In 2012, cancer was responsible for around 8 million deaths globally and, despite improvements in survival seen in recent decades, remains a major cause of death. The most common types of cancer in males are lung cancer, prostate cancer, colorectal cancer, and stomach cancer, and in females, the most common types are breast cancer, colorectal cancer, lung cancer, and cervical cancer.
CTSU’s involvement in research to understand the risk factors causing cancer dates back to the 1950s with Richard Doll’s landmark study of British Doctors that showed for the first time the association between smoking and lung cancer. Doll’s work into the causes of cancer continued when he moved to Oxford in 1969 in collaboration with his colleague Richard Peto, with both of them establishing CTSU in 1975.
Our work to better understand the causes and evaluating effective ways to prevent and treat cancer continue to the present day. Our studies are diverse in nature, including a programme of randomised trials in the treatment of childhood and adult leukaemia that have contributed to the significant improvements in patient survival seen in recent decades through to population based studies to understand the risk of cancer associated with environmental radon exposure . Our work also extends to better understanding the benefits and any hazards of common treatments for cancer. For example, this work has shown a small, but significant increase in the risk of heart disease in cancer patients after receiving radiotherapy and this finding has resulted in a change in treatment guidelines.
CTSU’s work in the treatment of breast cancer has made a major contribution to the improvement of survival seen in women in developed countries in the last few decades. Most notably, the ATLAS trial has clearly demonstrated the benefits of treating women for longer with tamoxifen and since the 1980s CTSU has worked with breast cancer trialists around the world to assemble the totality of trial evidence on the treatment of early breast cancer. The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) meta-analyses provide a definitive summary of the randomised evidence about the long-term outcomes of treatments for women with early breast cancer and continues to have a substantial impact on treatment guidelines.
CTSU is also exploring the effects of aspirin on cancer in the ASCEND trial of 15,000 people with diabetes (but who do not have any history of regular disease). Previous trials have suggested that aspirin may reduce the risk of colorectal cancer and perhaps, other cancers. But this needs to be studied in more detail and with larger numbers of cancers. The ASCEND trial has the advantage of a somewhat longer durationof aspirin use (approximately seven years) and will be able to follow trial participants indefinitely through health record linkage.