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Leeds Institute of Cancer and Pathology PhD Studentship 2015 intake Please contact the Lead Supervisor with informal enquiries Title of Project What happens when a ‘carer’ gets colorectal cancer? Lead Supervisor Current post(s) Dr Penny Wright Associate Professor in in [email protected] Psychosocial Cancer Care Co-Supervisor(s) Current post(s) Dr Amy Downing Senior Research Fellow Professor Claire Hulme Professor of Health Economics Section Patient Centred Outcome Research Section Epidemiology & Biostatistics Academic Unit of Health Economics, Leeds Institute of Health Sciences Subject Area Psychosocial Oncology Project Summary (up to 300 words) Colorectal cancer (CRC) is the third commonest cancer (both genders). Incidence escalates post the age of 50. One year survival stands at 76%. Poorer survival is related to older age and more advanced disease at diagnosis (1). In an English CRC survey, 20.6% defined themselves as being a ‘carer’ (paper under review). As the population ages the number of ‘carers’ increases. Carers report poor physical/mental health and suspension of attending medical check-ups or treatment due to lack of time or replacement care(2). However, there is uncertainty about whether having a caring role impacts on mortality (3). The cost to health and social care services of providing care is substantial and increasing. This would be considerably more were it not for the huge contribution made by informal carers. Therefore, maintaining carer health is important not only for the carer and the person being cared for but also for society. There is little published concerning carers who are diagnosed with cancer. The aim is to explore experiences and outcomes of carers diagnosed with CRC (common in both genders, occurring in age groups where caring is commonplace (e.g. caring for children, partners, parents)). If caring has an impact on survival (e.g. through late presentation) this is likely to be picked up in the first couple of years post diagnosis. A mixed methods approach will be employed (qualitative, qualitative, health economic).Routes to diagnosis and treatment choice analyses will be undertaken on data from linked data sets (e.g. as in the NCIN ‘Routes to Diagnoses’; Primary Care) to compare carer/non-carer outcomes. Longitudinal qualitative interviews of newly diagnosed CRC patients with caring responsibilities will be undertaken to explore in depth the experience of routes to diagnosis, treatment decision making and the impact on caring. Health economic outcomes will be examined in both qualitative and quantitative studies. Techniques associated with project Literature reviewing. Statistical analyses of large data sets using standard parametric and nonparametric techniques as required. Longitudinal qualitative interviewing and analysis using a Framework Analytical approach. Health economic analyses using, where possible, linked datasets for quantitative work and preliminary investigation from interview data of the carer and cared for costs (individual and societal). References (up to 3) 1. Downing A, Aravani A, Macleod U, Oliver S, Finan PJ, Thomas JD, et al. Early mortality from colorectal cancer in England: a retrospective observational study of the factors associated with death in the first year after diagnosis. British Journal of Cancer. 2013;108(3):681-5. 2. Carers UK. Facts about carers 2014. Available from: http://www.carersuk.org/for-professionals/policy/policy-library/facts-about-carers2014. 3. Ramsay S, Grundy E, O'Reilly D. The relationship between informal caregiving and mortality: an analysis using the ONS Longitudinal Study of England and Wales. J Epidemiol Community Health. 2013;67(8):655-60.