Category: Cancer

  • Bowel cancer: risk factors, genetic testing and screening explained

    Bowel cancer: risk factors, genetic testing and screening explained

    Bowel cancer is the third most common cancer in the UK, affecting men and women in roughly equal numbers. But many cases are preventable, and when it is caught early, survival rates are high. This guide covers what raises your risk, how inherited gene mutations are involved, and what screening is available.

    In this guide

    1. What causes bowel cancer?
    2. Family history and genetic risk
    3. Lifestyle risk factors
    4. Symptoms to know about
    5. Screening options
    6. Genetic testing for inherited risk
    7. Support and further information

    What causes bowel cancer?

    No single thing causes bowel cancer. For most people it comes down to a combination of genetics, lifestyle, age, and chance. Cases are most common after 45, but we are seeing a significant rise in bowel cancer in younger adults. Cases under 50 are predicted to double in the next ten years, which is one reason why earlier screening and genetic testing matter more than they used to.

    The good news is that bowel cancer is often slow to develop. The process from a normal bowel cell to a polyp to a cancer typically takes over ten years. That window is an opportunity. Identifying risk early, and screening at the right time, gives us a real chance to detect cancers before they cause symptoms, and in some cases to prevent them altogether.

    Family history and genetic risk

    Family history

    Having a parent or sibling with bowel cancer more than doubles your risk. If a close relative had polyps removed, your risk may also be elevated by as much as 35%. Family history matters even when there is no known genetic mutation, and it should always be factored into decisions about when to start screening.

    Inherited gene mutations

    Around 5% to 10% of bowel cancers are caused by an inherited fault in a gene. These mutations account for around 35% of bowel cancers diagnosed under the age of 50. The main conditions to know about are:

    Lynch syndrome is the most common inherited cause of bowel cancer. It is caused by mutations in one of five genes: MLH1, MSH2, MSH6, PMS2, and EPCAM. These genes normally produce proteins that repair errors in DNA. When they do not work properly, errors accumulate in bowel cells over time, making cancer more likely. Bowel cancer risk in Lynch syndrome ranges from around 12% to 75% by age 75, depending on which gene is affected. Lynch syndrome is also linked to cancers of the womb, ovaries, stomach, kidneys, and other organs, so a family history of any of these is relevant.

    Familial adenomatous polyposis (FAP) is caused by a mutation in the APC gene. It causes large numbers of polyps to develop in the bowel from childhood. Without treatment, up to 90% of people with FAP will develop bowel cancer by age 45. Some APC mutations cause a milder form, with fewer polyps and cancer developing slightly later, on average around age 54.

    MUTYH-associated polyposis (MAP) is caused by mutations in the MUTYH gene. People are usually only significantly affected if they inherit two faulty copies of the gene, one from each parent. The lifetime bowel cancer risk with two MUTYH mutations is estimated at between 43% and 100%. People with one faulty copy may also have a modestly increased risk.

    Other rarer mutations linked to bowel cancer risk include POLE, POLD1, MSH3, and NTHL1.

    Other health factors

    People with type 2 diabetes have a 22% to 33% higher risk of bowel cancer than those without. Inflammatory bowel disease, particularly ulcerative colitis, also raises risk. Previous radiotherapy to the abdomen or pelvis is another factor worth flagging to your GP.

    Lifestyle risk factors

    Alcohol

    Around two units of alcohol per day is associated with roughly a 4% increase in bowel cancer risk. As with most cancers, risk increases with the amount consumed.

    Weight and body fat

    Being overweight increases the risk of bowel polyps and bowel cancer. Weight carried around the abdomen is particularly significant. Visceral fat, the fat stored around the internal organs, is more metabolically active and more directly linked to cancer risk than fat stored under the skin. Waist measurement gives a rough guide, but an MRI body composition scan provides a more accurate picture.

    Exercise

    Regular physical activity has a meaningful protective effect. Brisk walking for 30 minutes five days a week can lower bowel cancer risk by up to 50%. This is one of the largest modifiable risk reductions available for any common cancer.

    Smoking

    Current smokers have around a 21% higher risk of bowel cancer compared to people who have never smoked.

    Diet

    Processed meat, including sausages, bacon, and ham, is associated with increased bowel cancer risk. High-quality unprocessed red meat eaten once or twice a week is likely to carry much lower risk as part of a balanced diet. A diet high in fibre supports a healthy gut microbiome and is recommended by the World Cancer Research Fund as a way to reduce bowel cancer risk. There is also some evidence that calcium-rich foods may be protective.

    Symptoms to know about

    Most bowel cancers found through screening are detected before any symptoms appear. But knowing the warning signs matters. See a GP promptly if you notice any of the following. None of these automatically means cancer, but all of them should be investigated.

    Bleeding from the back passage. Blood in your stools. A change in how often you go to the toilet, or persistent diarrhoea or constipation. Unexplained weight loss. Persistent tiredness without an obvious cause. A pain or lump in your abdomen.

    Screening options

    At-home stool testing

    Stool testing looks for tiny amounts of blood in a sample, invisible to the naked eye, that can indicate bleeding from the bowel. A small sample is collected at home, placed in a tube, and posted to a laboratory. A positive result doesn’t mean you definitely have cancer, but it means further investigation, usually a colonoscopy, is recommended.

    The NHS in England currently offers at-home stool testing to people aged 54 to 74, every two years, sent automatically to your registered address. People aged 75 and over can request a kit. Those at higher risk due to a known inherited condition may be offered earlier or more frequent testing.

    At Coyne Medical, we offer at-home stool testing from age 45, earlier than the NHS programme. We also use a lower detection threshold than the NHS standard, which means we identify more potential cases at an earlier stage. Testing is available every year rather than every two years. Annual testing in large studies has been shown to reduce the risk of dying from bowel cancer by around 33% over 30 years. The cost is £84, including the kit, results, and a free GP follow-up consultation for any abnormal result. You can add the test to any GP consultation and we include it with all our Health Screening Packages.

    Colonoscopy

    Colonoscopy is the most thorough bowel cancer screening test available, with a sensitivity of around 95% and the ability to both detect and remove polyps in the same procedure. Long-term data shows it can reduce bowel cancer incidence by 31% to 71% and mortality by 65% to 88%.

    A thin flexible camera is passed through the bowel, allowing direct inspection of the entire bowel lining. If polyps are found they can be removed immediately, which reduces future cancer risk. The preparation involved, a special diet and bowel-clearing medication beforehand, puts some people off, but the procedure itself is usually well tolerated. There is a very small risk of complications, around 4 to 8 in 10,000 procedures. For people not eligible for NHS colonoscopy, private costs are typically around £1,900 to £2,200. Some international health insurance policies cover colonoscopy screening as standard.

    Both FIT testing and colonoscopy are well-supported by evidence, and both UK and US guidelines agree these are the two options with the most benefit. The right choice depends on your circumstances. Colonoscopy is preferred for people with a higher-risk family history, a known gene mutation, or previous polyps. Annual FIT testing is a very reasonable starting point for people at average risk who want a non-invasive option. Your GP can help you decide.

    People with a confirmed high-risk inherited mutation such as Lynch syndrome are typically recommended colonoscopy every two years from age 25 rather than stool testing alone.

    Multi-Cancer Early Detection: TruCheck

    TruCheck is a blood test that detects circulating tumour cells shed by cancers into the bloodstream before symptoms develop. It screens for over 70 cancer types from a single blood draw, including bowel cancer. It is not a replacement for FIT testing or colonoscopy but adds an additional layer of detection, particularly useful for people who want comprehensive early cancer surveillance. It is generally suitable for people aged 40 and over without a prior cancer diagnosis.

    Multi-Cancer Early Detection →

    Genetic testing for inherited risk

    Genetic testing used to be reserved for people who clearly met high-risk criteria. But research shows this approach misses around half of people who carry a harmful mutation. Only about 5% of people in the UK with Lynch syndrome have been diagnosed. For each person identified, there is an opportunity not just to help them but to alert their relatives, who have a 50% chance of carrying the same mutation.

    At Coyne Medical, we offer genetic testing to everyone, not just those who meet the NHS criteria.

    Who should particularly consider it

    A personal or family history of bowel cancer, especially under age 50. Multiple relatives on the same side of the family with bowel cancer or related cancers such as womb, ovarian, or stomach cancer. A family history of ten or more bowel polyps. A known mutation in the family. Even without a clear family history, genetic testing is worth considering as part of a comprehensive health assessment.

    What a positive result means

    A positive result does not mean cancer is inevitable. What it does is change what screening makes sense for you, and opens up options that can significantly reduce your risk. For someone with an MLH1 mutation, for example, daily aspirin taken for two years has been shown to reduce bowel cancer risk by 60%. Colonoscopy screening from age 25 allows polyps to be found and removed before they become cancers. Some women with Lynch syndrome choose to have their womb removed after completing their family, to reduce the risk of endometrial cancer. Knowing your result puts these options within reach.

