Around 2.5 million people in the UK are currently living with and beyond cancer (sometimes referred to as “cancer survivors”) and this number will rise to 4 million by 2020. Many of these people will experience ongoing physical or psychological sequelae as a result of their original cancer diagnosis or its treatment. In effect, for many, cancer survivorship has become a long term condition (LTC).
Multimorbidity, the coexistence of LTCs, is an increasing challenge for health services. Commonly defined as the presence of two or more long term conditions, multimobidity is associated with increased mortality, reduced functional status and increased use of inpatient and outpatient care. The prevalence of multimorbidity increases with age: over 40% of those aged 70 to 74 years have three or more disorders; at 85 years’ old around 30% have five or more LTCs. Under the age of 85 multimorbidity is strongly associated with deprivation. Epidemiological work from the UK suggests that more than half the people with multimorbidity are actually under 65 and that those from relatively socioeconomically deprived areas are at increased risk. Young and middle aged adults in the most deprived areas have the same prevalence of multimorbidity as those around 10–15 years older in the most affluent areas.
This quantitative research doctorate will explore multimorbidity in those living with and beyond cancer using the Discovery database: a collaboration between the boroughs of Newham, Tower Hamlets, City and Hackney and Waltham Forest and the Homerton and Barts NHS Trusts, covering 200 GP practices and a population of 1.3 million. It will explore: patterns of co-morbidity in those living with and beyond cancer in East London with particular reference to deprivation and ethnicity, and patterns of health care resource use amongst this population.
Overall the project will contribute to our understanding about the impact of cancer survivorship and comorbidity on individuals and health services and ways adverse impacts might be mitigated.
Project-specific skills and experience required
This is a quantitative decorate so masters level training in statistics and epidemiology is essential. Experience of working with primary or secondary care databases would be an advantage.
All candidates should hold a Master’s qualification (or complete their Master’s by September 2019) in an appropriate discipline and have a minimum of a 2:1 or equivalent in their first degree. Applicants should preferably have knowledge of the UK health and care system. All applicants are required to have excellent written and verbal communication skills. They should also be willing to work collaboratively in multi-disciplinary and multi-professional teams.