Jane Wardle's research while affiliated with University College London and other places

Publications (807)

Article
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Objective: Ashkenazi-Jewish(AJ) population-based BRCA-testing is acceptable, cost-effective and amplifies primary prevention for breast-&-ovarian cancer. However, data describing lifestyle impact are lacking. We report long-term results of population-based BRCA-testing on lifestyle behaviour and cancer-risk perception. Design: Two-arm RCT (ISRCT...
Article
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Objective: To evaluate the association of Jewish cultural and religious identity and denominational affiliation with interest-in, intention-to undertake and uptake-of population-based BRCA (Breast Cancer Gene)-testing. Design: Cohort-study set within recruitment to GCaPPS-trial (ISRCTN73338115). Setting: London Ashkenazi-Jewish(AJ) population....
Article
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Objective: Unselected population-based BRCA testing provides the opportunity to apply genomics on a population-scale to maximise primary prevention for breast-and-ovarian cancer. We compare long-term outcomes of population-based and family-history (FH)/clinical-criteria-based BRCA testing on psychological health and quality of life. Design: Rand...
Conference Paper
Introduction/Background Unselected population-based BRCA-testing enables application of genomics on a population-scale to maximise primary-prevention for breast-&-ovarian cancer. We present factors affecting uptake and long-term follow-up results of the GCaPPS-trial comparing population-based and Family-History (FH)/Clinical-criteria based BRCA-tes...
Conference Paper
Objectives To evaluate the factors affecting interest, intention, uptake, and attitude towards unselected population-based BRCA-testing in the Ashkenazi Jewish (AJ) population. Methods Design: Cohort-study set within recruitment to the GCaPPS-trial (ISRCTN73338115). AJ women/men >18-years, from the North-London AJ-population were recruited through...
Article
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Objective To evaluate factors affecting unselected population‐based BRCA testing in Ashkenazi Jews (AJ). Design Cohort‐study set within recruitment to the GCaPPS trial (ISRCTN73338115). Setting North London AJ population. Population or sample Ashkenazi Jews women/men >18 years, recruited through self‐referral. Methods Ashkenazi Jews women/men u...
Chapter
Public awareness of the potential benefits and risks of cancer screening and attitudes towards screening are consistently found to be correlates of participation. In general, public enthusiasm for screening is high, although more detailed knowledge of risks and benefits is not always accurate, and new screening programmes may struggle to become nor...
Article
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Background Genetic risk assessment for breast cancer and ovarian cancer (BCOC) is expected to make major inroads into mainstream clinical practice. It is important to evaluate the potential impact on women ahead of its implementation in order to maximise health benefits, as predictive genetic testing without adequate support could lead to adverse p...
Article
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Background: Risk stratification using genetic and other types of personal information could improve current best available approaches to ovarian cancer risk reduction, improving identification of women at increased risk of ovarian cancer and reducing unnecessary interventions for women at lower risk. Amounts of information given to women may influ...
Article
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Objective: The aim of this study was to explore the potential effects of diet-induced weight loss on molecular biomarkers of colorectal cancer risk in serum and colorectal tissue. Methods: This single-arm exploratory study included 20 adults with BMI ≥ 30 kg/m2completing an 8-week, complete, low-energy liquid diet. Pre- and postintervention anth...
Article
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Purpose: Variability in the timing of infant developmental milestones is poorly understood. We used a twin analysis to estimate genetic and environmental influences on motor development and activity levels in infancy. Method: Data were from the Gemini Study, a twin birth cohort of 2,402 families with 10 twins born in the United Kingdom in 2007. Par...
Data
Copy of the questionnaire sent to eligible study participants. (PDF)
Article
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Background Presenting to primary care with potential cancer symptoms is contingent on one’s ability to recognize potentially serious symptoms. We investigated differences between smokers and non-smokers in symptoms experienced, awareness and consulting of potential respiratory, head and neck cancer symptoms. Methods Smokers and non-smokers aged ov...
Data
This table illustrates the study population representativeness. (PDF)
Article
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Background Uptake of colorectal cancer screening is low in the English NHS Bowel Cancer Screening Programme (BCSP). Participation in screening is strongly associated with socioeconomic status. The aim of this study was to determine whether a supplementary leaflet providing the ‘gist’ of guaiac-based Faecal Occult Blood test (gFOBt) screening for co...
Article
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Background Sociodemographic, health- and work-related factors have been found to influence return to work in cancer survivors. It is feasible though that behavioural factors, such as expectation of being at work, could also affect work-related outcomes. Therefore, the effect of earlier identified factors and expectation of being at work on future e...
