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Translational studies of HEAD and neck cancer in South America and Europe: a qualitative health systems analysis


Project Description

Background
Head and Neck Cancer (HNC) is the 6th most common cancer in both Europe and South America and is on the rise. Survival following diagnosis and treatment remains poor.

The HEADSpAcE (Translational studies of HEAD and neck cancer in South America and Europe) multicentre study is a EU Horizon2020 funded project. It aims to investigate the determinants of late stage of presentation of head and neck cancer, and assess the impact on prognosis and survival in Europe and South America.

This will involve a number of studies. This fully funded PhD studentship is part of a work package lead by the University of Glasgow entitled: “Socioeconomic, logistic, and biological predictors of delayed head and neck cancer diagnosis in Europe and Latin America”. It will involve mixed methodologies with a substantial qualitative research component.

Aims
To identify the main factors that lead to delay between time of first symptoms and time of diagnosis, including factors related to the patient, and factors related to the healthcare service system.

Methods
The studentship will focus on a centre-level analysis of the head and neck cancer care pathway and service, assessing how healthcare system characteristics relate to cancer outcomes. This work will be a process evaluation that is undertaken alongside the recruitment and follow-up of the HEADSpAcE multicentre clinical cohort study.

Two broad aspects to the doctoral project are envisaged. Below are indicative methods to be finalised with the successful candidate.
1. Lead on a centre-level analysis of all 11 centres in collaboration
a) Survey of key stakeholders from each centre (clinical leads, hospital / service management, primary care leads, public health specialist, policy leads). Information will be collected on the health care system model including: primary care and secondary care services availability / accessibility (costs), referral pathways, networks, and level of centralization. Case studies will also include data collection on annual case-load of HNC patients, proportion of late stage HNC diagnosis, and mapping of service structures and referral pathways.
b) Develop and distribute a proforma questionnaire and collate responses in Europe; coordinate responses from elsewhere in collaboration with INCA in South America.
c) Lead on analysis and write-up
2. Lead on in-depth qualitative cases studies in two centres (Glasgow and Rio)
a) Design and conduct/ supervise semi- structured face-to-face interviews focusing on barriers and facilitators across the pathway to early detection and diagnosis of head and neck cancers.
b) Interview a sample of 6 patients (including patients with late stage HNC), 6 primary care clinicians (including dentists and general practitioners / primary care physicians), 6 secondary care clinicians (including surgeons, oncologists, and nurse leads), and 6 public health / manager / policy leads.
c) Support coordination of interviews in Rio (undertaken by South American partner)
d) Lead on training and standardization of approach between UGLA and INCA
e) Lead on analyses of qualitative themes to understand determinants of health system performance (input, process, output) in relation to early detection of head and neck cancer to develop strategies for improvement.
f) Integrate these qualitative findings to enhance the understanding of the cohort study analyses.

The HEADSpAcE project has unique strengths. Firstly, the project is built on large accessible prospective biorepositories from both Europe and South America that have been collected and stored with the goal of conducting high quality translational collaborative research. Secondly, the project includes some of the leading cancer research teams investigating the role of genomics and infectious agents in HNC. The project will build on a longstanding and successful collaboration between investigators in Europe and South America, going back over 20 years, that includes partners from different regions of South America, that serve very diverse populations.

Environment
The successful candidate will be based within Glasgow University Dental School, and will work within the Community Oral Health group, which has a strong track record in head and neck cancer research. Glasgow University Dental School hosts a vibrant group of around 20 PhD students, and the MVLS college provides a programme of research skills training courses (link), ensuring our postgraduates are equipped with the necessary attributes on graduation.

Funding Notes

A good degree (minimum of a 2:1) relevant to health services / public health and/or social science and a relevant Master’s degree or an equivalent professional qualification e.g. in public health, or research methods.

References

Collaborators

IARC International Agency for Research on Cancer, France
ICO Catalan Institute of Oncology, Spain
UNITO University of Turin, Italy
CUNI Charles University, Czech Republic
DKFZ German Cancer Research Center, Germany
UGLA University of Glasgow, UK
UBRIS University of Bristol, UK
INCA Brazilian National Cancer Institute, Brazil
AC-CCC A.C. Camargo Cancer Center, Brazil
HCB Barretos Cancer Hospital, Brazil
AFECC Hospital Santa Rita de Cassia, Brazil
UnBosque University El Bosque, Colombia
UdelaR University of the Republic, Uruguay
IOAR Institute of Oncology Angel H. Roffo, Argentina
UTHSC University of Tennessee Health Science Center, USA

How good is research at University of Glasgow in Allied Health Professions, Dentistry, Nursing and Pharmacy?

FTE Category A staff submitted: 13.80

Research output data provided by the Research Excellence Framework (REF)

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