    What a negative result means

    No harmful mutations were found in the tested genes. This is genuinely reassuring, though it does not eliminate all bowel cancer risk if you have a strong family history. Appropriate screening based on your other risk factors should continue.

    Protecting your family

    When one person discovers a gene mutation, they can share that information with relatives who can then be tested themselves. Many people find real comfort in knowing they have given their children or siblings the chance to get ahead of something that might otherwise go undetected.

    Vaccinations on the horizon

    The University of Oxford is currently developing a cancer prevention vaccine for people with Lynch syndrome. This is one example of how rapidly the science is moving. Knowing your genetic risk now may open the door to treatments and prevention strategies that do not yet exist.

    At Coyne Medical we offer an inherited cancer risk panel covering 35 genes including all of the Lynch syndrome genes, APC, and MUTYH, available as an at-home saliva test from £650 or an in-clinic blood test from £900. Our Advanced Genetic Screen covers 55 genes and also includes a pharmacogenomics report, it is included as standard in our Ultimate health screening package.

    Inherited cancer risk panel →

    Advanced genetic screen →

    Support and further information

    Lynch Syndrome UK is a patient-led organisation providing information, support, and advocacy for people affected by Lynch syndrome. Lynch Choices offers support from testing through to diagnosis and information on screening and preventive therapies. The Royal Marsden Hospital provides a detailed Beginner’s Guide to Lynch Syndrome online. PolyposisPatient offers peer support for all polyposis conditions. Bowel Cancer UK provides information and helpline support for anyone affected by bowel cancer.

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  • Can you prevent breast cancer? Risk, screening and genetic testing explained

    Can you prevent breast cancer? Risk, screening and genetic testing explained

    Breast cancer affects 1 in 7 women over their lifetime. But risk is not uniform, and early detection changes outcomes dramatically. This guide covers what raises your risk, what the latest screening tools can offer, and when genetic testing should be part of the picture

    1. What causes breast cancer?
    2. Family history and genetic risk
    3. Lifestyle risk factors
    4. Breast density
    5. Symptoms to know about
    6. Screening options
    7. Genetic testing for inherited risk
    8. Support and further information

    What causes breast cancer?

    No single thing causes breast cancer. For most women, it comes down to a mix of genetics, hormones, lifestyle, and chance. The good news is that many risk factors can be identified, and some can be changed.

    Breast cancer is the most common cancer in UK women. Around 150 new cases are diagnosed every day. 1 in 7 women will be diagnosed with breast cancer during their lifetime. Survival has improved a lot in recent years, mainly because of better treatments and earlier diagnosis. Stage 1 breast cancer now has a five-year survival rate above 98%. That figure drops significantly when cancer is found later, which is why screening matters so much.

    Family history and genetic risk

    Family history

    If your mother, sister, or daughter has had breast cancer, your own risk is roughly double the average. The risk is higher if they were diagnosed under 50, or if several relatives on the same side of the family have been affected. It is also worth knowing that breast cancer genes can be passed down through male relatives, who may carry a mutation without ever developing the disease themselves.

    Inherited gene mutations

    About 5% to 10% of breast cancers are caused by an inherited fault in a gene. The most well known are BRCA1 and BRCA2. Women with a BRCA1 mutation can have a lifetime breast cancer risk of up to 90%. Other genes, including PALB2, CHEK2, and ATM, also raise risk, though usually by a smaller amount. These gene faults do not cause cancer directly. What they do is make it harder for the body to repair DNA damage over time, which means errors in cells are more likely to build up into cancer.

    Hormonal factors

    Starting periods early or reaching menopause late both mean more years of oestrogen exposure, which is linked to a modest increase in breast cancer risk.

    The relationship between HRT and breast cancer has caused a lot of confusion, but the evidence is now much clearer. Combined HRT, which includes both oestrogen and a synthetic progesterone, does carry a small real increase in risk. The estimate is around ten extra cases per 1,000 women taking it for up to 14 years from age 50. Body-identical progesterone (sometimes called Utrogestan or micronised progesterone) appears to carry much less risk, and current evidence suggests the increase may be close to zero in the first five years of use. Women who take oestrogen alone, because they have had a hysterectomy, are not thought to have any meaningful added breast cancer risk from HRT. If you are weighing up HRT and are worried about breast cancer, your GP should look at your full risk picture rather than giving a blanket answer.

    Lifestyle risk factors

    Alcohol

    Even moderate drinking raises breast cancer risk. Around two units a day, roughly a single glass of wine, is linked to about a 9% increase in risk. That is a bigger rise than most people expect, and larger than the risk from combined HRT.

    Weight and body fat

    Being overweight after the menopause increases risk. Fat tissue produces oestrogen, and higher oestrogen levels after the menopause are linked to breast cancer. Weight carried around the middle is particularly important. Visceral fat, the fat stored around your internal organs, is more hormonally active than fat under the skin, and more directly linked to cancer risk. This is why knowing your body composition, not just your weight, matters.

    Exercise

    Regular exercise reduces risk. Brisk walking for 30 minutes, five days a week, can lower breast cancer risk by up to 12%.

    Smoking

    Current smokers have around a 10% higher risk compared to people who have never smoked.

    Having children and breastfeeding

    Women who have had children have a lower overall risk than those who have not. Breastfeeding adds further protection, probably because it delays the return of periods.

    Previous radiotherapy

    If you have had radiotherapy to your chest, for example for lymphoma, this raises your breast cancer risk. Let your GP know so they can factor it into your screening plan.

    Breast density

    Breast density is one of the less talked about risk factors, even though it affects up to half of women over 40.

    Dense breast tissue means your breasts contain more fibrous and glandular tissue relative to fat. This matters for two reasons. First, women with the highest density category have roughly double the breast cancer risk of women with mostly fatty breast tissue. Second, dense tissue and potential cancers both appear white on a mammogram, which means dense breasts can hide problems that mammography might otherwise catch.

    Breast density can only be seen on a mammogram. It has nothing to do with how your breasts feel. We have written a dedicated guide that covers what dense breasts mean for your screening choices and what options are available at Coyne Medical.

    Understanding dense breasts →

    Symptoms to know about

    Most breast cancers are found through screening before any symptoms appear. But it is still important to know what to look out for. See a GP promptly if you notice any of the following. None of these automatically means cancer, but all of them should be checked.

    A lump or swelling in the breast, upper chest, or armpit. A change to the skin, such as puckering or dimpling. Redness or a change in colour of the breast. A nipple that has become newly inverted or changed shape. A rash or crusting around the nipple. Unusual discharge from either nipple. A change in the size or shape of the breast that you cannot explain.

    Screening options

    NHS mammography

    The NHS invites women aged 50 to 71 for a mammogram every three years. Mammography uses low-dose X-rays and can detect cancers before they are large enough to feel. If you think you may have missed an invitation, you can find your nearest NHS breast screening centre online and self-refer. Women identified as higher risk through family history may be offered NHS screening from age 40 instead.

    Why starting earlier makes sense

    The UK starts breast screening later than most comparable countries. There is strong evidence that annual mammography from age 40 can reduce the risk of dying from breast cancer by around 25% over ten years. At Coyne Medical, annual mammography from 40 is included as standard in our Complete and Ultimate health screening packages. Mammograms are mildly uncomfortable but only take a few minutes. Modern machines use a very low radiation dose, similar to about seven weeks of natural background radiation.

    Breast ultrasound

    Ultrasound uses sound waves rather than radiation and is particularly useful for women with dense breasts. It can find cancers that mammography misses, and it can tell the difference between solid lumps and fluid-filled cysts. At Coyne Medical, breast ultrasounds are carried out by Dr Neil Upadhyay, a Consultant Radiologist at Imperial College Healthcare NHS Trust with specialist expertise in breast imaging.

    Book a breast ultrasound →

    Breast MRI

    MRI is the most sensitive test available for breast cancer detection. It is recommended for women at high risk, such as those with a confirmed BRCA1 or BRCA2 mutation, or women who have had radiotherapy to the chest. The European Society of Breast Imaging also recommends MRI for women with dense breasts who have additional risk factors, such as a significant family history. It is not used for general population screening because of cost and a higher rate of false alarms, but for the right patient it offers much greater sensitivity than mammography alone. If you have dense breasts and other risk factors, speak to your GP about whether MRI is appropriate for you.

    Multi-Cancer Early Detection: TruCheck

    TruCheck is a blood test that looks for tumour cells that have broken off from a cancer and entered the bloodstream, before any symptoms have appeared. It screens for over 70 types of cancer from a single blood draw.

    The evidence for breast cancer detection is particularly strong. In a 2022 study by Crook et al., published in the journal Cancers, the test correctly identified breast cancer with a sensitivity of over 92% across a population of more than 9,000 participants. A follow-up clinical study found similar results.

    TruCheck Multicancer Early Detection Blood test is generally suitable for people aged 40 and over who have not previously been diagnosed with cancer. People aged 35 to 39 with a strong family history or a known gene mutation can also be considered. It is not a replacement for imaging but adds an extra layer of detection.

