A National Health Service Cervical Screening Programme (NHSCSP) was first introduced in England in 1988. Informed by the knowledge that chronic infection with human papillomavirus (HPV) causes cervical cancer, girls and boys are now offered the HPV vaccine. New screening strategies for cervical cancer are emerging including primary HPV testing of cervical samples and self-sampling strategies to improve cervical screening uptake. Despite these advances the enduring challenge of poor (around 71%) and variable uptake of cervical screening across different socio-economic groups remains.
Aim: to assess the cost effectiveness of alternative cervical screening strategies in specific sub-groups of the population eligible for cervical screening taking account of the impact of imperfect uptake.
Objectives:
1. Critique the current economic evidence base for available screening strategies in cervical screening programmes and describe if, and how, socio-economic status was considered as a factor affecting the relative cost-effectiveness of national cervical screening programmes (using systematic review).
2. Quantify the diagnostic test accuracy of urine HPV testing compared with other screening strategies taking into account the rate of background vaccination against HPV across screening cohorts (using network meta-analysis of diagnostic test accuracy).
3. Understand the cost-effectiveness of alternative screening strategies, including self-sampling, in a national cervical screening programme, taking account of different socio-economic groups in the eligible population (using decision-analytic model based distributional cost-effectiveness analysis).
4. Quantify the impact of imperfect uptake of self-sampling strategies on their relative cost-effectiveness in a national cervical screening programme (using static and dynamic value of implementation methods).
This PhD programme will be supervised by a Manchester-based multidisciplinary team comprising experts in economic analysis of screening programmes (Katherine Payne), cervical cancer and HPV testing (Emma Crosbie), and systematic review and network meta-analysis of diagnostic tests (Tanya Walsh). The PhD also involves collaboration with the Cambridge ACED involving Steve Morris (health economics).
Led by Professor Robert Bristow and Professor Gareth Evans, ACED in Manchester aims to build on this heritage and leverage the pre-existing strengths of the Manchester eco-system to deliver novel innovations in prevention and early detection research.
Entry Requirements
Candidates are expected to hold (or be about to obtain) a minimum upper second class honours degree (or equivalent) in a related area/subject. Candidates with previous laboratory experience are particularly encouraged to apply.
How To Apply
For information on how to apply for this project, please visit the Faculty of Biology, Medicine and Health Doctoral Academy website (https://www.bmh.manchester.ac.uk/study/research/apply/). Informal enquiries may be made directly to the primary supervisor. On the online application form select the appropriate subject title.
For international students, we also offer a unique 4 year PhD programme that gives you the opportunity to undertake an accredited Teaching Certificate whilst carrying out an independent research project across a range of biological, medical and health sciences.
Equality, Diversity and Inclusion
Equality, diversity and inclusion is fundamental to the success of The University of Manchester, and is at the heart of all of our activities. The full Equality, diversity and inclusion statement can be found on the website https://www.bmh.manchester.ac.uk/study/research/apply/equality-diversity-inclusion/”
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