A5022324670- BRCA gene mutations in cancer
- Ovarian cancer diagnosis and treatment
- Nutrition, Genetics, and Disease
- Endometrial and Cervical Cancer Treatments
- Cardiac, Anesthesia and Surgical Outcomes
- Endometriosis Research and Treatment
- Genetic Associations and Epidemiology
- COVID-19 and healthcare impacts
- Cancer Genomics and Diagnostics
- Intraperitoneal and Appendiceal Malignancies
- Advances in Oncology and Radiotherapy
- Genetic factors in colorectal cancer
- Surgical Simulation and Training
- Cervical Cancer and HPV Research
- Global Health and Surgery
- Reproductive Biology and Fertility
- CRISPR and Genetic Engineering
- Genetically Modified Organisms Research
- Testicular diseases and treatments
- Genomics and Rare Diseases
- Appendicitis Diagnosis and Management
- Ovarian function and disorders
- DNA Repair Mechanisms
- Health Systems, Economic Evaluations, Quality of Life
- Optimism, Hope, and Well-being
University of Aberdeen
2021-2025
University College London Hospitals NHS Foundation Trust
2025
University College Hospital
2025
University College London
2025
Royal Marsden Hospital
2023-2024
Nutrition Sciences (Belgium)
2024
Royal Ottawa Mental Health Centre
2024
Barts Health NHS Trust
2019-2023
Royal London Hospital
2020-2023
Queen Mary University of London
2016-2022
Clinical criteria/Family history-based BRCA testing misses a large proportion of carriers who can benefit from screening/prevention. We estimate the cost-effectiveness population-based in general population women across different countries/health systems. A Markov model comparing lifetime costs and effects BRCA1/BRCA2 all ≥30 years compared with clinical criteria/FH-based testing. Separate analyses are undertaken for UK/USA/Netherlands (high-income countries/HIC), China/Brazil (upper–middle...
Background BRCA carrier identification offers opportunities for early diagnoses, targeted treatment and cancer prevention. We evaluate BRCA- detection rates in general Ashkenazi Jewish (AJ) populations across Greater London estimate time-to-detection of all identifiable carriers. Methods data from 1993 to 2014 were obtained National Health Service genetic laboratories compared with modelled predictions prevalence published literature geographical UK Office Statistics. Proportion carriers...
Objective Unselected population‐based BRCA testing provides the opportunity to apply genomics on a population‐scale maximise primary prevention for breast‐and‐ovarian cancer. We compare long‐term outcomes of and family‐history ( FH )/clinical‐criteria‐based psychological health quality life. Design Randomised controlled trial RCT ) ISRCTN 73338115) GC PPS , with two‐arms: (i) population‐screening PS ); (ii) /clinical‐criteria‐based testing. Setting North London Ashkenazi‐Jewish AJ...
Epithelial tubo-ovarian cancer (EOC) has high mortality partly due to late diagnosis. Prevention is available but may be associated with adverse effects. A multifactorial risk model based on known genetic and epidemiological factors (RFs) for EOC can help identify women at higher who could benefit from targeted screening prevention.
Background Genome-wide association studies have identified >30 common SNPs associated with epithelial ovarian cancer (EOC). We evaluated the combined effects of EOC susceptibility on predicting risk in an independent prospective cohort study. Methods genotyped single nucleotide polymorphisms (SNPs) a nested case–control study (750 cases and 1428 controls) from UK Collaborative Trial Ovarian Cancer Screening trial. Polygenic scores (PRSs) were constructed their associations using logistic...
We present findings of a cancer multidisciplinary-team (MDT) coordinated mainstreaming pathway unselected 5-panel germline BRCA1/BRCA2/RAD51C/RAD51D/BRIP1 and parallel somatic BRCA1/BRCA2 testing in all women with epithelial-OC highlight the discordance between strategies across two centres. Patients were counselled consented by MDT member. The uptake multi-gene was 97.7%. Counselling clinical-nurse-specialist more frequently needed >1 consultation (53.6% (30/56)) compared to medical...
Background Risk-reducing salpingo-oophorectomy is the 'gold standard' for preventing tubo-ovarian cancer in women at increased risk. However, when performed pre-menopausal women, it results premature menopause and associated detrimental health consequences. This, together with acceptance of central role fallopian tube etiopathogenesis high-grade serous carcinoma, by far most common type cancer, has led to risk-reducing early salpingectomy delayed oophorectomy being proposed as a two-step...