    Multi-Cancer Early Detection →

    Genetic testing for inherited risk

    Genetic testing used to be offered only to people with a clear family history of cancer. But research now shows this approach misses nearly half of people who carry a high-risk mutation. Mutations can run through male relatives who never develop breast cancer. Relatives may have died young before any cancer appeared. Families may simply be small, with no obvious pattern to notice.

    At Coyne Medical, we offer genetic testing to everyone, not just those who meet a high-risk threshold. We know fewer than 5% of people in the UK with a high-risk mutation have been identified. We want to help you find any inherited risk early.

    Who should particularly consider it

    A personal or family history of breast or ovarian cancer, especially under age 50. Several affected relatives on the same side of the family. Male relatives with breast, prostate, or pancreatic cancer. Ashkenazi Jewish heritage, which carries a higher rate of BRCA1 and BRCA2 mutations in the population. A known mutation in the family. If any of these factors apply to you, it is worth finding out.

    What a positive result means

    A positive result does not mean you will get cancer. What it does is change what screening makes sense for you, and opens the door to options that could significantly reduce your risk. Women with a BRCA1 mutation, for example, are offered annual mammography and MRI by the NHS from age 30, and may be candidates for medication or surgery that can cut breast cancer risk by over 95%.

    What a negative result means

    No harmful mutations were found in the tested genes. This is genuinely reassuring. It does not eliminate all breast cancer risk, particularly if you have a strong family history, but it is meaningful information. You should still continue appropriate screening based on your other risk factors.

    What about male relatives?

    Half of people who carry a BRCA1 or BRCA2 mutation are male. Men with these mutations have a raised risk of prostate cancer, male breast cancer, and pancreatic cancer. A man with a BRCA2 mutation has up to a 60% lifetime risk of prostate cancer, more than eight times the population average. Male relatives in families affected by breast or ovarian cancer should consider testing too.

    At Coyne Medical we offer an inherited cancer risk panel covering 35 genes, available as an at-home saliva test from £650 or an in-clinic blood test from £900. Our Advanced Genetic Screen covers 55 genes and also includes a pharmacogenomics report. Genetic testing is included as standard in our Ultimate health screening package.

    Inherited cancer risk panel →

    Advanced genetic screen →

    Support and further information

    If you have concerns about your breast cancer risk or about inherited breast cancer in your family, the following organisations can help. The National Hereditary Breast Cancer Helpline offers support for people at risk of hereditary breast cancer. Breast Cancer Now is a leading UK charity with information and a clinical nurse helpline. Jnetics focuses specifically on prevention and diagnosis in the Jewish community. Peer support groups for people with BRCA and other gene mutations are also available online and can be a valuable source of connection alongside clinical advice.

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  • Understanding dense breasts

    Understanding dense breasts

    If you’ve been told you have dense breasts after a mammogram, you may have questions about what it means and whether you need to do anything differently. This guide explains what breast density is, why it matters for cancer detection, and what your options are.

    What are dense breasts?

    Breast tissue is made up of a mixture of fat, fibrous tissue, and glandular tissue. Breast density refers to the proportion of fibrous and glandular tissue relative to fat, as seen on a mammogram. The more fibrous and glandular tissue you have, the denser your breasts are considered to be. On a mammogram test your breast tissue will appear more white.

    Density is graded on a four-point scale, from A (almost entirely fatty) through to D (extremely dense). Categories C and D are generally referred to as dense. Up to half of women over 40 years of age have dense breast tissue, so if you have been told your breasts are dense, you are far from alone. Density is a normal biological characteristic, not a disease or abnormality in itself.

    Why breast density matters

    There are two distinct reasons why breast density is clinically relevant, and it is worth understanding both.

    The first is cancer risk. Dense breast tissue is independently associated with a higher risk of developing breast cancer. Women with category D density have roughly double the risk of breast cancer compared to women with category B tissue. The reasons are not fully understood, but this association is well established in the research literature and informs screening guidance worldwide.

    The second is mammogram sensitivity. Dense tissue and potential cancers both appear white on a mammogram, which means that dense tissue can obscure abnormalities that might otherwise be detectable. Studies suggest that between 30% and 50% of cancers may not be visible on mammogram in women with dense breasts. This is sometimes called the masking effect.

    These two factors together mean that if you have dense breasts, your standard mammogram may be both less reassuring and less complete than it would be for someone with fatty tissue.

    What the guidance says

    The European Society of Breast Imaging published updated guidance in 2022 recommending that women with dense breasts be informed about the limitations of mammography and offered additional imaging, either ultrasound or MRI, depending on their overall risk profile. In the United States, mammogram facilities are now legally required to report breast density to patients so they can make informed decisions about supplemental screening. Extra screening is also routine in other European countries including France.

    UK guidance has been slower to formalise this, but the clinical case for supplemental imaging in women with dense breasts is well supported by the evidence, and an increasing number of women are seeking private assessment outside the NHS screening programme as a result.

    Your options for supplemental screening

    For most women with dense breasts who are at average or slightly elevated risk, breast ultrasound is the recommended first step beyond mammography. It uses sound waves rather than radiation, is non-invasive, and is particularly good at distinguishing between solid masses and fluid-filled cysts in dense tissue. It can detect cancers that are not visible on mammogram.

    For women at higher than average risk, for example, those with a strong family history of breast cancer, a breast MRI is the most sensitive available test. Your GP can help you discuss whether MRI screening is appropriate for your situation.

    If you are unsure which option is right for you, a GP consultation is a good starting point. Understanding your full risk picture, including family history and any relevant genetic factors, will help you and your doctor decide on the most appropriate next step.

    How Coyne Medical can help

    We offer breast ultrasound at our Fulham clinic with Dr Neil Upadhyay, a Consultant Radiologist with specialist expertise in breast imaging. Appointments are available on a private self-pay basis without a GP referral, though we would always recommend discussing your results with a GP who knows your full history.

    If you would like to understand your broader cancer risk before or alongside breast imaging, our genetic cancer testing service covers 35 inherited cancer risk genes including BRCA1 and BRCA2, with results reviewed by a Coyne Medical GP.

    Book a breast ultrasound →

    FAQs

    You may be told in your mammogram report. In England, NHS mammogram letters do not routinely tell you about breast density. At Coyne Medical we always request this extra information in your mammogram report, if you are using a different private provider do ask them about this. If you are unsure what your report says or what it means for you, bring it to a GP consultation and they can help you interpret it in the context of your overall health history.

    Yes. Breast density typically decreases with age and tends to reduce after the menopause, partly because falling oestrogen levels lead to a reduction in glandular tissue. Hormone replacement therapy can maintain or increase density in some women. It is worth being aware that your density category at one screening may not reflect your density at the next.

    Yes. Breast ultrasound uses sound waves and does not involve ionising radiation, making it safe to repeat as often as clinically indicated. It is the same technology used in pregnancy ultrasound scans and has an extensive safety record.

    No. The majority of women with dense breasts do not develop breast cancer. Density is one risk factor among several, and having it does not make cancer inevitable. What it does mean is that your standard mammogram may not give you the full picture, and supplemental imaging is worth considering.

    There is no reliable way to significantly reduce breast density through lifestyle changes, though maintaining a healthy weight and limiting alcohol may have a modest effect for some women. The most important thing is not to try to change your density, but to make sure your screening approach accounts for it.

    Genetic testing is a separate consideration from breast density, though for some women the two are relevant at the same time. If you have dense breasts and a family history of breast or ovarian cancer, or if you are of Ashkenazi Jewish heritage, genetic testing for BRCA1, BRCA2, and other inherited cancer risk genes is definitely worth discussing with your GP. At Coyne Medical, we offer inherited cancer risk panels as a standalone service or as part of our health screening packages. We offer this to all women regardless of family history, as studies show about half those that test positive for a gene like BRCA1 do not have a worrying family history.

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    Not sure which screening is right for you?

    Book a 30-minute Discovery Call with one of our GPs. We will talk through your health history, your concerns and your goals, and recommend the right programme for you.
    The £250 fee is fully credited against any health screening package you go on to book.

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  • The Future of Prostate Cancer Screening: How to Avoid an Unnecessary Biopsy

    The Future of Prostate Cancer Screening: How to Avoid an Unnecessary Biopsy

    Introduction: A Smarter Approach to Prostate Cancer Screening

    Prostate cancer screening has long relied on the prostate-specific antigen (PSA) test. This is a simple blood test used by doctors worldwide, including at our private GP surgery in Fulham. However, while PSA testing is widely available, it has its flaws. It can often lead to unnecessary biopsies and anxiety.

    Thankfully, advanced screening methods such as the Stockholm3 test (STHLM3) are revolutionising prostate cancer detection. the Stockholm3 might sound like a 90s Indie band. However, it offers higher accuracy and fewer unnecessary procedures in patients with elevated PSA.

    If you’re considering prostate cancer screening in London, here’s what you need to know about the latest innovations.

