• Organization of a psychosocial clinical trials group in which a network of researchers could address key questions in multi-center studies that would allow access to large, population-based samples;

  • Clinical trials of psychosocial interventions that are conducted within routine breast cancer care in which cost and quality of life are outcome measures; and

  • A registry of ongoing psychosocial research/trials to assist researchers in identifying and tracking new areas of study.

  1. The NCI should support a special study to ascertain the use of, and unmet need for, cancer-related supportive care services (including psychosocial services) in the United States. The results of such a study could provide benchmarks against which care can be measured and performance monitored. Such a study would document existing disparities in service use by age, race/ethnicity, geography, and insurance coverage.

Evidence Report on the Occurrence, Assessment, and Treatment of Depression in Cancer Patients (Pirl, 2004)

More research is needed on factors that may cause varying rates of depression and that predict which patients are most at risk. Longitudinal studies are needed to estimate the incidence of depression starting at the time of or, ideally, before diagnosis of cancer.

Many instruments with a wide range of complexity are currently being used to measure depressive symptoms…. Multiple methods of assessment make it difficult to compare studies. A consensus choice of instruments may help to standardize research on depression that is comorbid with cancer.

From Cancer Patient to Cancer Survivor: Lost in Transition (IOM and NRC, 2006)

Recommendation 5 The Centers for Medicare and Medicaid Services (CMS), National Cancer Institute (NCI), Agency for Healthcare Research and Quality (AHRQ), the Department of Veterans Affairs (VA), and other qualified organizations should support demonstration programs to test models of coordinated, interdisciplinary survivorship care in diverse communities and across systems of care.

Recommendation 10 The NCI, CDC, AHRQ, CMS, VA, private voluntary organizations such as the American Cancer Society, and private health insurers and plans should increase their support of survivorship research and expand mechanisms for its conduct. New research initiatives focused on cancer patient follow-up are urgently needed to guide effective survivorship care.

Research is especially needed to improve understanding of …

  • The cost-effectiveness of alternative models of survivorship care and community-based psychosocial services including:

    • Survivors’ and caregivers’ attitudes and preferences regarding outcomes and survivorship care;

    • Needs of racial, ethnic groups, residents of rural areas, and other potentially underserved groups; and

    • Supportive and rehabilitation programs.

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