Evaluating the Effectiveness of a Novel Mobile Clinical Unit (the Man Van) in Addressing Health Inequalities in Prostate Cancer
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Embargo End Date
2026-07-06
ICR Authors
Authors
Moghul, M
Document Type
Thesis or Dissertation
Date
2026-01-06
Date Accepted
Abstract
Prostate cancer is the most common male cancer in the United Kingdom and the second most common worldwide. Significant health inequalities exist with Black men and those from socioeconomically deprived backgrounds disproportionately affected by late-stage diagnoses and poorer outcomes.This thesis evaluates effectiveness of the Man Van, a novel mobile clinical unit designed to address inequalities in prostate cancer. The research is composed of multiple components: an introduction into prostate cancer and health inequalities, a systematic review of mobile clinical units for prostate cancer, the Man Van pilot study to establish feasibility, development of a novel patient experience questionnaire, an up-scaled and optimised phase 2 of the Man Van evaluated with mixed-methods data including qualitative interviews with participants and stakeholders of the project and a health economics analysis. Sub-studies were conducted evaluating the use of point-of-care (POCT) prostate-specific antigen (PSA) testing and polygenic risk scores (PRS) for prostate cancer both through the Man Van.The findings demonstrate that the Man Van successfully engaged populations traditionally underserved by healthcare, with high proportions of participants from ethnically diverse and socioeconomically deprived communities. The service facilitated the early detection of clinically significant prostate cancers, as well as diabetes, hypertension and other health conditions. Patient-reported data revealed strong satisfaction and trust in the model, with the health economics evaluation demonstrating cost-effectiveness when compared to PSA testing within primary care. Stakeholder interviews provided further context including facilitators and barriers for implementing a more widespread model. POC testing showed feasibility but the accuracy was insufficient to support its use at present. PRS showed a modest increase in detection rates within this high-risk population.Collectively, this research supports the use of the Man Van to transform early cancer detection strategies and address entrenched health inequalities both nationally and globally.
Citation
2026
DOI
Source Title
Publisher
Institute of Cancer Research (University Of London)
ISSN
eISSN
Collections
Research Team
Prostate & Bladder Cancer