    The PSA Test: A Good but Imperfect Tool

    The PSA test measures prostate-specific antigen levels in the blood, helping detect potential prostate issues. However, elevated PSA levels don’t necessarily indicate cancer. Benign prostate enlargement, infections, or inflammation can also cause an increase.

    This low specificity often leads to unnecessary MRI scans and biopsies, causing undue stress for patients. At our Fulham GP clinic, we focus on providing cutting-edge screening options that minimise unnecessary interventions.

    Stockholm3 Test: A Game-Changer in Prostate Cancer Screening

    The Stockholm3 test (STHLM3) is an innovative approach that combines:
    ✅ Biomarkers (blood-based indicators of prostate health)
    ✅ Genetic testing (to assess hereditary cancer risks)
    ✅ Clinical data (age, family history, and other risk factors)

    How Does Stockholm3 Improve Prostate Cancer Diagnosis?

    A major study found that Stockholm3 reduced the need for prostate biopsies by 32% while maintaining high accuracy in detecting aggressive cancers.

    The National Institute for Health and Care Excellence (NICE) has also acknowledged Stockholm3’s potential to improve prostate cancer screening, helping reduce unnecessary MRI scans and biopsies.

    Reflex Testing: Enhancing PSA Results with Greater Accuracy

    At our Fulham private GP clinic, we understand the importance of precision in diagnostics. The Stockholm3 test acts as a reflex test, meaning:

    • If PSA levels are elevated, Stockholm3 analyzes additional risk factors to determine whether a biopsy is truly needed.
    • This prevents unnecessary biopsies while still identifying high-risk patients.

    By integrating Stockholm3 testing into our private GP services in London, we offer a more tailored, patient-friendly approach to prostate cancer screening.

    Stockholm3’s Global Success: A Reliable Test for All Ethnicities

    One concern with many prostate cancer screening tests is their effectiveness across different ethnic groups. The SEPTA trial, conducted in North America, confirmed that Stockholm3 is highly accurate across diverse populations, showing:

    • Better specificity (fewer false positives)
    • Non-inferior sensitivity (still detects all significant cancers)

    This is a crucial breakthrough, as ethnicity is a known risk factor for prostate cancer. At our private GP clinic in London, we strive to provide the best screening options for all patients.

    The Future of Prostate Cancer Screening in London

    Advancements like Stockholm3 represent a major step forward in prostate cancer detection. As we move toward a more personalised, risk-based approach, our clinic is committed to offering the most advanced screening technologies available.

    If you’re considering prostate cancer screening in Fulham, our expert private GPs provide:
    ✅ Comprehensive prostate health assessments
    ✅ Advanced genetic testing
    ✅ Cutting-edge screening methods

    Book a Prostate Cancer Screening with a Private GP in Fulham

    Early detection saves lives, but screening should be accurate and stress-free. At our London private GP surgery, we offer advanced prostate cancer screening that helps you avoid unnecessary biopsies while ensuring your health remains a top priority.

    🔹 Contact us today to book a prostate health consultation at our Fulham GP clinic.

    DR LUCY HOOPER
    MB BS BSc MRCGP MA DRCOG DCH

    Lucy is a GP and co-founder of Coyne Medical. She graduated with honours from Imperial College London, trained at St Mary’s Hospital, and holds a Master’s in Medical Ethics and Law. Her clinical interests span women’s health, preventive medicine, and genomics, with a particular focus on using advanced biomarkers to build a more complete picture of long-term health.

    British Society for Genetic Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in BBC, The Guardian, Women’s Health, The Times and Tatler

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    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

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  • Vitamin D: A Ray of Prevention in Colorectal Cancer

    Vitamin D: A Ray of Prevention in Colorectal Cancer

    Rickets is the archetypical disease of vitamin D deficiency in children. It was ubiquitous in the industrialised cities of the UK. Theobald Palm finished studying medicine at the University of Edinburgh in the 1800s. The son of Scottish Presbyterian missionaries, he was born in Ceylon, now Sir Lanka. Following medical school, began medical missionary work in Japan. There he noticed that rickets was virtually absent. Had Palm remained a medical missionary, nothing might have transpired. But he returned to the UK and there he noted an epidemic of rickets in large towns that had limited sunlight exposure. As with many groundbreaking medical discoveries, for many years, Palm’s observations were largely ignored. Ultimately, following Palm’s shrewd observations, it was recognised that the production of vitamin D in the body was contingent on exposure to UVB.

    What is Vitamin D?

    Perhaps surprisingly, vitamin D is not a vitamin at all. It is actually a prohormone involved in the tight regulation of calcium and phosphate levels. Hence, it is vital for healthy bones, effective muscle contraction, immune function and other important cellular functions.

    So vitamin D has long been celebrated for its role in bone health. Yet its influence on broader health outcomes is garnering increasing attention. This is particularly the case in preventing early-onset colorectal cancer (CRC). Recent research leveraging the extensive UK Biobank data provided compelling insights into how vitamin D might play a pivotal role in warding off CRC, especially among adults under 50. The UK biobank is a huge repository of biomedical data that can be accessed by medical researchers worldwide.

    A Closer Look at the Research

    The study in question delved into the health records of 236,382 Korean adults. It tracked a range of health metrics, including serum 25-hydroxyvitamin D [25(OH)D] levels. The follow-up period averaged 6.5 years. In this time the researchers discovered that higher levels of vitamin D were associated with significantly reduced risks of developing colorectal cancer. These were findings that held strong even after adjusting for numerous potential confounders.

    Vitamin D and Its Protective Mechanisms

    What’s particularly intriguing about this study is its implications for both young and older adults. For those under 50, maintaining higher levels of vitamin D was linked with a nearly 60% reduction in CRC risk. This protective effect, although slightly attenuated, was also evident in the older cohort. Hence, the study suggests that vitamin D’s benefits span age groups.

    The biological underpinnings of vitamin D’s protective effects relate to its regulatory role of our DNA. Vitamin D helps orchestrate the expression of several genes. This includes those involved in cell growth and repair. Such mechanisms are vital for cancer prevention. Essentially, vitamin D acts much like a fastidious manager within a complex system. It ensures that everything runs smoothly and efficiently. Importantly, it also shuts down potential problems before they escalate.

    Practical Implications and Lifestyle Integration

    Given the association between vitamin D levels and reduced CRC risk, particularly among younger adults, there is a strong case for assessing your vitamin D status. This is especially the case for those with a family history of colorectal cancer. Here’s how you can incorporate this knowledge into a proactive health strategy:

    1. Regular Screening: Consider regular checks of your vitamin D levels as part of your routine health assessments. This is especially pertinent during the darker months. It’s also particularly important if your lifestyle limits sun exposure.
    2. Mindful Supplementation: If your vitamin D levels are found to be lacking, supplementation could be a key strategy. It’s a simple, safe way to potentially reduce your risk of serious health issues like colorectal cancer.
    3. Dietary Sources: Sunlight is the primary source of vitamin D. However, incorporating vitamin D-rich foods like fatty fish, fortified dairy products, and certain mushrooms can also help boost your levels.
    4. Understanding Your Genetics: The study highlighted that genetic factors might influence how vitamin D impacts us. Engaging with genetic screening could provide personalised insights, tailoring your approach to supplementation.

    A Final Thought

    We have to navigate a plethora of dietary advice and health strategies. Understanding the nuanced role of nutrients like vitamin D in disease prevention is crucial. This isn’t just about taking a supplement. It’s also about integrating a scientifically backed approach into your daily routine for long-term health benefits.

    Theobald Palm extolled the virtues not only of sunlight. He urged the use of open spaces, especially playgrounds for children. This is something we should take to heart. A vitamin D supplement may be beneficial. But the benefits of safe sun exposure, movement and nature compound to maximise health benefits. 

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Cancer Health Guides
  • Understanding Ovarian Cancer: Early Detection, Genetic Testing, and Prevention

    Understanding Ovarian Cancer: Early Detection, Genetic Testing, and Prevention

    Every day, 11 women in the UK lose their lives to ovarian cancer. This disease claims more lives than all other gynaecological cancers combined. Tragically, most cases are diagnosed at an advanced stage—stage 3 or 4—where the survival rate for stage 4 is a mere 15%. However, if detected early, at stage 1, the five-year survival rate soars to 95%.

    Ovarian cancer is shrouded in myths and misconceptions, leading to a lack of awareness among both women and healthcare professionals about effective prevention and early detection methods. With advancements in science, we now have the tools to detect this disease early and, in some cases, prevent it altogether, significantly improving survival rates.

    This video is essential viewing for anyone with a family history of ovarian cancer, anyone with ovaries, or anyone who cares about someone with ovaries. Join us as we dispel myths, spread awareness, and empower you with life-saving knowledge about ovarian cancer.

    Genetics of Ovarian Cancer

    Let’s first talk about the genetics of ovarian cancer. 

    About 20% of ovarian cancers are caused by a genetic variant inherited from a parent. You might have heard people describing this as having inherited a “gene mutation” or “faulty gene”. 

