Prof Richard Neal
Associate Director
![Prof Richard Neal](https://www.cantest.org/wp-content/uploads/2018/01/Profile_Richard_Neal-min.jpg)
Richard is an Associate Director of CanTest. He is a part-time GP and Professor of Primary Care at the University of Exeter. Richard relocated to the South-West in August 2021 from Leeds, where he was Professor of Primary Care Oncology at the Leeds Institute of Health Sciences. His research focuses around the interface of primary care and cancer, especially around the diagnosis of cancer in general practice, and cancer screening.
He is a Visiting Professor at the University of Leeds and continues to work very closely with the Leeds hub of CanTest, the Leeds hub of the DHSE Policy Research Unit of Cancer Awareness Screening and Early Diagnosis, and the Leeds Centre for Personalised Medicine and Health.
He is Co-Chief Investigator of the WICKED programme (Wales Interventions Cancer Knowledge Early Diagnosis), funded by Cancer Research Wales, and is co-investigator on the Yorkshire Lung Screening Trial, funded by Yorkshire Cancer Research. He chairs the RCGP Scientific Foundation Board and is past Chair of the NCRI Primary Care Clinical Studies Group.
Twitter: @richarddneal
University of Exeter, UK
Early diagnosis and primary care trials
- The role of imaging in the diagnosis of symptomatic lung cancer
- Aids to cancer diagnosis in primary care
- Development of a primary care head and neck risk assessment tool
- Risk of lung cancer in symptomatic patients with negative chest x-ray results
- What factors influence GPs’ decision to request imaging for possible lung cancer?
- Development of a risk assessment tool for ruling out cancer in patients being referred for possible cancer diagnosis
- Is General Practice chest x-ray rate associated with lung cancer outcomes?
- Wales Interventions and Cancer Knowledge about Early Diagnosis
- Examination of Diagnostic Pathways of People with Lung Cancer (PhD)
- Investigation of potential for using point of care tests for early cancer diagnosis in primary care (PhD)
- Development and pilot testing of measurement tool for diagnosis of lung cancer
- Factors influencing the patient/practitioner decision to investigate or refer older adults with symptoms potentially indicating cancer
- A review of clinical guidelines on the diagnosis of cancer in older adults
- CanImpact: the impact of the COVID-19 pandemic on cancer detection in primary care
- Experiences along the diagnostic pathway for patients with advanced lung cancer
- Cancer referral in younger patients – do age threshold guidelines need updating?
- Investigating the use of routine blood tests and reflex testing to improve the early diagnosis of myeloma
- Urgent referrals for suspected cancer in England 2009/10-2019/20: temporal trend analysis of population-based routine data
- Target Product Profiles for Early Cancer Diagnostics
- The effect of increasing age, frailty and cognitive impairment on time to diagnosis of suspected cancer: a population based electronic health records study
- Stanciu MA, Law R-J, Nafees S, Hendry M, Yeo ST, Hiscock J, Lewis R, Edwards RT, Williams NH, Brain K, Brocklehurst P, Carson-Stevens A, Dolwani S, Emery J, Hamilton W, Hoare Z, Lyratzopoulos G, Rubin G, Smits S, Vedsted P, Walter FM, Wilkinson C, Neal RD. Development of an intervention to expedite cancer diagnosis through primary care: Protocol. BJGP Open 4 September 2018; bjgpopen18X101595
- Bradley SH, Kennedy MPT, Neal R. Recognising Lung Cancer in Primary Care. Avances in Therapy 2018; 1-12
- Neal RD, Sun F, Emery JD, Callister ME. Lung Cancer. BMJ, 2019, 365:I1725
