PhD Student | ‘Towards patient-led follow-up after curative treatment of cancer'

About your role
The project consists of two work packages. Work package 1 is led by Prof. dr. Hans de Wilt (Radboud University Medical Center) and will consist of a cluster randomized trial investigating patient-led home-based follow-up compared to hospital-based follow-up? Work package 2 is led by Dr. Veerle Coupé (Amsterdam UMC) and will focus on risk-based follow-up strategies to optimize one-size-fits-all follow-up. As a PhD student, you will analyze and synthesize data from the Netherlands Cancer Registry, data from the Dutch Prospective Colorectal Cancer Cohort and data from the RCT in workpackage 1, developing survival models and building a health-economic microsimulation model. To identify optimal risk-based follow-up strategies, you will simulate multiple risk-based follow-up strategies, projecting long-term effects of follow-up on survival, cost, and cost-effectiveness.

As a PhD student your main tasks are:

• To develop and validate survival models for predicting localized and metastatic disease recurrence and survival in stage II and III colorectal cancer in relation to pathological and clinical risk factors;
• To integrate the survival models with data on quality of life and costs in a health-economic model, programmed in R statistics or C++;
• To predict the impact of different risk-based follow-up strategies in stage II and III colorectal cancer;
• To publish your research findings in biomedical, health-economic, and/or epidemiological journals;
• To write a PhD thesis for defence at the Vrije Universiteit Amsterdam;
• To assist in teaching activities in biostastics courses for medical students.

The project
As a PhD student in biostatistics and health-economic modelling, you will be working on the project ‘Towards patient-led follow-up after curative treatment of stage II and III colorectal cancer’ funded by ZonMw, the Netherlands Organisation for Health Research and Development (project leaders Dr. Veerle Coupé and Prof. dr. Hans de Wilt). In this ZonMw funded project, we will develop a protocol for patient-centered follow-up for curatively treated stage II/III colorectal cancer (CRC) patients, in which intensity and setting of follow-up is adapted to the need of the patient and an individual’s risk of recurrence.
After surgical treatment for stage II and III colorectal cancer, approximately 20% of patients develops a recurrent tumor or metastases. The general assumption is that early detection of a recurrence leads to increased survival, but this is not confirmed in studies comparing intensive versus less intensive follow up. However, so far, only “one-size-fits-all” follow-up schedules have been implemented, while there is a high interpersonal variability in recurrence risk. Current follow-up may therefore provide suboptimal protection for patients with increased risk profiles, inefficient allocation of resources and decreased quality of life for patients at low risk. Therefore, patient organizations and policy makers call for a more patient-centered, tailored follow-up.