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Maximising acceptability of risk stratification in the NHS breast screening programme

  • Full or part time

    Dr S Scott
  • Application Deadline
    Friday, November 08, 2019
  • Funded PhD Project (European/UK Students Only)
    Funded PhD Project (European/UK Students Only)

Project Description

To start: 1 January 2020 (negotiable)

Background: Women aged 50-70 years in England are offered 3-yearly breast screening but there is increasing interest in stratifying screening to women’s individual breast cancer risk. This would optimise the harm/benefit ratio and would decrease the risk of overdiagnosis in low-risk women. Alongside work to develop the risk assessment algorithm and appropriate management of women in different risk groups, it is essential that we understand how to maximise acceptability and uptake in women in the target age-group.

Aims: The project will use a series of three studies to 1) explore women’s attitudes to risk-stratified breast screening, 2) quantify the importance of a range of attributes for the acceptability of risk-stratified screening, and 3) compare the acceptability of different approaches to risk-stratified screening.

Methodology: Study 1 will be an exploratory study using in-depth interviews to assess women’s attitudes to risk stratification and identify the most important attributes of risk assessment and risk stratification that determine acceptability. Study 2 will use a Discrete Choice Experiment to quantitatively measure the relative importance of different aspects of risk-stratified screening (e.g. screening intervals, risk of overdiagnosis) and elicit acceptable trade-offs between benefits and harms. This will inform the design of Study 3, in which women will be randomised to view one of three different risk-stratified screening scenarios so we can identify the most acceptable option. Throughout the work, acceptability will be assessed in relation to scenarios where the harm/benefit ratio makes implementation feasible, so the findings will be of direct relevance to policy and practice.

Applicants: We are looking for applicants with a 2.1 or first-class undergraduate degree in psychology or a related discipline, an MSc in health psychology or equivalent research experience, an interest in qualitative and quantitative methods, and a commitment to applied health research.

Supervisors: Dr Jo Waller and Dr Suzanne Scott are health psychologists with strong track records in applying psychology and behavioural science in the context of cancer screening and early diagnosis. Professor Nora Pashayan (UCL) is public health clinician with expertise in risk stratification algorithms. There will also be a wider team involved with the project including experts in health economics and risk communication.

Research group: The student will be based with Jo Waller in the Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences and will have close links with the Health Psychology Section of the IoPPN. The group is led by Professor Peter Sasieni. It includes around 30 grant-funded researchers. Group members have substantial expertise in epidemiology, behavioural science, clinical studies, use of routine registries and databases, as well as related statistical methodologies. Members of the group collaborate in cancer screening research internationally. The Group is based on the Guy’s Campus. The group includes the Cancer Research UK King’s College London Cancer Prevention Trials Unit. It is a partner in the NIHR Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis. The group is committed to both public and patient involvement in its research and public engagement more generally.

Applications must be made through Kings Apply (https://apply.kcl.ac.uk) including CV and cover letter stating the application reference number 2019/CPS/S42.

Funding Notes

Sponsor: Breast Cancer Now
Stipend: £17,000
Award: A full time 3 year PhD studentship

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