- Walter FM, Thompson MJ, Wellwood I, Abel GA, Hamilton W, Johnson M, Lyratzopoulos G, Messenger MP, Neal RD, Rubin G, Singh H, Spencer A, Sutton S, Vedstead P, Emery JD. Evaluating diagnostic strategies for early detection of cancer: the CanTest framework. BMC Cancer, 2019, 19:586
- Renzi C, Kaushal A, Emery J, Hamilton W, Neal RD, Rachet B, Rubin G, Singh H, Walter FM, de Wit NJ, Lyratzopoulos G. Comorbid chronic diseases and cancer diagnosis: disease-specific effects and underlying mechanisms. Nature Reviews: Clinical Oncology, 2019, https://doi.org/10.1038/s41571-019-0249-6
- Jones D, Neal RD, Duffy SRG, Scott SE, Whitaker KL, Brain K. Impact of the COVID-19 pandemic on the symptomatic diagnosis of cancer: the view from primary care. The Lancet Oncology, 2020. doi: 10.1016/S1470-2045(20)30242-4
- di Martino E, Andersen AC, Mengel-Jørgensen T, Jensen MB, Bradley S, Neal RD. Is there a place for point-of-care ultrasound in UK primary care? British Journal of General Practice, 2020; 70 (696): 323-324. doi: 10.3399/bjgp20X710801
- Atkin C, Iqbal G, Planche T, Pratt G, Yong K, Wood J, Raynes K, Low E, Higgins H, Neal RD, Dunn J, Drayson MT, Bowcock S. Diagnostic pathways in multiple myeloma and their relationship to end organ damage: an analysis from the Tackling Early Morbidity and Mortality in Myeloma (TEAMM) trial. British Journal of Haematology, 2020, doi: 10.1111/bjh.17044
- di Martino E, Ayaz-Shah A, Shinkins B, Jain S, Neal RD. A urine test for bladder cancer: available soon in primary care? Trends in Urology & Men’s Health, 2020, 11(4), doi: 10.1002/tre.760
- Bradley SH, Hatton NLF, Aslam R, Bhartia B, Callister MEJ, Kennedy MPT, Mounce L, Shinkins B, Hamilton WT, Neal RD. Estimating lung cancer risk from chest x-ray and symptoms: a prospective cohort study. British Journal of General Practice, 2020, doi: 10.3399/bjgp20X713993
- Achkar MA, Zigman Suchland M, Walter FM, Neal RD, Goulart BHL, Thompson MJ. Experiences along the diagnostic pathway for patients with advanced lung cancer in the USA: a qualitative study. BMJ Open, 2021; 11:e045056, doi: 10.1136/bmjopen-2020-045056
- Archer S, Calanzani N, Honey S, Johnson M, Neal R, Scott SE, Walter FM. Impact of the COVID-19 pandemic on cancer assessment in primary care: a qualitative study of GP views. BJGP Open, 2021, doi: 10.3399/BJGPO.2021.0056
- Bhartia B.S.K, Hatton N, Aslam R, Bradley SH, Darby M, Hamilton W, Hurst E, Kennedy M.P.T, Mounce L.T.A., Neal R.D., Shinkins B, Callister M.E.J. A prospective cohort evaluation of the sensitivity and specificity of the chest X-ray for the detection of lung cancer in symptomatic adults. European Journal of Radiology, 2021, doi.org/10.1016/j.ejrad.2021.109953.
- Bradley SH, Bhartia BS, Callister ME, Hamilton WT, Hatton NLF, Kennedy MP, Mounce L, Shinkins B, Neal R, et al. Chest X-ray sensitivity and lung cancer outcomes: a retrospective observational study. British Journal of General Practice, 2021. doi: 10.3399/BJGP.2020.1099
- Disbeschl S, Surgey A, Roberts JL, Hendry A, Lewis R, Goulden N, Neal R, et al. Protocol for a feasibility study incorporating a randomised pilot trial with an embedded process evaluation and feasibility economic analysis of ThinkCancer!: a primary care intervention to expedite cancer diagnosis in Wales. Pilot and Feasibility Studies, 2021. doi:10.1186/s40814-021-00834-y
- Neal, R, Smith L. Urgent cancer referrals: how well are they working and can they be improved? British Journal of General Practice, 2021; 71 (710): 390-391. doi: 10.3399/bjgp21X716801
- Rubin G, Walter FM, Emery J, Hamilton W, Hoare Z, Howse J, Nixon C, Srivastava T, Thomas C, Ukoumunne OC, Usher-Smith JA, Whyte S, Neal RD. Electronic clinical decision support tool for assessing stomach symptoms in primary care (ECASS): a feasibility study. BMJ Open, 2021;11:e041795. doi: 10.1136/bmjopen-2020-041795