    The most common genes involved in this are BRCA1 Or B-R-C-A-1 and BRCA2. 

    If you have inherited a harmful copy of one of these genes, we medically call this having a “pathological” variant. For patients, this might mean your risk of ovarian cancer might be up to 60% in your lifetime. BRCA1 and 2 are not the only genes which are linked to ovarian cancer, there are other genes which are less common and carry different risks. 

    Angelina Jolie famously shared her story of finding out about her BRCA 1 mutation in 2013 in the New York Times.  I think she really helped to open the conversation around genetic screening for lots of women. She had sadly already lost her mother to cancer, who was diagnosed with breast and ovarian cancer. Angelina Jolie chose to have risk-reducing surgery.  Since then many other women have followed in her footsteps, talking about their genetic mutations and surgical decisions such as Christina Applegate, Sharon Osborne and many not so close to Hollywood like me.

    So who should have genetic screening?

    I want to share the words of Dr Mary-Claire King, she is the scientist who first identified the BRCA1 gene in 1990. 

    She says “To identify a woman as a carrier only after she develops cancer is a failure of cancer prevention,”.

    I whole heartedly agree with her. Despite the passing of decades since the discovery of the BRCA1 gene far too many people only find out they carry a gene after a cancer diagnosis in themselves or someone they love.

    Over 95% of women who have inherited a harmful variant in BRCA1 or BRCA2 are undiagnosed in the UK. That’s hundreds of thousands of people who don’t know they are at high risk of cancer, ovarian cancer, plus breast cancer and more. 

    I am extremely fortunate to have been able to access private genetic screening. And I am passionate about bringing this option to more patients and am proud we are able to offer this at Coyne Medical. We can take a sample in clinic after talking through the options, we usually test for multiple cancer genes linked to several cancers including ovarian, breast, colon and more. We only test for genetic changes which are linked to proactive steps you can take to reduce your risk. Such as recommendations for extra screening or checks. 

    But I know that is not an option for all patients, so I was also delighted that in March this year, the guidelines on NHS funded testing were updated by NICE. They now recommend that anyone who has a family history of ovarian cancer in a first or second degree relative be considered for genetic testing.

     A first-degree relative is for instance parent or sister. A second-degree relative is much broader and includes grandparents, aunts, nieces or half-sisters. This includes relatives on either your mum or dad’s side of the family.  So if private testing is not an option for you do speak to your GP about the new guidelines. In the past it may be that you were denied testing on the NHS but could now be eligible.

    What if you don’t have any family history of ovarian cancer?

    Yes, you can still have genetic screening. Traditionally we have only screened patients with a family history. We know from large studies on breast and ovarian cancer that if we only use the family history criteria we will miss over 50% of people with a pathological mutation in BRCA1 or BRCA2.  So if you really want toif you want to get serious about optimising your cancer screening and prevention we think genetic screening is crucial. You don’t want to be one of the patients that only find out after they get cancer, knowing you might have been able to prevent it earlier. 

    Personally, I know the truth behind the statistics. I tested positive for a pathological variant in a gene called PALB2 in 2021. It puts me at increased risk of ovarian cancer and breast cancer. I did not meet the traditional criteria for genetic testing and would not have known without choosing to have private genetic screening. I feel incredibly lucky I found my gene mutation while I was completely healthy, instead of after having a cancer. I have been able to join Angelina Jolie in choosing preventative risk-reducing surgery. To know my risk and then take action to reduce my risk of cancer feels like a very special gift. I would love to see more women share this. 

    Could a family history of other cancers be linked to ovarian cancer?

    Yes, many of the genes that increase the risk of ovarian cancer are linked to other cancers.

    If your family history includes breast cancer, pancreatic cancer or prostate cancer. Those are all flags that you have a higher chance of having inherited a gene mutation. We would certainly encourage you to consider genetic screening. 

    And it’s not just women. We would also encourage men with a family history of these cancers to consider genetic screening. Finding a gene mutation will help us manage their health risks and cancer screening. But it will also potentially help their daughters, granddaughters, nieces, sisters…

    MYTH is that: “It doesn’t matter as there is no family history on my Mum’s side.”

    Wrong. You can inherit these gene mutations from either your mother or father. 

    Women who inherit from their Dad are more often missed. Men are less likely to get breast cancer and can’t get ovarian cancer. So for their daughter their family history often appears less worrying. The same is true for people from small families. A history of cancer in a grandmother or aunt on Dad’s side of the family, is often not talked about or not seen as a big risk factor. I would encourage everyone to find out the most they can about their family history. During the dark days of the first lockdown I started researching my family tree which has been fascinating. After I discovered that I had a gene mutation I searched in more detail and got a copy of my great grandmother’s death certificate, this showed she had died from breast cancer in her 40’s. I almost certainly inherited my mutation from her. So get talking to relatives if you can or use the wonders of the internet to do a bit more research. Of course, we focussed on ovarian cancer today but family history of all cancers as well as other diseases such as heart attacks are also really important information. 

    Do you have any Jewish ancestry?

    Having a parent or grandparent of Jewish ancestry is a big risk factor for inheriting a BRCA1 or BRCA2 genetic variant, up to a 1 in 40 chance. We would recommend all people with this risk factor use genetic screening to find out if they carry a high-risk mutation. The NHS has recently started a project offering testing for gene variants in only the BRCA1 and BRCA2 genes, as these are the genes which are more commonly mutated in those with Jewish ancestry, if you’re interested you can find out more about the project online and I’ll put the link to that in our notes. 

    How does finding a high-risk ovarian cancer gene help you prevent cancer?

    Some women will opt to have their ovaries and fallopian tubes removed. Especially if they have already entered menopause, you could say they are no longer serving any purpose so why keep them and add to your cancer risk? 

    The decision can be more difficult for younger women, for whom surgery will bring on an early menopause and impact on their choices for fertility. It is important that women in this scenario get the best advice on which option is best for them. And their options for pregnancy in the future. 

    There is a brilliant UK study called “Protector”, it is led by  Professor Ranjit Manchanda, who is a great advocate for increasing access to genetic screening for women. The study offers women who want to keep their ovaries the option of removing their fallopian tubes only initially, followed by removal of the ovaries at a later date. We know many ovarian cancers start at the end of the fallopian tubes where they meet the ovaries. The study wants to show this option can help women who wish to delay their surgery, so this option could help reduce risk without the negative impact of menopause in younger women. Both surgical options are big decisions, and need careful thinking through the pros and cons so each woman can find the right decision for her health. Thankfully the actual surgeries are usually laparoscopic or keyhole operations, and can usually be done as a daycase procedure. 

    Can I do anything else to prevent ovarian cancer?

    Yes, there are lots of factors we can focus on to reduce the risk of ovarian cancer. And they will also reduce your risk of lots of other cancers such as breast and colon cancer. Keeping a healthy weight and not smoking are the two biggest risk factors which you can control. The combined oral contraceptive pill also reduces risk, even if only taken for a short period of time. The protection from taking the pill also persists, so the positive benefit continues for several years after stopping the pill. For high-risk women though such as having a BRCA1 or 2 mutation the combined oral contraceptive increases the risk of breast cancer so it may not be suitable as an option. Breastfeeding is protective for ovarian cancer risk, with a 24% risk reduction. I know personally breastfeeding can be really challenging, certainly the hardest part of life as a new mum with my first baby. So I am really conscious of not adding to the mummy guilt with this but if you have a family history it is good to know that this choice could have a positive impact on your own health.  Having children reduces the chance of having ovarian cancer. Of course not alone a reason to have a baby! There has been a lot of concern about using talcum powder on the genital area and ovarian cancer, the evidence is mixed but it is sensible to avoid this. 

    Early Detection

    But now let’s think about early detection. For those cancers we can’t prevent, we need to diagnose them as early as possible. Early diagnosis is vital. Sadly two-thirds of women are diagnosed at a late stage.

    If we can diagnose women early at stage 1 the survival rate is over 94% at 5 years, versus only 16% for women diagnosed at stage 4. So how can we screen you for ovarian cancer and detect it early?

    For women who do not have a high-risk gene mutation we don’t routinely recommend all women using ultrasound or the CA125 blood test for ovarian cancer screening because the biggest UK trial didn’t show this could improve survival in women. They studied over 200,000 women over about 16 years, split into 3 groups, no screening, screening with an ultrasound scan and screening with an ultrasound scan and a blood test for CA125. The results showed women screened with an ultrasound and the CA125 blood test did seem to be diagnosed with cancer at an earlier stage, but they couldn’t show this saved a significant number of lives. We know the CA125 blood test is not perfect, it can give “false alarms”, as other conditions like endometriosis or fibroids can cause high CA125 levels too.  

