. My research has delved deeper into understanding and addressing barriers to participation in cancer early detection and diagnosis, emphasising that without societal acceptance, these new innovations might struggle to gain traction and could inadvertently widen existing cancer inequalities. Behavioural science is well placed to address these challenges through carefully designed research studies.

My research primarily focuses on lung cancer screening, using low-dose CT scans for early detection in high-risk populations including individuals with smoking histories and those from socioeconomically deprived backgrounds. Yet, engaging these high-risk groups in screening remains a formidable challenge in part due to the stigma associated with lung cancer. The UK National Screening Committee now formally recommends targeted lung screening and my research has highlighted the existing evidence gaps in engaging these populations effectively, underscoring the need for further research to develop and evaluate interventions to close these gaps.

The emergence of MCED blood tests, designed to detect multiple cancer types in a single blood draw, presents a host of challenges. It will be essential to ensure that the potential benefits of MCEDS are equitable across all groups in society, and to involve diverse voices in MCEDs research for more equitable outcomes. We have started doing this through my work as the UK co-chair of the Health Equity Workgroup of the Multicancer Early Detection Consortium.

Looking ahead, with the help of the CReSt strategy, I envision a collaborative future, aiming for larger-scale, impactful research initiatives through programmatic funding. It is important to leverage resources within Wales and utilise data repositories like the SAIL databank and HealthWise Wales, for streamlined and robust research.

My vision and hope for the future is to forge stronger collaborations through CReSt and to utilise Wales’ resources to address health inequalities in cancer detection while striving for more ambitious and impactful research initiatives.”