Stratified, precision or personalised medicine? Cancer services in the 'real world' of a London hospital

Day, Sophie E.; Coombes, R. Charles; McGrath-Lone, Louise; Schoenborn, Claudia and Ward, Helen. 2017. Stratified, precision or personalised medicine? Cancer services in the 'real world' of a London hospital. Sociology of Health and Illness, 39(1), pp. 143-158. ISSN 0141-9889 [Article]

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Abstract or Description

We conducted ethnographic research in collaboration with a large research-intensive London breast cancer service in 2013-14 so as to understand the practices and potential effects of stratified medicine. Stratified medicine is often seen as a synonym for both personalised and precision medicine but these three terms, we found, also related to distinct facets of treatment and care. Personalised medicine is the term adopted for the developing 2016 NHS England Strategy, in which breast cancer care is considered a prime example of improved biological precision and better patient outcomes. We asked how this biologically stratified medicine affected wider relations of care and treatment. We interviewed formally 33 patients and 23 of their carers, including healthcare workers; attended meetings associated with service improvements, medical decision-making, public engagement, and scientific developments as well as following patients through waiting rooms, clinical consultations and other settings. We found that the translation of new protocols based on biological research introduced further complications into an already-complex patient pathway. Combinations of new and historic forms of stratification had an impact on almost all patients, carers and staff, resulting in care that often felt less rather than more personal.

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UK, personalised medicine, oncology, breast cancer, ethnography, stratification, patient-centred care, healthcare markets

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27 July 2016Published Online
1 January 2017Published

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Date Deposited:

20 Apr 2016 16:01

Last Modified:

02 Mar 2021 13:07

Peer Reviewed:

Yes, this version has been peer-reviewed.


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