‘A World Where People No Longer Fear Cancer’: An Anthropology of Barrett’s Oesophagus in the UK

In recent decades, researchers, policymakers, clinicians and patients in the UK have collectively sought to achieve what may once have been deemed impossible: they have aspired to control cancer. One way in which this has been done is by calculating statistics about cancer risk in ‘populations’, before applying these figures to ‘the individual’. As a result, such individuals may become patients who are eligible for risk management interventions that aim to facilitate cancer prevention and early detection. This thesis takes the ‘capsule sponge test’, a new device used to screen people for Barrett’s oesophagus (a condition that increases a person’s risk of oesophageal cancer), as an example of one such cancer control practice. On the basis of long-term ethnographic fieldwork with professionals working to implement this test in the NHS and with people diagnosed with Barrett’s oesophagus, this text offers a detailed account of the ways in which risk diagnoses are both transformative and transformed in the practices of everyday life. At its core, this work asks how the value of knowledge about risk is enacted, negotiated and lived. In biomedicine and in the UK more generally, efforts to diagnose cancer risk are often thought of as self-evidently valuable. In contrast, social scientists sometimes criticise these practices, notably by using Foucauldian notions of discipline and governmentality. This thesis is neither a critique nor a celebration of risk diagnostic practices. Instead, this is an ethnographic study of the multiple and complex ways in which such practices acquire different values – which may become known as ‘benefits’ and ‘harms’ – in different settings, from clinics to anthropological papers. In doing so, this work aspires to make space for the ambivalence that pervades cancer control efforts, enriching both social scientific and biomedical literature by offering complexity and nuance to the vision of cancer prevention and early detection. Centring the daily experiences of researchers, clinicians and patients aspiring to control cancer, this thesis explores how people make meaningful lives because of, and in spite of, the proliferation of statistics about future risks evoked by diagnostic practices. It brings the anthropology of science and ethics into conversation to illustrate how different ways of engaging – and not engaging – with cancer control interventions can be considered virtuous for those working to live well amid a healthcare service widely deemed to be ‘in crisis’.

Level dc:type.qualificationlevel

Doctoral

Grantor dc:publisher.institution

University of Cambridge

Year dc:date.issued

2024

Author dc:creator

• Davies, Elspeth

Advisors dc:contributor.advisor

• McDonald, Maryon
• Candea, Matei

• anthropology
• cancer
• early detection
• risk

Licence

• https://www.repository.cam.ac.uk/bitstreams/f7796eae-7cd4-4e87-8e86-aa8835001e59/download
• http://purl.org/NET/rdflicense/allrightsreserved

Language dc:language

eng

Author Identifier

0009-0000-3499-681X

OAI identifier oai:identifier

oai:www.repository.cam.ac.uk:1810/377506