Article
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Objectives In examining informed choice in cancer screening, we investigated public awareness that some screening programmes aim to prevent cancer, while others seek to detect cancer at an early stage. Methods A population-based survey of adults aged 50–70 in England (n = 1433), including data on demographic characteristics and screening experienc...
Article
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Objectives Response rates to health‐related surveys are declining. This study tested two strategies to improve the response rate to a health psychology survey mailed through English general practices: (1) sending a shortened questionnaire and (2) offering a monetary incentive to return a completed questionnaire. Design Randomized controlled trial....
Article
Life skills play a key role in promoting educational and occupational success in early life, but their relevance at older ages is uncertain. Here we measured five life skills-conscientiousness, emotional stability, determination, control, and optimism-in 8,119 men and women aged 52 and older (mean 66.7 y). We show that the number of skills is assoc...
Article
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Background Obesity in pregnancy is associated with insulin resistance, which underpins many common complications including gestational diabetes mellitus (GDM) and fetal macrosomia. Objectives To assess the effect of a complex behavioural intervention based on diet and physical activity (PA) on the risk of GDM and delivery of a large-for-gestationa...
Article
Background The UK guideline recommends 3-yearly surveillance for patients with intermediate-risk (IR) adenomas. No study has examined whether or not this group has heterogeneity in surveillance needs. Objectives To examine the effect of surveillance on colorectal cancer (CRC) incidence; assess heterogeneity in risk; and identify the optimum freque...
Article
Background: There is evidence that birthweight is positively associated with body mass index (BMI) in later life, but it remains unclear whether this is explained by genetic factors or the intrauterine environment. We analysed the association between birthweight and BMI from infancy to adulthood within twin pairs, which provides insights into the...
Article
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Background Bowel cancer screening reduces cancer-specific mortality. There is a socioeconomic gradient in the uptake of the English NHS Bowel Cancer Screening Programme (BCSP), which may lead to inequalities in cancer outcomes. Objective To reduce socioeconomic inequalities in uptake of the NHS BCSP’s guaiac faecal occult blood test (gFOBt) withou...
Article
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Background Cancer screening invitations can explicitly recommend attendance or encourage individuals to consider the risks and benefits before deciding for themselves. Public preferences for these approaches might vary. We explored ethnic minority women’s preferences for a strong recommendation to be screened. Methods Women aged 30–60 years from In...
Article
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Ovarian cancer is the fifth most common cancer in UK women, and the leading cause of gynaecological cancer death. Five-year survival rates, of around 40%, have shown little improvement despite recent advances in cancer treatment. Mutations in the cancer susceptibility genes BRCA1 and BRCA2 confer lifetime risks of breast and ovarian cancer of up to...
Article
Objective: Randomised controlled trials are required to address causality in the reported associations between maternal influences and offspring adiposity. The aim of this study was to determine whether an antenatal lifestyle intervention in obese pregnant women associated with improved maternal diet and reduced gestational weight gain leads to a...
Article
Limited literature exists on attitudes towards, knowledge of and where cancer survivors seek information on physical activity. This study aimed to address these gaps in the literature. Interviews were conducted with 19 UK-based adult cancer survivors. Interviews covered participants’ knowledge of the relationship between physical activity and cance...
Article
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Background: Excess adiposity is a risk factor for poorer cancer survival, but there is uncertainty over whether losing weight reduces the risk. We conducted a critical review of the literature examining weight loss and mortality in overweight or obese cancer survivors. Methods: We systematically searched PubMed and EMBASE for articles reporting...
Chapter
There is no clear consensus on whether stress reliably leads to increased or decreased caloric intake, although shifts in food choice seem likely. Research suggests the relationship between stress and changes in food intake is moderated by individual differences in psychological and physiological pathways as well as the type of stressor and the foo...
Article
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Objective To test whether the number of reports of enjoyment of life over a four year period is quantitatively associated with all cause mortality, and with death from cardiovascular disease and from other causes. Design and setting Longitudinal observational population study using the English Longitudinal Study of Ageing (ELSA), a nationally repre...
Article
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Background Understanding dietary patterns in obese pregnant women will inform future intervention strategies to improve pregnancy outcomes and the health of the child. The aim of this study was to investigate the effect of a behavioral intervention of diet and physical activity advice on dietary patterns in obese pregnant woman participating in the...
Article
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Introduction Positive health behaviours such as regular physical activity and a healthy diet have significant effects on cancer outcomes. There is a need for simple but effective behaviour change interventions with the potential to be implemented within the cancer care pathway. Habit-based advice encourages repetition of a behaviour in a consistent...
