The Nation's Investment in Cancer Research
A Plan and Budget Proposal for Fiscal Year 2008
Prepared by the Director, National Cancer Institute as mandated by The National Cancer Act (P.L. 92-218)
Understanding the Factors that Influence Cancer Outcomes
We will support and conduct studies to increase our understanding of and ability to measure the environmental, behavioral, sociocultural, and economic influences that affect the quality of cancer care, survivorship, and health disparities.
Today's Research
Building on more than two decades of population-based surveillance research (tracking and studying cancer trends), NCI is intensifying its efforts to define, foster, and support studies to improve our understanding of the factors that affect the outcomes of cancer and the impact of cancer care. Examples of NCI research include:
- Improving measurement of cancer outcomes
- Alternative approaches to measuring health-related quality of life, economic burden, and satisfaction in cancer care
- Psychometric (psychological measurement) approaches to increase the accuracy and reduce the cost of outcomes assessment conducted at the patient level
- Supporting large, prospective cohort (defined population) studies to investigate cancer outcomes
- The impact of high-profile interventions on patient-centered outcomes
- Dissemination of new therapies in the community
- The influence of modifiable risk factors
- Racial/ethnic- and gender-related disparities in care
- Use the results of outcomes research from community settings to improve methodology
Tomorrow's Strategies
NCI will improve outcomes research methods, increase use of evidence-based cancer interventions, and expand use of research knowledge to guide cancer policies. NCI will:
- Develop standardized measures of cancer care outcomes across the cancer continuum (prevention, early detection, diagnosis, treatment, survivorship, and end of life).
- Identify research databases to study influences on cancer care and outcomes.
- Use improved outcome measurement techniques and database resources to increase the understanding of behavioral and sociocultural factors that influence cancer outcomes.
- Study the factors that affect access to cancer care.
- Build sustainable community-based structures to support research on cancer outcomes.
- Understand how to disseminate research results and promote the adoption of evidence-based cancer interventions by a diverse population of patients, health care providers, and the public.
Moving Research Forward
…by Transforming Cancer Care Outcomes Research
In 1999, NCI launched its Quality of Cancer Care Initiative to improve the state of the science for defining, monitoring, and improving the quality of cancer care. Since then, research on several fronts is shaping a new model for moving research results from the laboratory bench to the bedside, particularly the effects of cancer care interventions on patients' lives.
NCI's wide-ranging outcomes research agenda focuses on the many aspects of cancer care to improve the experience of individuals after a cancer diagnosis. This research is intended to generate tools and information to enhance the quality of cancer care decision making and ultimately the quality of cancer care.
…and Progress in Pursuit of our Goal
- The Patient-Reported Outcomes Measurement Information System (PROMIS). NCI is taking an important role in PROMIS, a National Institutes of Health Roadmap Initiative. PROMIS aims to develop ways to measure patient-reported symptoms, such as pain and fatigue, and aspects of health-related quality of life across a wide variety of chronic diseases and conditions, including cancer. Two years into development, researchers are designing and building an innovative technology that promises to revolutionize how patients report clinically important symptoms and outcomes. This technology will provide clinical research communities with a consistent and validated approach to measure these clinically relevant, but subjective and difficult-to-measure outcomes.
- The Cancer Care Outcomes Research and Surveillance Consortium (CanCORS). Through CanCORS, NCI is supporting the largest ever observational study of cancer care delivered in diverse, population-based health care settings. This prospective cohort study has enrolled 10,000 patients with newly diagnosed lung or colorectal cancer. Vital information will be collected on how clinical practices affect outcomes, and what influence certain characteristics—of patients, providers, and community health care delivery systems—have on the services that patients eventually receive. CanCORS is providing a unique opportunity to examine community practices regarding palliative (non-curative symptom control) and end-of-life care. This study takes into account the perspective of the patient, caregiver, and providers among a diverse group of patients followed over time. NCI is supporting developmental research to test the feasibility of collecting such measures routinely within clinical practice.