    But the results were different in women who have are at “high risk” such as with a BRCA gene mutation, they are now recommended to consider regular screening with CA125 blood test and a special algorithm for monitoring their results called ROCA. The test has been available privately for some time but this is a new recommendation in 2024 for the NHS and not yet easily available nationally but hopefully this will change soon. The ROCA test has been show to detect ovarian cancer earlier, before symptoms appear. For high-risk women they can have this done 3 times a year, the results will be tracked and if a significant increase is noted this will prompt more tests. This might be a good option for high-risk gene carriers to consider, especially if you have decided against surgery or are waiting to have done at an older age. 

    Are there are any other ways of screening for ovarian cancer?

    Yes we now have a new blood test that can be used to screen for ovarian cancer. It uses a normal blood sample taken in the clinic and the laboratory to look for ‘circulating tumour cells’, (CTCs). When a cancer or ‘tumour’ starts to grow in the body some of the cells will get into the bloodstream called CTCs. The really exciting part of this is that these CTCs can be found in early-stage 1 cancers.  

    The blood test is called a Multi Cancer Early Detection test, we offer tests by Trucheck that can either focus on female cancers, including breast and ovarian cancer,  or we can screen for up to 70 solid organ tumours. We offer this test at Coyne Medical, always after a full consultation with the doctor to understand if it’s the right test for you. We always want to make sure that patients are up to date with their standard cancer screening as these newer tests should be seen as a great optional add-on. 

    Likewise we also use whole-body MRI scans as an add-on cancer screening tool. These scans from from head through the neck, chest and abdomen to the pelvis. In the pelvic area they can detect cysts or fluid which can indicate an ovarian cancer. In large studies of whole-body MRI the rate of detecting a cancer is 1 to 2% in healthy adults over 40, but this has to be balanced against finding small ‘abnormalities’ which can cause stress and need further checks. That’s why it’s important you go through the possibilities with your doctor before testing. As well as making sure your doctor is there to support you through the results and any follow-up.

     MYTH: “A smear test checks for ovarian cancer.”

    This is sadly common, about 1 in 4 women think this is true but sadly not. Cervical screening will not detect ovarian cancer. Though it is a really important cancer screening to make sure you are up to date with. 

    Knowing the symptoms is key for every woman

    Symptoms to watch for include:

    • Persistent increase in abdominal size or bloating (not bloating that comes and goes)
    • Persistent pelvic and abdominal pain
    • Unexplained change in bowel habits
    • Difficulty eating and feeling full quickly, or feeling nauseous
    • Needing to urinate (wee) more regularly

    Other symptoms can include tiredness, losing weight, pain during sex, and back pain. These can be symptoms of many other conditions too so don’t panic but see your doctor. Your doctor might check a blood test called CA125 and you may also need an ultrasound scan. 

    Knowledge is Power

    Knowledge is power, yet many women and doctors are not well-informed about ovarian cancer. A study by Target Ovarian Cancer found that less than 5% of women felt confident recognizing its signs. Surprisingly, many doctors also mistakenly believe that symptoms only appear in the late stages of the disease. 

    We’re committed to empowering women with the knowledge they need to make informed health decisions. If you know other women who could benefit from this information, please share it with them. Together, we can spread awareness and equip more women with the knowledge they need.

    Follow us if you’d like to learn more about disease prevention and early detection. 

    Cancer Research UK [https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/ovarian-cancer/mortality#heading-Zero] Accessed 8 May 2024.

     Chandrasekaran D, Manchandra R. ‘Germline and somatic genetic testing in ovarian cancer patients’. BJOG 2018: volume 125, issue 11, page 1,460. DOI: 10.1111/1471-0528.15225

    Evans, D.G., Shenton, A., Woodward, E. et al. Penetrance estimates for BRCA1 and BRCA2based on genetic testing in a Clinical Cancer Genetics service setting: Risks of breast/ovarian cancer quoted should reflect the cancer burden in the family. BMC Cancer 8, 155 (2008). https://doi.org/10.1186/1471-2407-8-155

    https://ascopost.com/issues/february-10-2015/dr-mary-claire-king-proposes-population-screening-in-all-young-women-for-brca-mutations/#:~:text=%E2%80%9CTo%20identify%20a%20woman%20as,Dr

    Manchanda R, Blyuss O, Gaba F, et al. Current detection rates and time-to-detection of all identifiable BRCA carriers in the Greater London population, Journal of Medical Genetics 2018;55:538-545.

    National Institute of Clinical Excellence. Ovarian cancer: identifying and managing familial and genetic risk, NICE Published 21/3/2024, [https://www.nice.org.uk/guidance/ng241] Accessed 8 May 2024.

    Beitsch PD, Whitworth PW, Hughes K, Patel R, Rosen B, Compagnoni G, Baron P, Simmons R, Smith LA, Grady I, Kinney M, Coomer C, Barbosa K, Holmes DR, Brown E, Gold L, Clark P, Riley L, Lyons S, Ruiz A, Kahn S, MacDonald H, Curcio L, Hardwick MK, Yang S, Esplin ED, Nussbaum RL. Underdiagnosis of Hereditary Breast Cancer: Are Genetic Testing Guidelines a Tool or an Obstacle? J Clin Oncol. 2019 Feb 20;37(6):453-460. doi: 10.1200/JCO.18.01631. Epub 2018 Dec 7. PMID: 30526229; PMCID: PMC6380523. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380523/

    Petrucelli N, Daly MB, Pal T. BRCA1- and BRCA2-Associated Hereditary Breast and Ovarian Cancer. 1998 Sep 4 [Updated 2023 Sep 21]. In: Adam MP, Feldman J, Mirzaa GM, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK1247/

    Ozanne EM, O’Connell A, Bouzan C, Bosinoff P, Rourke T, Dowd D, Drohan B, Millham F, Griffin P, Halpern EF, Semine A, Hughes KS. Bias in the reporting of family history: implications for clinical care. J Genet Couns. 2012 Aug;21(4):547-56. doi: 10.1007/s10897-011-9470-x. Epub 2012 Jan 12. PMID: 22237666.

    Metcalfe KA, Eisen A, Lerner-Ellis J, Narod SA. Is it time to offer BRCA1 and BRCA2 testing to all Jewish women? Curr Oncol. 2015 Aug;22(4):e233-6. doi: 10.3747/co.22.2527. PMID: 26300672; PMCID: PMC4530819.

    The NHS Jewish BRCA Testing Programme

    The Protector Study

    Cancer Research UK, [https://www.cancerresearchuk.org/about-cancer/ovarian-cancer/risks-causes] Accessed 9 May 2024.

    Collaborative Group on Epidemiological Studies of Ovarian Cancer; Beral V, Doll R, Hermon C, Peto R, Reeves G. Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23,257 women with ovarian cancer and 87,303 controls. Lancet. 2008 Jan 26;371(9609):303-14. doi: 10.1016/S0140-6736(08)60167-1. PMID: 18294997.

    Babic A, Sasamoto N, Rosner BA, et al. Association Between Breastfeeding and Ovarian Cancer Risk. JAMA Oncol. 2020;6(6):e200421. doi:10.1001/jamaoncol.2020.0421

    Merritt MA, Green AC, Nagle CM, Webb PM; Australian Cancer Study (Ovarian Cancer); Australian Ovarian Cancer Study Group. Talcum powder, chronic pelvic inflammation and NSAIDs in relation to risk of epithelial ovarian cancer. Int J Cancer. 2008 Jan 1;122(1):170-6. doi: 10.1002/ijc.23017. PMID: 17721999.

    Cramer DW, Liberman RF, Titus-Ernstoff L, Welch WR, Greenberg ER, Baron JA, Harlow BL. Genital talc exposure and risk of ovarian cancer. Int J Cancer. 1999 May 5;81(3):351-6. doi: 10.1002/(sici)1097-0215(19990505)81:3<351::aid-ijc7>3.0.co;2-m. PMID: 10209948.

    Cancer Research UK, [https://crukcancerintelligence.shinyapps.io/EarlyDiagnosis/] Accessed 9 May 2024.

    Cancer Research UK, [https://crukcancerintelligence.shinyapps.io/CancerStatsDataHub/] Accessed 9 May 2024.

    Menon U, Gentry-Maharaj A, Burnell M, Singh N, Ryan A, Karpinskyj C, Carlino G, Taylor J, Massingham SK, Raikou M, Kalsi JK, Woolas R, Manchanda R, Arora R, Casey L, Dawnay A, Dobbs S, Leeson S, Mould T, Seif MW, Sharma A, Williamson K, Liu Y, Fallowfield L, McGuire AJ, Campbell S, Skates SJ, Jacobs IJ, Parmar M. Ovarian cancer population screening and mortality after long-term follow-up in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial. Lancet. 2021 Jun 5;397(10290):2182-2193. doi: 10.1016/S0140-6736(21)00731-5. Epub 2021 May 12. PMID: 33991479; PMCID: PMC8192829.

    The Roca Test

    Zugni F, Padhani AR, Koh DM, Summers PE, Bellomi M, Petralia G. Whole-body magnetic resonance imaging (WB-MRI) for cancer screening in asymptomatic subjects of the general population: review and recommendations. Cancer Imaging. 2020 May 11;20(1):34. doi: 10.1186/s40644-020-00315-0. PMID: 32393345; PMCID: PMC7216394.

