Postdoctoral Fellow in psychology, sociology, social sciences or nursing

Background. Older adults have poorer cancer survival than middle-aged adults, and they do not benefit from advances in diagnosis and treatment to the same extent as middle-aged adults. The treatment phase is a critical moment where age-related disparities occur in cancer outcomes, especially because physicians have a limited evidence-base for treatment strategies in comorbid and older patients due to their underrepresentation in clinical trials.

Progressively, there is a move from a paternalistic model, where the patient has a passive role towards a shared decision-making model (SDM), where the patient is active and patient preferences are at the heart of the decision-making process. This model is particularly relevant when managing cancer in older patients because of the potential for cancer treatment to interact with co-morbidities or their treatments, and greater uncertainty around treatment benefits. However, research consistently reports older patients are more likely to trust physicians and their treatment recommendations, suggesting they transfer their right to decide their treatment to the physician. This could be partially explained by an inability to understand and adequately appraise clinical information (‘health literacy’). Older adults have lower health literacy than younger adults, and health literacy declines as age increases. Moreover, healthcare providers rarely inquire about patients’ preferences or attempt to involve patients in the decision-making process and tend to overestimate patients’ capacities to understand health information.

Objectives. As the interaction between a physician and patient is the core of cancer management, the project aims to observe how cancer management decisions are made between the physician and the patient (and their family/caregiver) with the ultimate goal to inform the design of tailored training for medical staff, to improve patient support and to add to the evidence base on the decision-making process in cancer management among older patients.

Activities

The post holder is expected to conduct a systematic literature review on treatment-decision making for older patients with cancer and to undertake a qualitative study to understand treatment-decision making process under the co-supervision of Dr Sophie Pilleron (PI) and Dr Valerie Moran who works at LISER (Luxembourg Institute of Socio-Economic Research) as well as LIH.

The post holder will have the opportunity to supervise Master students.

The post holder will also assist Dr Sophie Pilleron, the PI, in managing the REDICO (Reducing Disparities in Cancer Outcome) program, which is part of the Ageing, Cancer and Disparities research group in the Department of Precision Health.

The position may be renewed for 3 additional years (funds already available).

Training and research environment. The Ageing, Cancer and Disparities research group is funded by a 5-year ATTRACT FNR funding (2023-2027). Its research activities focus on reducing age-related disparities in cancer outcomes by individuating actions to be set up in all disease phases (diagnosis, treatment decision, active treatment), relevant for patients, public health and clinicians. Researchers are supported by easy access to scientific expertise, an active seminar program as well as the possibility for close collaborations with research groups with LIH and in other research institutes and universities.