Wendy Atkin Epi­demi­ol­o­gist whose re­search led to a vi­tal break­through in bowel can­cer screen­ing

The Guardian - Journal - - Obituaries - Ara Darzi

Break­through is an overused word when ap­plied to med­i­cal ad­vances. But in the case of the 2010 trial of a new screen­ing test for bowel can­cer led by Wendy Atkin, pro­fes­sor of gas­troin­testi­nal epi­demi­ol­ogy at Im­pe­rial Col­lege Lon­don, who has died of acute myeloid leukaemia aged 71, it is fully de­served. Its im­pact will be felt by mil­lions.

The trial was the first in the world to show that bowel can­cer – the sec­ond biggest can­cer killer in the UK – could be pre­vented with a sim­ple, five-minute test.

The ex­am­i­na­tion – where a sig­moi­do­scope (a cam­era mounted on a thin, flex­i­ble tube) is in­serted into the rec­tum to de­tect polyps, which are then ab­lated (burnt) or snipped off – is now be­ing of­fered to all 55- to 60-year-olds in Eng­land af­ter a fol­low-up study showed it re­duced deaths from bowel can­cer by 43% for as long as 17 years af­ter screen­ing, mak­ing it the most ef­fec­tive of all can­cer screen­ing tests. In the lower bowel, the test pre­vented half of po­ten­tial can­cers from de­vel­op­ing in that area.

More­over, de­tec­tion, di­ag­no­sis and treat­ment are de­liv­ered at the same time in one brief ap­point­ment, with no need for a re­peat – ever. Can­cer screen­ing was never so worth­while. Sim­i­lar schemes are now be­ing de­vel­oped in other coun­tries.

Atkin knew that bowel can­cer nor­mally starts in the polyps, which had been the sub­ject of her 1991 PhD from Univer­sity Col­lege Lon­don, and she rea­soned that a screen­ing pro­gramme to re­move them might pre­vent the can­cer de­vel­op­ing. Af­ter two pi­lot stud­ies the main trial was launched in 1994, and its re­sults pub­lished in the Lancet in 2010. It was a huge chal­lenge, in­volv­ing the re­cruit­ment of more than 170,000 peo­ple in 14 cen­tres around the UK.

What is re­mark­able is that the trial was com­pleted at all. Bowel can­cer is 90% cur­able if caught early but half of those who get it die from it be­cause they are too squea­mish to look for warn­ing signs, such as blood in the fae­ces, or too em­bar­rassed to go to the doc­tor when they ap­pear. Crit­ics said at the time that peo­ple would never vol­un­teer for such a test.

Atkin re­cruited Pro­fes­sor Jane War­dle, di­rec­tor of the health be­hav­iour re­search unit at UCL, to help per­suade peo­ple to get in­volved. And once per­suaded, the test was well re­ceived. War­dle, who died in 2015, said at the time: “Most peo­ple thought the whole pro­ce­dure was ab­so­lutely fan­tas­tic … We mea­sured well­be­ing be­fore and af­ter. Screen­ing seemed to make peo­ple hap­pier.”

That Atkin suc­ceeded is a trib­ute to her en­ergy, en­thu­si­asm and com­mit­ment to the cause. She was a for­mi­da­ble statis­ti­cian, which was cru­cial in per­suad­ing her main fun­der, Can­cer Re­search UK, to back the trial. She was highly fo­cused, and pushed till she got what she wanted. She once told me: “I don’t do fail­ure.” Six months af­ter the trial the gov­ern­ment pledged £60m to in­cor­po­rate flex­i­ble sig­moi­doscopy into the NHS screen­ing pro­gramme.

Although ex­act­ing in her stan­dards, Atkin also cared deeply for her team, was some­one peo­ple turned to for ad­vice, and was open and gen­er­ous to­ward her suc­ces­sors.

Born in Bow, east Lon­don,

Wendy was the el­der daugh­ter of Gella (nee Bin­der), who worked for Gen­eral Mo­tors, and David Green, a phar­ma­cist. Af­ter Streatham and Clapham high school, Wendy fol­lowed her fa­ther by en­rolling in the Chelsea School of Phar­macy, King’s Col­lege, in 1965. There, at a so­cial event, she met Peter Atkin, a law stu­dent, and they mar­ried in 1971.

Atkin be­gan her ca­reer in clin­i­cal re­search for the Well­come Foun­da­tion and the drug in­dus­try, but in 1982, fol­low­ing the birth of their two chil­dren, Peter’s work took the fam­ily to New York, where she stud­ied for a mas­ter’s de­gree in pub­lic health at Columbia Univer­sity.

The fam­ily re­turned to the UK in 1985 and af­ter Atkin com­pleted her PhD she worked for the Im­pe­rial Can­cer Re­search Fund, then at St Mark’s hos­pi­tal, a spe­cial­ist bowel hos­pi­tal in north-west Lon­don.

In 1997, she was ap­pointed hon­orary se­nior lec­turer at Im­pe­rial Col­lege Lon­don, where she de­vel­oped the 2002 Na­tional In­sti­tute for Health and Care Ex­cel­lence (Nice) guide­lines for mon­i­tor­ing peo­ple with col­orec­tal polyps that are still in use to­day.

She was ap­pointed pro­fes­sor in 2004 and set up the can­cer screen­ing and pre­ven­tion re­search group at Im­pe­rial in 2008, con­tribut­ing to a range of screen­ing re­search in can­cer of the breast and pan­creas as well as bowel. She was ap­pointed OBE in 2013.

She stepped down last Novem­ber due to ill health and re­tired in May. Out­side work, her in­ter­ests were her fam­ily, play­ing the flute, her Mon­day bridge party with friends and walk­ing in the coun­try­side near her week­end home in the Chilterns.

She is sur­vived by Peter, her chil­dren, Juliet and Felix, two grand­chil­dren, and her sis­ter, Heather.

Most peo­ple thought the whole pro­ce­dure was ab­so­lutely fan­tas­tic. Screen­ing seemed to make them hap­pier

JOHN NI­CHOL­SON

Atkin was a good statis­ti­cian, which was cru­cial in per­suad­ing Can­cer Re­search UK to back her test tri­als

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