    DR LUCY HOOPER
    MB BS BSc MRCGP MA DRCOG DCH

    Lucy is a GP and co-founder of Coyne Medical. She graduated with honours from Imperial College London, trained at St Mary’s Hospital, and holds a Master’s in Medical Ethics and Law. Her clinical interests span women’s health, preventive medicine, and genomics, with a particular focus on using advanced biomarkers to build a more complete picture of long-term health.

    British Society for Genetic Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in BBC, The Guardian, Women’s Health, The Times and Tatler

    Book a GP Consultation

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Cancer Health Guides
  • 10 facts you need to know to prevent ovarian cancer or detect it early

    10 facts you need to know to prevent ovarian cancer or detect it early

    There are so many myths about Ovarian Cancer. For this Ovarian Cancer Awareness month, I’d love to share information to help educate as many women, and doctors on ovarian cancer. We need to use the latest science to make sure we prevent as many cancers as possible and diagnose any ovarian cancer as early as possible. 11 women die every day in the UK of ovarian cancer so every woman should know how to reduce their risk.

    1. Any family history of ovarian cancer matters

    About 20% of ovarian cancers happen because of a change or variant in a gene that has been inherited from a parent. You might also hear these called a “gene mutation” or “faulty gene”. 

    The most common genes involved in this are BRCA1 and BRCA2. If you have inherited a harmful, what we call a “pathological” variant in one of these genes you can have a risk of up to 60% of ovarian cancer in your lifetime. Other genes also increase your risk to lower levels. 

    Angelina Jolie shared her story of finding out about her BRCA1 variant in 2013, she helped to open the conversation around genetic screening. She sadly lost her mother to cancer due to the same BRCA1 variant. She chose to have risk-reducing surgery to reduce her risk of breast and ovarian cancer. She spoke powerfully of how grateful she was to reduce her cancer risk, likely by over 95%. 

    2. We need to offer more people genetic screening

    We estimate over 95% of women who have inherited a harmful variant in BRCA1 or BRCA2 are undiagnosed in the UK. That’s hundreds of thousands of people who don’t know they are at high risk of ovarian cancer, plus others including breast cancer. 

    If you have a family history of ovarian cancer it is sensible to consider genetic screening. Because for these groups screening gives the power of prevention. There are two main options for this. Some women will opt to have their ovaries and fallopian tubes removed. Especially if they have already entered menopause, you could say they are no longer serving any purpose so why keep them and add to your cancer risk? There is a brilliant UK study called “Protector” which offers women who want to keep their ovaries the option of removing their fallopian tubes. We think many cancers start at the end of the tubes close to the ovaries so this option could help reduce risk without the negative impact of menopause in younger women.

    3. Anyone can benefit from genetic screening

    Traditional criteria for screening only those with a family history will miss 50% of people with a pathological variant in BRCA1 or BRCA2. 

    So if you want to get serious about optimising your cancer screening and prevention we think genetic screening is crucial. 

    I know the truth behind these statistics. I tested positive for a pathological variant in a gene called PALB2 in 2020. I did not meet the normal criteria for testing and would not have known without choosing genetic screening. I feel incredibly lucky I found my gene mutation while I was healthy. I have been able to join Angelina Jolie in having preventative risk-reducing surgery. To be able to reduce my risk of cancer by over 95% feels like a very special gift and I would love to see more women share this. 

    4. A family history of other cancer could be linked to ovarian cancer

    The genes that increase the risk of ovarian cancer are linked to other cancers. If your family history includes breast cancer, pancreatic cancer or prostate cancer it is especially important to consider genetic screening. 

    We would also encourage men with a family history of these cancers to consider genetic screening, not just for their own health but because it could impact their daughters, granddaughters, nieces, and sisters..

    5. MYTH: “It doesn’t matter as there is no family history on my Mum’s side.”

    This is such a common myth. You can inherit these gene mutations from either your mother or father. Women who inherit from their Dad are more often not tested, that’s because their Dad is less likely to get breast cancer and can’t get ovarian cancer they are less likely to meet those rubbish “family history” criteria.  A history of cancer in a grandmother or aunt, who may have died before you were even born sounds less concerning than if it is your own mother but it is still a really important risk factor. 

    6. Jewish ancestry is a major RED flag to consider genetic screening

    Having a parent or grandparent with this ancestry is a big risk factor for inheriting a BRCA1 or BRCA2 genetic variant, up to a 1 in 40 chance. The NHS has recently started a project offering testing for gene variants which are more common in that background, if you’re interested you can find out more about the project here. You would also be eligible for our genetic screening which will screen not just BRCA1 and BRCA2 but also a wider range of genes linked to cancers which we can reduce or prevent. 

    7. There are things you can do to look after your health and reduce your risk

    There are lots of factors we can focus on to reduce the risk of ovarian cancer. And they will also reduce your risk of lots of other cancers such as breast and colon cancer. Keeping a healthy weight and not smoking are key. The oral contraceptive pill also reduces risk, as does breastfeeding. There has been a lot of concern about using talcum powder on the genital area and ovarian cancer, the evidence is mixed but it is sensible to avoid this. 

    8. Be symptom aware

    For those cancers we can’t prevent, we need to diagnose these as early as possible. Sadly two-thirds of women are diagnosed at a late stage. If we can diagnose women early at stage 1 the survival rate is over 94% at 5 years, versus only 16% for women diagnosed at stage 4. 

    Symptoms to watch for include:

    • Persistent increase in abdominal size or bloating (not bloating that comes and goes)
    • Persistent pelvic and abdominal pain
    • Unexplained change in bowel habits
    • Difficulty eating and feeling full quickly, or feeling nauseous
    • Needing to urinate (wee) more regularly

    Other symptoms can include tiredness, losing weight, pain during sex, and back pain. These can be symptoms of many other conditions too so don’t panic but see your doctor. They should consider checking a blood test called Ca125 and you may also need an ultrasound scan. 

    9. MYTH: “A smear test checks for ovarian cancer.”

    This is sadly common, about 1 in 4 women think this is true but sadly not. Cervical screening will not detect ovarian cancer.

    10. We can screen for ovarian cancer

    We don’t routinely recommend women use ultrasound or the Ca125 blood test for ovarian cancer screening because the biggest UK trial didn’t show this could improve survival in women, it is possible some women were diagnosed at an earlier stage. The test can also give “false alarms”, other conditions like endometriosis or fibroids can cause high Ca125 levels too. 

    We now have a new blood test that can be used to screen for ovarian cancer. It uses a normal blood sample taken in the clinic and the laboratory to look for ‘circulating tumour cells’, (CTCs). When a cancer or ‘tumour’ starts to grow in the body some of the cells will get into the bloodstream called CTCs. The really exciting part of this is that these CTCs can be found in early-stage 1 cancers.  

    The blood test is called a Multi Cancer Early Detection test, we offer tests by Trucheck that can either focus on female cancers or screen for up to 70 solid organ tumours. 

    Knowledge is power

    Many women and doctors lack knowledge of ovarian cancer. A study by Target Ovarian Cancer showed less than 5% of women were confident in knowing the signs of ovarian cancer. Many doctors also falsely believed women only get symptoms of late-stage ovarian cancer.

    We are passionate about giving women the knowledge and power to make the best choices for their health. If you think any other women in your life would find this useful then please share with them and hopefully, more women will be armed with knowledge. 

    DR LUCY HOOPER
    MB BS BSc MRCGP MA DRCOG DCH

    Lucy is a GP and co-founder of Coyne Medical. She graduated with honours from Imperial College London, trained at St Mary’s Hospital, and holds a Master’s in Medical Ethics and Law. Her clinical interests span women’s health, preventive medicine, and genomics, with a particular focus on using advanced biomarkers to build a more complete picture of long-term health.

    British Society for Genetic Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in BBC, The Guardian, Women’s Health, The Times and Tatler

    Book a GP Consultation

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Cancer Health Guides
  • Unmasking Early Signs of Colorectal Cancer in Younger Adults: Key Insights from Recent Study

    Unmasking Early Signs of Colorectal Cancer in Younger Adults: Key Insights from Recent Study

    There has been a concerning rise in early-onset colorectal cancer among individuals under 50. A recent study by Dr. Cassandra D. L. Fritz and colleagues at Washington University in St. Louis has brought critical insights that could aid in early detection and timely diagnosis. This information is not just data; it’s a potential lifesaver.

    The Rise of Early-Onset CRC

    Colorectal cancer is traditionally associated with older age. However, it is alarmingly increasing among the younger population. Indeed, we have colleagues and relatives under 40 who have been afflicted. This shift underscores the need for heightened awareness and vigilance, especially in spotting early signs.

    The Study: A Closer Look

    The researchers conducted an extensive study involving 5,075 individuals with early-onset colorectal, using data from U.S. commercial insurance beneficiaries. The focus was on identifying ‘red-flag’ signs and symptoms that occurred from three months to two years before the diagnosis.