This paper deals with the use of hormone replacement therapy (HRT) after removal fallopian tubes and ovaries to prevent ovarian cancer in premenopausal high risk women. Some women have an alteration their genetic code, which makes them more likely develop cancer. Two well-known genes can carry are BRCA1 BRCA2 genes. Examples other associated increased include RAD51C, RAD51D, BRIP1, PALB2 Lynch syndrome Women a strong family history and/or breast cancer, may also be at developing choose...
For healthcare institutions developing a robotic programme, delivering value for patients, clinicians, and payers is key. However, the impact on surgeon, training pathways, logistics are often overlooked. We conducted study of surgery surgeons, access to surgical training, factors associated with successful programme. In our international mixed-methods study, customised web-based survey was circulated gynaecological oncologists. The Wilcoxon rank-sum test Fisher's exact test, tested...
Although trials of neoadjuvant chemotherapy for ovarian cancer use 3 cycles, real world practice varies. We evaluated the effect higher order cycles chemotherapy, followed by cytoreduction surgery or no on survival, tumor resectability, and post-operative morbidity. For our international, retrospective cohort study, inclusion criteria were women with stage III to IV undergoing interval (after 3-4 chemotherapy) delayed (≥5 cycles) alone cycles). Multivariate regression analyses used model...
To evaluate factors affecting unselected population-based BRCA testing in Ashkenazi Jews (AJ).
The medical complexity of surgical patients is increasing, and risk calculators are crucial in providing high-value, patient-centered care. However, pre-existing models not validated to accurately predict for major gynecological oncology surgeries, many generalizable low- middle-income country settings (LMICs). international GO SOAR database dataset was used develop a novel predictive calculator post-operative morbidity mortality following surgery. Fifteen candidate features readily...
Unselected population-based personalised ovarian cancer (OC) risk assessment combining genetic/epidemiology/hormonal data has not previously been undertaken. We aimed to perform a feasibility study of OC stratification general population women using tool followed by management. Volunteers were recruited through London primary care networks. Inclusion criteria: ≥18 years. Exclusion prior ovarian/tubal/peritoneal cancer, previous genetic testing for genes. Participants accessed an...
Objective To determine risk‐reducing early salpingectomy and delayed oophorectomy (RRESDO) acceptability effect of surgical prevention on menopausal sequelae/satisfaction/regret in women at increased ovarian cancer (OC) risk. Design Multicentre, cohort, questionnaire study (IRSCTN:12310993). Setting United Kingdom (UK). Population UK without OC ≥18 years, risk, with/without previous RRSO, ascertained through specialist familial cancer/genetic clinics BRCA support groups. Methods Participants...
Background Acceptance of the role fallopian tube in ‘ovarian’ carcinogenesis and detrimental sequelae surgical menopause premenopausal women following risk-reducing salpingo-oophorectomy (RRSO) has resulted early-salpingectomy with delayed oophorectomy (RRESDO) being proposed as an attractive alternative strategy who decline/delay oophorectomy. We present results a qualitative study evaluating decision-making process among BRCA carriers considering prophylactic surgeries (RRSO/RRESDO) part...
Abstract Background Epithelial tubo-ovarian cancer (EOC) has high mortality partly due to late diagnosis. Prevention is available but may be associated with adverse effects. A multifactorial risk model based on known genetic and epidemiological factors (RFs) for EOC can help identify females at higher who could benefit from targeted screening prevention. Methods We developed a of European ancestry incorporating the effects pathogenic variants (PVs) in BRCA1, BRCA2, RAD51C, RAD51D BRIP1 ,...
<h3>Introduction/Background</h3> Acceptance of the role fallopian tubes in ovarian carcinogenesis and detrimental sequelae surgical menopause pre-menopausal women following risk reducing salpingo-oophorectomy (RRSO), has resulted early salpingectomy with delayed oophorectomy (RRESDO) being proposed as an attractive alternative strategy who decline/delay oophorectomy. We present results a qualitative study evaluating decision making process amongst BRCA carriers considering prophylactic...
Gynaecological malignancies affect women in low and middle income countries (LMICs) at disproportionately higher rates compared with high (HICs) little known about variations access, quality, outcomes global cancer care. Our study aims to evaluate international variation post-operative morbidity mortality following gynaecological oncology surgery between HIC LMIC settings. Study design consisted of a multicentre, prospective cohort undergoing for (NCT04579861). Multilevel logistic regression...