Using Linked Data to Explore Risk Factors for Low Uptake of Cancer Screening in Women in Southeast England
Supervisors: Dr Elizabeth Ford, Dr Imogen Rogers, Prof C Llewellyn, Dr Maja Nikšić
Application deadline: Friday, September 04, 2026
Funded PhD Project (UK Students Only)
About the Project
Cancer screening programmes for bowel, breast, cervical and lung cancer collectively prevent thousands of deaths annually in England, yet uptake remains persistently and inequitably distributed across the population, with sex-specific risk factors for low uptake, especially in women, and ethnicity and deprivation being strong intersecting variables. Significant gaps remain in understanding how other protected characteristics and potential health inequality risk factors; including disability, neurodiversity, LGBTQ+ status, long-term conditions or severe mental illness; compound screening inequity in women. This programme of PhD research aims to characterise women’s inequalities in cancer screening systematically, identify the highest-risk population combinations, and generate actionable insights to inform intervention design.
Study 1: Systematic review and narrative synthesis of published evidence on inequalities in uptake across one or more national NHS screening programmes.
While reviews exist for individual inequality axes, wide, comprehensive assessment of the breadth of evidence for individual characteristics has yet to be examined including where intersectionality may compound inequalities, and which factors specifically affect women and why.
Study 2: Linked data analysis of inequalities in screening uptake.
We will apply to link individual-level data from one or more national cancer screening programme datasets to a source of patient-level demographic, clinical, and socioeconomic data. Candidate linkage sources include the Clinical Practice Research Datalink (CPRD Aurum), a national dataset, and the Sussex Integrated Dataset (SID), formed of locally relevant linked NHS and social care records.
The analysis will examine uptake across multiple markers of potential disadvantage simultaneously, aiming to identify women’s specific barriers to participation, including geographic location, area-level deprivation, ethnicity, disability, autism spectrum conditions, SMI and other long-term conditions and, where data quality permits, LGBTQ+ status to identify which combinations of characteristics produce the greatest compounding of risk. A particular focus will be placed on identifying population clusters who are systematically and multiply disadvantaged in screening participation, building on the established literature and extending it to underexamined groups. If using local Sussex data, we could also conduct a geospatial analysis of service accessibility and uptake in breast screening clinics.
Study 3: Qualitative investigation of barriers and facilitators in high-risk groups.
Using the findings of national linked-data analysis identifying independent and intersecting predictors of non-participation, we will select one or two population sub-groups identified as facing the starkest and least-explained inequalities in screening uptake, we will conduct qualitative interviews or focus groups to understand the mechanisms behind non-participation. Women will be recruited through community and third-sector partners, with coproduction principles applied to the topic guide development and interpretation of findings. The findings will be synthesised, using an underpinning theoretical model, into actionable recommendations for commissioners, screening providers, and primary care, with direct relevance to NHS Integrated Neighbourhood Teams and their remit for proactive population health management in underserved communities.
Research Environment
This PhD will be based in the Department of Primary Care and Public Health (PCPH) at Brighton and Sussex Medical School (BSMS), a joint medical school of the Universities of Brighton and Sussex with close integration with NHS Sussex and Sussex Local Authorities. The department hosts experts across a wide range of disciplines and methodologies, including general practice, public health, epidemiology, medical statistics, data science, psychology and behavioural medicine, with health inequalities as a unifying focus. The Health Data Science group uses routinely collected health data, disease registries, and large research cohorts to understand risk factors for disease, identify health inequalities, and develop digital health tools for healthcare improvement. The PhD is jointly funded by the NIHR Applied Research Collaboration (ARC) in Kent, Surrey and Sussex. The ARC provides the PhD student with access to a wide network of applied researchers, knowledge mobilisation expertise, and public and community involvement infrastructure across the region, including dedicated support for co-production and implementation, both of which are central to the third study in this programme. The studentship holder will also benefit from support through the ARC KSS academy and benefit from being part of the ARC KSS PhD peer cohort. The academy will support PhD students in their research training, placements and will benefit from being a member of the NIHR academy.
Entry requirements
This studentship is suitable for those with background in medical statistics, public health, epidemiology, psychology, health data science or another relevant subject area with a good range of statistics training. We invite applications from students who have received or are on target to achieve a relevant undergraduate degree with minimum 2:1 classification (or equivalent). An MSc is preferred but not essential. We invite candidates who have experience with and commitment to research inclusion and public and community involvement and engagement.
How to apply
Applicants must apply through the University’s application portal (StudentView) where the project will be listed. The deadline for applications is Friday 4 September 2026. Interviews will be held in September or October 2026. Informal enquiries are welcome and should be submitted to Dr Elizabeth Ford e.m.ford@bsms.ac.uk.
Funding Notes
This is a 3.5-year PhD studentship funded by the NIHR Applied Research Collaboration in Kent, Surrey and Sussex funded, with a projected start date of 1 January 2027. Funding will cover tuition fees for UK students (at the Home rate), a stipend at the current UKRI rates and a research allowance which will cover research project and training costs. International applicants are welcome to apply but will be required to cover the difference between Home and International fees.