(MRC DTP) Autism and other psychiatric conditions in paediatric cancer survivors: a population-based cohort study utilising multiple routinely collected UK data linkages

Paediatric cancer survivors are at increased risk of psychiatric illnesses including anxiety disorders, and depression, as well as cognitive impairments and academic difficulties. A small number of studies of childhood brain tumour survivors have reported an increased incidence of social skills and social competence difficulties such as those seen in Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), although no epidemiological studies have been undertaken on this topic to date.

Anecdotal evidence suggests elevated incidence of ASD in children diagnosis with cancer, but the nature of this relationship is unclear. Genes associated with cancer play in important role in neural development. Conversely, many of the risk genes implicated in ASD also increase susceptibility to cancers. Genome-wide studies of ASD indicate likely involvement of key molecular mechanisms such as the Ras Mapkinase and chromatin remodelling pathways, which are known to be strongly associated with cancer. Given that cancer associated genes also play an important role in neural development, the timing of the gene mutation may perhaps lead to increased vulnerability to cancer or to ASD, or to both conditions. However, the evidence to date of the association between cancer and ASD is inconsistent. These links are important to investigate to advance the therapeutics for both cancer and ASD.

There is a lack of large population-based studies investigating the epidemiology of childhood mental illness in cancer survivors. This proposal seeks to investigate the relationship between childhood cancer and psychiatric morbidities, including ASD, via nationally representative primary care records held in the Clinical Practice Research datalink (CPRD) linked with the national Hospital Episodes Statistics (HES),national cancer registry and ONS mortality records. These databases provide access to anonymised longitudinal primary care data with information on diagnoses, prescribed medication, and referral to secondary care, and they cover approximately 15% of the population of England. By establishing incidence rates, absolute and relative risks of childhood mental illnesses, including ASD, the study’s findings will be informative for clinicians and researchers. It will inform enhanced clinical care for children diagnosed with cancers by advocating early neurodevelopmental / mental health assessments, and access to early intervention strategies for ASD and ADHD. Furthermore, it will facilitate a better understanding of common mechanisms underpinning both cancer and ASD (and other psychiatric conditions) and may ultimately help to inform the development of new therapeutics


Professor Roger Webb: https://www.research.manchester.ac.uk/portal/en/researchers/roger-webb(d78773ef-6dd1-418b-a105-2cc44d6abfd5).html

Dr Shruti Garg: https://www.research.manchester.ac.uk/portal/shruti.garg.html

Professor Darren Ashcroft: https://www.research.manchester.ac.uk/portal/darren.ashcroft.html

Entry Requirements:
Applicants must have obtained, or be about to obtain, at least an upper second class honours degree (or equivalent) in a relevant subject.

UK applicants interested in this project should make direct contact with the Primary Supervisor to arrange to discuss the project further as soon as possible. International applicants (including EU nationals) must ensure they meet the academic eligibility criteria (including English Language) as outlined before contacting potential supervisors to express an interest in their project. Eligibility can be checked via the University Country Specific information page (https://www.manchester.ac.uk/study/international/country-specific-information/).

If your country is not listed you must contact the Doctoral Academy Admissions Team providing a detailed CV (to include academic qualifications – stating degree classification(s) and dates awarded) and relevant transcripts.

Following the review of your qualifications and with support from potential supervisor(s), you will be informed whether you can submit a formal online application.

To be considered for this project you MUST submit a formal online application form - full details on how to apply can be found on the MRC Doctoral Training Partnership (DTP) website www.manchester.ac.uk/mrcdtpstudentships