- Merriel SWD, Lee L, Neal R. Community diagnostic centres: Bringing diagnostics closer to home. British Journal of General Practice 2021; 71 (713): 534-535. doi: 10.3399/bjgp21X717701
- Jones D, Di Martino E, Bradley SH, Essang B, Hemphill S, Wright JM, Renzi C, Surr C, Clegg A, De Wit N, Neal R. Factors affecting the decision to investigate older adults with potential cancer symptoms: a systematic review. British Journal of General Practice 2022; 72 (714): e1-e10. doi: 10.3399/BJGP.2021.0257
- di Martino E, Smith L, Bradley SH, Hemphill S, Wright J, Renzi C, Bergin R, Emery J, Neal RD. Incidence trends for twelve cancers in younger adults—a rapid review. Br J Cancer (2022). doi: 10.1038/s41416-022-01704-x
- Bradley SH, Barclay M, Cornwell B, Abel GA, Callister MEJ, Gomez-Cano M, Round T, Shinkins B, Neal RD. Associations between general practice characteristics and chest X-ray rate: An observational study. British Journal of General Practice 2022; 72 (714): e34-e42. doi: 10.3399/BJGP.2021.0232
- Anthony BF, Disbeschl S, Goulden N, Hendry A, Hiscock J, Hoare Z, Lewis R, Roberts J, Rose J, Williams NH, Walker D, Neal R, Wilkinson C, Edwards RT. (2022) Improving the diagnosis of cancer in primary care: a feasibility economic analysis of the ThinkCancer! study. International Journal of Population Data Science, 7(2). doi: 10.23889/ijpds.v7i2.1736
- Smith S, Sansom N, Hemphill S, Bradley SH, Shinkins B, Wheatstone P, Hamilton W, Neal RD. Trends and variation in urgent referrals for suspected cancer 2009/2010–2019/2020, British Journal of General Practice 2022; 72 (714): 34-37. doi: 10.3399/bjgp22X718217
- Smith L, Carmichael J, Cook G, Shinkins B, Neal RD. Diagnosing myeloma in general practice: How might earlier diagnosis be achieved? British Journal of General Practice 2022; 72 (723): 462-463. doi: 10.3399/bjgp22X720737
- Savage R, Messenger M, Neal RD, Ferguson R, Johnston C, Lloyd KL, Neal MD, Sansom N, Selby P, Sharma N, Shinkins B, Skinner JR, Tully G, Duffy S, Hall G. Development and validation of multivariable machine learning algorithms to predict risk of cancer in symptomatic patients referred urgently from primary care: a diagnostic accuracy study. BMJ Open 2022; 12:e053590. doi: 10.1136/bmjopen-2021-053590
- Zigman Suchsland M, Kowalski L, Burkhardt HA, Prado MG, Kessler LG, Yetisgen M, Au MA, Stephens KA, Farjah F, Schleyer AM, Walter FM, Neal RD, Lybarger K, Thompson CA, Achkar MA, Sarma EA, Turner G, Thompson M. How Timely Is Diagnosis of Lung Cancer? Cohort Study of Individuals with Lung Cancer Presenting in Ambulatory Care in the United States. Cancers. 2022; 14(23):5756. doi: 10.3390/cancers14235756
- Briggs E, de Kamps M, Hamilton W, Johnson O, McInerney CD, Neal RD. Machine Learning for Risk Prediction of Oesophago-Gastric Cancer in Primary Care: Comparison with Existing Risk-Assessment Tools. Cancers. 2022; 14(20):5023. doi: 10.3390/cancers14205023
- Smith AF, Frempong SN, Sharma N, Neal RD, Hick L, Shinkins B. An exploratory assessment of the impact of a novel risk assessment test on breast cancer clinic waiting times and workflow: a discrete event simulation model. BMC Health Serv Res 22, 1301 (2022). doi: 10.1186/s12913-022-08665-0
- Jones D, Di Martino E, Bradley SH, Essang B, Hemphill S, Wright JM, Renzi C, Surr C, Clegg A, Neal R. Factors influencing symptom appraisal and help-seeking of older adults with possible cancer: a mixed-methods systematic review. British Journal of General Practice 2022; 72 (723): e702-e712. doi: 10.3399/BJGP.2021.0655