“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 per cent 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 90per cent 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, 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 the family’s weekend home in the Chilterns.
She is survived by Peter, her children, Juliet and Felix, two grandchildren, and her sister, Heather.
• Wendy Sheila Atkin, epidemiologist, born 5 April 1947; died 2 October 2018