Examining the risk of cancer and cancer mortality in people with psoriasis

Psoriasis is a common, chronic inflammatory skin disease which has been associated with numerous co-morbidities. Given the inflammatory nature of the disease, use of anti-psoriatic treatments in this population (such as immune-suppressive treatments, phototherapy) and the high prevalence of adverse lifestyle factors such as excessive smoking and alcohol consumption, people with psoriasis may be at a higher risk of cancer compared to the general population.

Several earlier studies have investigated the risk of cancer in people with psoriasis and examined overall or cancer-specific mortality with conflicting results. Furthermore, the majority of them have relied on information using solely derived from primary or secondary care sources, thus not taking full advantage of linking primary care databases to hospital records, cancer specific registries or national mortality records.

The Clinical Practice Research Datalink (CPRD), a large primary care database from the UK, is used widely around the world for research purposes. Electronic health records from CPRD general practices in England have been linked to hospital (Hospital Episodes Statistics), and mortality records (Office for National Statistics) and Cancer Registration Data, bringing together all the information from cancer registries in England. Linkage across different databases and specific cancer registries provides a unique opportunity for investigating incident cancer and cancer mortality (for overall and cause-specific cancer) in people with psoriasis. This project will use these important data resources to estimate the cancer-specific incidence and the cancer-specific mortality in people with psoriasis.

This PhD studentship provides an excellent opportunity to conduct multidisciplinary research in one of the leading centres for pharmacoepidemiology using large routinely collected data sources and to work with experts in the field of pharmacoepidemiolgy, biostatistics and dermatology. The studentship is part of the Global Psoriasis Atlas, an international project examining the epidemiology and burden of psoriasis.

Excellent specialised training for examining large routinely collected datasets will be provided. Supervisors Ashcroft, Griffiths, Parisi and Kontopantelis have jointly conducted many CPRD-based studies, and their teams of postdoctoral researchers and PhD students in the Centres for Pharmacoepidemiology & Drug Safety, Dermatology, and The Farr Institute for Health Informatics Research will provide additional ongoing ad hoc advice and support. The successful candidate would also have access to epidemiological/statistical courses at the University, including modules from the online Masters in Public Health (e-MPH), as well as short courses in the Faculty of Biology Medicine and Health (e.g. course run by Dr Mark Lunt - Division of Musculoskeletal & Dermatological Sciences). The successful candidate would be expected to regularly attend meetings of the CPRD User Group and Pharmacoepidemiology Journal Club. Funding for attending external courses and/or presenting research findings at conferences will also be available.

International research on the global epidemiology of psoriasis: Development of the Global Psoriasis Atlas (GPA). The GPA will create the first-ever, comprehensive global database on the epidemiology of psoriasis. It responds to a World Health Organisation (WHO) call to fill global knowledge gaps on the incidence and prevalence of this serious non-communicable disease. The lead academic centre delivering the research programme is based at the University of Manchester and will host this PhD studentship. In delivering this research programme, the project team will continue to work closely with the International Federation of Psoriasis Associations (IFPA), the International League of Dermatological Societies (ILDS) and the International Psoriasis Council (IPC), who together represent patients, health professionals and dermatologists internationally.

The PhD project is suitable for an ambitious individual wishing to develop a research portfolio in disease epidemiology and to have experience in dealing with large databases of electronic health records. Applicants are expected to hold, or about to obtain, a minimum upper second class undergraduate degree (or equivalent) in epidemiology, statistics, biostatistics or health sciences; a relevant masters degree in one of these disciplines is also desirable. 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.