Article
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Background: The NHS Bowel Cancer Screening Programme in England offers biennial guaiac faecal occult blood testing (gFOBt). There is a socioeconomic gradient in participation and socioeconomically disadvantaged groups have worse colorectal cancer survival than more advantaged groups. We compared the effectiveness and cost of an enhanced reminder l...
Article
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Background The act of detecting bodily changes is a pre-requisite for subsequent responses to symptoms, such as seeking medical help. This is the first study to explore associations between self-reported body vigilance and help-seeking in a community sample currently experiencing cancer ‘alarm’ symptoms. Methods Using a cross-sectional study desig...
Article
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Background: Primary care is the 'first port of call' for weight control advice, creating a need for simple, effective interventions that can be delivered without specialist skills. Ten Top Tips (10TT) is a leaflet based on habit-formation theory that could fill this gap. The aim of the current study was to test the hypothesis that 10TT can achieve...
Article
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Background Cancer screening is a behavior that represents investment in future health. Such investment may depend on how much ‘future’ a person expects. PurposeThe purpose of this study was to investigate the prospective association between perceived personal life expectancy and participation in fecal occult blood test screening for colorectal canc...
Article
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Background: we aimed to develop and validate a population-representative 10-year mortality risk index for older adults in England. Methods: data were from 10,798 men and women aged 50 years and older in the population-based English Longitudinal Study of Ageing in 2002/03, randomly split into development (n = 5,377) and validation cohorts (n = 5,...
Article
Objective: Inequalities exist in colorectal cancer (CRC) screening uptake, with people from lower socioeconomic status backgrounds less likely to participate. Identifying the facilitators and barriers to screening uptake is important to addressing screening disparities. We pooled data from 2 trials to examine educational differences in psychologica...
Article
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Background To assess public preferences for colorectal cancer (CRC) surveillance tests for intermediate-risk adenomas, using a hypothetical scenario. Methods Adults aged 45–54 years without CRC were identified from three General Practices in England (two in Cumbria, one in London). A postal survey was carried out during a separate study on preferen...
Article
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Background To assess public preferences for colorectal cancer (CRC) surveillance tests for intermediate-risk adenomas, using a hypothetical scenario. Methods Adults aged 45–54 years without CRC were identified from three General Practices in England (two in Cumbria, one in London). A postal survey was carried out during a separate study on preferen...
Article
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Objective Determine whether (fictitious) health screening test benefits affect perceptions of (unrelated) barriers, and barriers affect perceptions of benefits. Methods UK adults were recruited via an online survey panel and randomised to receive a vignette describing a hypothetical screening test with either high or low benefits (higher vs. lower...
Article
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Objective: Cancer has long inspired fear but the effect of fear is not well understood; it seems both to facilitate and deter early diagnosis behaviours. To elucidate fear's behavioural effects, we systematically reviewed and synthesised qualitative literature to explore what people fear about cancer. Methods: We searched Medline, Embase, PsycIn...
Poster
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This poster describes an RCT to assess the impact of a 12 month reminder within the English NHS Bowel Scope Screening Programme on uptake of Bowel Scope Screening (Flexible Sigmoidoscopy)
Article
The home environment is likely to influence children's diet and activity patterns and ultimately, their weight trajectories. Identifying family characteristics associated with a more ‘obesogenic’ home can provide insight into the determinants, and has implications for targeting and tailoring strategies to promote healthier lifestyles. The present s...
Article
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Background: This study explored differences in sexual activity, function, and concerns between cancer survivors and cancer-free controls in a population-based study. Methods: The data were from 2982 men and 3708 women who were 50 years old or older and were participating in the English Longitudinal Study of Ageing. Sexual well-being was assessed...
Article
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Background: Eating self-regulatory capacity can help individuals to cope with the obesogenic environment and achieve, as well as maintain, a healthy weight and diet. At present, there is no comprehensive, reliable and valid questionnaire for assessing this capacity and measuring change in response to self-regulation interventions in adults. This p...
Article
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Background: The NHS Cancer Screening Programmes in England now operate a policy of 'informed choice' about participation in cancer screening. Engagement with written information about screening is important to facilitate informed choice, although the degree to which the screening-eligible public engages with the available information is unknown. W...
Article
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Background Advances in genetic technologies are expected to make population-wide genetic testing feasible. This could provide a basis for risk stratified cancer screening; but acceptability in the target populations has not been explored. Methods We assessed attitudes to risk-stratified ovarian cancer (OC) screening based on prior genetic risk ass...