Although these organizations are not the only sponsors of breast cancer-related psychosocial research, they represent the major funding sources for such research. Excluded from this review is research supported by health plans, insurers, pharmaceutical companies, and other private organizations. Much of the research in these settings is proprietary. The chapter concludes with the Board’s identification of priority areas for research and recommendations to increase research opportunities.

Evaluating trends in research publications is one way to assess the level of activity within a discipline. A resource for tracking such studies in the National Library of Medicine (NLM) Medline bibliographic database, which stores information about individual citations including index terms used to characterize each article (articles are indexed according to a dictionary of medical subject headings called MESH terms).

The volume of breast cancer-related psychology research articles appears to have almost tripled from 1990 to 2000 (from 150 to 431 citations), but throughout the period such articles represent a small fraction of breast cancer-related research, less than 7 percent according to Medline searches (Figures 8-1 and 8-2). These trends reflect publications in English, but not limited to articles written by United States investigators. Figures 8-1 and 8-2 therefore reflect trends in the general medical literature, not necessarily trends in the United States. These trends must be interpreted with caution because they may reflect changes in the way MESH headings are applied to index the literature rather than real increases in breast cancer-related psychological research.

A more direct way to assess the status of United States-based breast cancer-related psychosocial research is to describe topics of investigation and levels of research spending. There is no one comprehensive source of information on research support; as part of its review, the Board relied on the following sources:

• Listings of research projects provided by some organizations (e.g., National Cancer Institute);

• The federal listing of research projects (CRISP);

• Review of agency web sites (e.g., Department of Defense); and