    Key Findings: Red Flags in the Spotlight

    The study identified four significant red-flag symptoms and signs associated with an increased risk of early-onset colorectal cancer:

    • Abdominal Pain
    • Rectal Bleeding
    • Diarrhoea
    • Iron Deficiency Anaemia

    The odds ratios (ORs) for these symptoms ranged from 1.34 to 5.13, indicating a substantial link to early-onset CRC.

    Risk Amplification with Multiple Symptoms

    The presence of one, two, or at least three of these symptoms was associated with progressively higher risks:

    • 1 symptom: 1.94-fold increase
    • 2 symptoms: 3.59-fold increase
    • 3 or more symptoms: 6.52-fold increase

    Age and Cancer Type: Specific Considerations

    Interestingly, these associations were even stronger in younger individuals and those with rectal cancer.

    Diagnostic Timelines: A Crucial Element

    About 19.3% of patients had their first symptom between three months and two years before diagnosis, with a median diagnostic interval of 8.7 months. Approximately 49.3% exhibited their first symptom within three months of diagnosis, highlighting the critical window for early detection.

    A Call for Proactive Health Management

    This study underscores the importance of early recognition of these red-flag symptoms. Early detection is key in battling CRC, especially in its early onset. Understanding these warning signs and acting promptly can make a significant difference in outcomes. If you or someone you know experiences these symptoms, at any age, please seek medical evaluation. Your health and well-being are paramount. 

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Cancer Health Guides
  • Can you detect breast cancer in a blood test?

    Can you detect breast cancer in a blood test?

    When a tumour grows in the body some of its cells can break off and enter the bloodstream. These cells are called Circulating Tumour Cells (CTCs).

    The Trucheck Breast Cancer screening blood test uses a ‘normal’ blood test taken by your doctor at the clinic. It goes to the specialist laboratory in Surrey where it is examined looking for CTCs. Even a few CTCs in the bloodstream can indicate cancer.

    A breakthrough study published last year showed the blood test actually performed better than mammogram screening to detect cancers. The blood test found 92% of breast cancer, this was more than able to be detected by normal mammogram screening. We know in real life no test is perfect and there is a small chance of a false alarm.

    The blood test has also shown promising results compared to the GRAIL’s Galleri and CancerSEEK blood tests which only had a sensitivity to detect around 30% of breast cancer cases.

    Crucially the blood test can detect early cancers in stage 1 before there has been any spread to the lymph nodes or elsewhere in the body, and before any lump appears.

    1 in 7 women will be diagnosed with breast cancer in their lifetime. Diagnosing cancer earlier when treatment is easier and more successful is crucial.

    DR LUCY HOOPER
    MB BS BSc MRCGP MA DRCOG DCH

    Lucy is a GP and co-founder of Coyne Medical. She graduated with honours from Imperial College London, trained at St Mary’s Hospital, and holds a Master’s in Medical Ethics and Law. Her clinical interests span women’s health, preventive medicine, and genomics, with a particular focus on using advanced biomarkers to build a more complete picture of long-term health.

    British Society for Genetic Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in BBC, The Guardian, Women’s Health, The Times and Tatler

    Book a GP Consultation

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Cancer Health Guides
  • Trucheck™ vs. Galleri®: Comparing Advanced Blood Tests for Early Cancer Detection

    Trucheck™ vs. Galleri®: Comparing Advanced Blood Tests for Early Cancer Detection

    Introduction – The Future of Cancer Screening with Advanced Blood Tests

    Cancer screening has taken a significant leap forward with the introduction of advanced blood tests like Trucheck™ and Galleri®. These innovative screening methods aim to detect cancer at its earliest stages, providing vital information for timely interventions and improved outcomes. In this blog, we will compare Trucheck™ and Galleri®, exploring their scientific principles, advantages, and considerations, to help you make informed decisions about cancer screening.

    How Do Trucheck™ and Galleri® Blood Tests Work?

    Trucheck™ – Detecting Circulating Tumor Cells (CTCs)

    Trucheck™, developed by Datar Cancer Genetics, focuses on detecting circulating tumour cells (CTCs) and circulating ensembles of tumour-associated cells (C-ETACs) in peripheral blood samples. By employing primary negative enrichment, Trucheck™ enables the survival of malignant cells while allowing non-malignant cells to undergo apoptosis (programmed cell death). The subsequent analysis of tissue-specific markers on these cells helps identify cancer types and their likely organ of origin. Trucheck™ offers high sensitivity, specificity, and an overall advantage in detecting over 70 solid organ cancers.

    Galleri® – Analyzing Cell-Free DNA (cfDNA) for Cancer Detection

    Galleri®, another groundbreaking blood test, detects over 50 types of cancer and predicts the origin of cancer signals with high accuracy. This test examines the methylation patterns of cell-free DNA (cfDNA) found in the bloodstream. Methylation patterns, which regulate gene expression, can be altered in cancer, contributing to tumour growth. By leveraging next-generation sequencing (NGS) and machine-learning algorithms, Galleri® analyses the methylation patterns of cfDNA to identify cancer-specific abnormalities. These patterns provide valuable information about the presence and origin of potential cancers.

    Accuracy & Sensitivity of Each Test

    Trucheck™ demonstrates an overall sensitivity ranging from 82.5% to 88.2% for different cancer types. It boasts a specificity of 99%, correctly identifying 99 out of 100 individuals without cancer. False positives occur at an estimated rate of 1% to 3% according to the studies available so far. Trucheck™ has been designed as a complement to, not replacement for, standard cancer screening, offering peace of mind to individuals with negative results while prompting further tests or referrals for those with positive results.

    Galleri®, as demonstrated in the SYMPLIFY study, achieved a sensitivity of 66.3% overall, ranging from 24.2% for stage I cancers to 95.3% for stage IV cancers. This demonstrates Galleri’s ability to detect cancer signals across various stages but that it is most reliable with later-stage tumours. With a positive predictive value (PPV) of 75.5% and a negative predictive value (NPV) of 97.6%, Galleri®shows promise in accurately identifying individuals with cancer. The test’s specificity stands at 98.4%, further enhancing its precision in distinguishing cancer from non-cancer cases.

    Availability & Cost – Which Test is More Accessible?

    Trucheck™ is available as a standalone test or add-on service for patients undergoing health screening at Coyne Medical and several other private clinics in London and beyond. It may not be covered by healthcare insurance or the NHS prior to a formal cancer diagnosis. Further diagnostic procedures and referrals prompted by positive results may require self-payment.

    On the other hand, Galleri® is currently being evaluated in clinical trials and is not widely available outside of these trials. The SYMPLIFY study demonstrated its potential in a cohort of patients referred for diagnostic investigations related to suspected gynaecological, lung, and gastrointestinal cancers. It is not currently available in the UK in private care. It is only available through NHS research trials. 

    Considerations and Future Implications:

    Both Trucheck™ and Galleri® have the potential to revolutionise cancer screening, but it’s important to consider certain factors. Trucheck™ offers a broader range of tests for different cancer types, while Galleri’s focus lies in detecting over 50 cancer types. Trucheck™ uses CTCs and their clusters as biomarkers, primarily for solid organ malignancies, whereas Galleri® examines cfDNA methylation patterns.

    While Trucheck™ and Galleri® boast impressive sensitivity, it’s crucial to understand that false negatives can still occur. Neither test can replace standard screening methods such as mammograms, colon cancer screening, or cervical screening. Additionally, the emotional impact and potential for anxiety associated with both tests’ results should be taken into consideration.

    Looking ahead, the development of advanced blood tests like Trucheck™ and Galleri® brings us closer to a future where early cancer detection becomes a reality. These tests have the potential to complement existing screening methods, offering individuals a comprehensive and personalised approach to cancer prevention and treatment.

    Trucheck™ and Galleri® blood tests represent groundbreaking advancements in cancer screening, utilising cutting-edge technologies and scientific understanding to improve early detection rates. Trucheck™ focuses on CTCs, while Galleri® examines cfDNA methylation patterns. Both tests demonstrate considerable accuracy and hold promise for transforming cancer diagnosis and treatment.

    It is essential to consult with healthcare professionals to determine the most suitable screening approach based on individual risk factors, age, and personal medical history. By considering these innovative blood tests alongside standard screening methods, we move closer to a future where early cancer detection becomes the norm, leading to better outcomes and improved quality of life. Trucheck™ cancer screening blood test is available at Coyne Medical. Learn more on our website here.

    Book a Cancer Blood Test in London at Coyne Medical

    It is essential to consult with healthcare professionals to determine the most suitable screening approach based on individual risk factors, age, and personal medical history. By considering these innovative blood tests alongside standard screening methods, we move closer to a future where early cancer detection becomes the norm, leading to better outcomes and improved quality of life. Trucheck™ cancer screening blood test is available at Coyne Medical.

    BOOK MULTICANCER EARLY DETECTION BLOOD TEST

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Cancer Health Guides