PhD Studentship: Exploring the complex relationships between pre-existing conditions and cancer diagnosis in an ageing population

University of Exeter - Medical School - College of Life and Environmental Science

Join a world-leading, cross-continental research team

The University of Exeter and the University of Queensland are seeking exceptional students to join a world-leading, cross-continental research team tackling major challenges facing the world’s population in global sustainability and wellbeing as part of the QUEX Institute. The joint PhD programme provides a fantastic opportunity for the most talented doctoral students to work closely with world-class research groups and benefit from the combined expertise and facilities offered at the two institutions, with a lead supervisor within each university. This prestigious programme provides full tuition fees, stipend, travel funds and research training support grants to the successful applicants. 

Ten generous, fully-funded studentships are available for the best applicants, 5 offered by the University of Exeter and 5 by the University of Queensland. This select group will spend at least one year at each University and will graduate with a joint degree from the University of Exeter and the University of Queensland.

Find out more about the PhD studentships

Successful applicants will have a strong academic background and track record to undertake research projects based in one of the three themes of:  Physical Activity and Nutrition; Healthy Ageing; and Environmental Sustainability.


Exeter Academic Lead:  Professor Anne Spencer
Queensland Academic Lead:  Professor Stephen Birch

Project Information

Delayed diagnosis for many cancers is associated with poor survival, and while cancer survival in Australia ranks highly in the world the UK still lags behind. Early cancer diagnosis is associated with better outcomes and can reduce the high costs of complex end-stage treatments. But the presence of one or more pre-existing health conditions, known to increase with age,  are likely to delay cancer diagnosis. The world’s population is ageing, with attendant increases in the prevalence both of multiple health conditions and cancer. Therefore, a better understanding of how pre-existing conditions impact on the selection of patients for cancer testing and the cost-effectiveness of testing is urgently needed.

This is an exciting multi-disciplinary PhD project, exploring the relationship between pre-existing conditions and cancer diagnostics in symptomatic patients in primary care. The project will incorporate the impact on patients of receiving a positive test in terms of anxiety and costs that are often overlooked in economic-evaluations. It will deliver new knowledge and increase research capacity by:

  1. Exploring the extent to which the clinical benefits/outcomes of diagnostic testing for symptomatic patients differ systematically according to pre-existing conditions.
  2. Using choice modelling approaches to explore if patient and practitioner preferences among diagnostic strategies (frequency, invasiveness of test procedures) and outcomes of the tests differ systematically according to the presence/type of pre-existing conditions.

Three research phases:

• A systematic review of the published and unpublished literature on the impact of pre-existing conditions on the effectiveness and characteristics of cancer diagnostics.
• Quantification, using observational data, of the impact of pre-existing conditions on cancer diagnostics on the positive and negative predictive values of symptoms for cancer.
• Choice-based experiments to explore patient and practitioner preferences towards different diagnostic test strategies and the risk-benefit trade-offs in terms of potential delays in cancer diagnosis

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South West England