Evidence Gaps in Cancer Survivorship Care: A Report From the 2019 National Cancer Institute Cancer Survivorship Workshop

Abstract

Today, there are more than 16.9 million cancer survivors in the United States; this number is projected to grow to 22.2 million by 2030. While much progress has been made in understanding cancer survivors needs and in improving survivorship care since the seminal 2006 Institute of Medicine report From Cancer Patient to Cancer Survivor: Lost in Transition, there is a need to identify evidence gaps and research priorities pertaining to cancer survivorship. Thus, in April 2019, the National Cancer Institute convened grant-funded extramural cancer survivorship researchers, representatives of professional organizations, cancer survivors, and advocates for a one-day in-person meeting. At this meeting, and in a subsequent webinar aimed at soliciting input from the wider survivorship community, evidence gaps and ideas for next steps in the following six areas, identified from the 2006 Institute of Medicine report, were discussed: surveillance for recurrence and new cancers, management of long-term and late physical effects, management of long-term and late psychosocial effects, health promotion, care coordination, and financial hardship. Identified evidence gaps and next steps across the areas included the need to understand and address disparities among cancer survivors, to conduct longitudinal studies as well as longer-term (>5 years post-diagnosis) follow-up studies, to leverage existing data, and to incorporate implementation science strategies to translate findings into practice. Designing studies to address these broad evidence gaps, as well as those identified in each area, will expand our understanding of cancer survivors’ diverse needs, ultimately leading to the development and delivery of more comprehensive evidence-based quality care.

Integrative oncology: Addressing the global challenges of cancer prevention and treatment

“…The intersection of aging and cancer survivorship can be particularly difficult to navigate for people affected by cancer. Despite progress in supportive care for survivors, gaps still exist in addressing complex symptoms such as anxiety, pain, fatigue, insomnia, neuropathy, and cognitive dysfunction 40,41 . Moreover, the physical, emotional, and social ramifications of cancer may linger years after treatment, 42 further challenging the infrastructure and resources of health care systems 43 …”

Identification of TRPV4 as a novel target in invasiveness of colorectal cancer

“…Colorectal cancer (CRC) is the third most common human malignancy and the fourth crucial cause of cancerrelated death in worldwide [1][2][3][4][5][6]. CRC metastasis is the main cause of mortality in patients [7][8][9].…”

Moving the Translational Needle in Breast Cancer Survivorship: Connecting Intervention Research to Clinical Practice

“…In general, findings from the network analyses were consistent with other recent efforts in identifying evidence gaps and setting cancer survivorship research priorities. 6 Another important point by Kemp et al 4 was the singleproblem/single-symptom approach used in most reviews, as evidenced by the low level of connectivity between domains and outcomes. Of note, these analyses were based on purely topical information and did not incorporate actual findings or strength of evidence from individual reviews in considering network connectivity, modularity, or other features.…”

“…11 More recently, care coordination was identified as a key evidence gap in survivorship care in workshop of the National Cancer Institute. 6 Although research on care coordination is limited and robust measures are lacking, studies have demonstrated improved outcomes across the cancer care continuum, including better symptom control, more appropriate health care utilization, fewer medical errors, and decreased costs when care is well coordinated. 10,12 Given that care for breast cancer survivors often involves ongoing management from multiple specialist teams, care coordination is key.…”