October APEx Seminar - Dr Sam Merriel & Dr Garth Funston

October APEx Seminar - Dr Sam Merriel & Dr Garth Funston

Speaker: Dr Sam Merriel

Talk Title: 'Modernising General Practice TESTing for the detection of clinically significant PROstate cancer: The GP-TEST-PRO study’

Abstract: Prostate cancer is the most common cancer in UK men, with over 50,000 new cases each year. The route to diagnosis for over 80% of men with prostate cancer starts in primary care. Prostate Specific Antigen (PSA) is the only test currently available to GPs for detecting prostate cancer and has some well-established limitations, including false positive results and over diagnosis of slow-growing tumours. Recent advances in prostate cancer diagnostics are impacting secondary care pathways and risk-stratified approaches to prostate cancer screening, but there is a dearth of primary care evidence. The GP-TEST-PRO study will be a fully paired, prospective, diagnostic cohort study comparing the performance of PSA to promising new biomarker, imaging, and genomic tests with the aim of improving the early detection of clinically significant prostate cancer in primary care.

Bio: Dr Sam Merriel is an NHS GP working in the North-West of England and NIHR/MRC EME Advanced Fellow. He is part of the Centre for Primary Care and Health Services Research at the University of Manchester, where he leads the Manchester Primary care Cancer research Team (MPaCT). His main research interests are in the early detection and prevention of cancer and the evaluation and implementation of new diagnostic tests in primary care. After obtaining his medical degree in Australia, he moved to the UK where he undertook an NIHR Academic Clinical Fellowship in General Practice, working within the Centre for Academic Primary Care at the University of Bristol. He completed his PhD on prostate cancer imaging with Professor Willie Hamilton at the University of Exeter, funded by a Cancer Research UK Catalyst Award (CanTest) before moving to Manchester in 2022. Sam serves as an Associate Editor and Editorial Board member for the British Journal of General Practice (BJGP) and is deputy lead for the Cancer Prevention & Early Detection theme of the NIHR Manchester Biomedical Research Centre.

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Speaker: Dr Garth Funston

Talk Title: Optimising diagnostic pathways for ovarian cancer: a risk based triage approach  

Abstract: Cancer antigen 125 (CA125) is recommended as a first line test in women with possible symptoms of ovarian cancer in general practice. However, the current CA125 threshold is not based on primary care evidence. The Ovatools models were developed and validated using primary care data from over 300,000 women and provide the risk of ovarian cancer based on a woman’s age and CA125 level. A recent health economic evaluation indicates that using Ovatools, or ‘age-specific’ CA125 thresholds to triage women for ultrasound or urgent cancer referral is likely to be cost effective and could improve patient outcomes. Similar risk-based triage approaches, guided by health economic evidence, could be used to help optimise referral thresholds and diagnostic pathways for other cancers and health conditions.  

Bio: Garth is an academic GP at the Wolfson Institute of Population Health at Queen Mary University of London, where he Co-Leads the Cancer Early Diagnosis Unit. His research focuses on developing and evaluating approaches for the prevention and early detection of cancer within primary care. He has a particular interest in diagnostic test evaluation, risk prediction modelling and cancer inequalities. 

Garth undertook clinical training at the Universities of St Andrews and Cambridge followed by clinical academic training posts (Academic Foundation Programme and NIHR Academic Clinical Fellowship) in Manchester. In 2021 he completed a Cancer Research UK funded PhD at the University of Cambridge, which focused on the detection of ovarian cancer in primary care. He was appointed Clinical Senior Lecturer in Primary Care Cancer Research at QMUL in 2023.