Cancer Survivorship Research Reveals Disparities

October 31, 2011

COLUMBUS, Ohio – Despite a general increase in research addressing cancer survivorship, researchers have found that a disproportionate number of studies focus on specific tumor sites, prevention, early detection and post-treatment effects impacting cancer survivors.

"Prostate cancer survivors make up 20 percent of the total cancer survivorship population, but only 5 percent of current research projects focus specifically on prostate cancer survivors," said Electra D. Paskett, associate director for population sciences at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James). Breast cancer survivors represent 22 percent of the survivor population, yet 40 percent of current research focuses on female breast cancer survivors.

Researchers at Ohio State's Comprehensive Cancer Center found that colorectal, gynecologic and hematological cancers are also underrepresented in current cancer survivorship studies.

Study findings were published in the October issue of Cancer Epidemiology, Biomarkers & Prevention.

"Looking at previous survivorship research and where it has taken us is crucial in moving forward efficiently and effectively to improve the quality of life for cancer survivors," said Paskett, who holds the Marion N. Rowley Designated Chair in Cancer Research at Ohio State. "We are making progress in the fight against cancer and it shows in our growing survivor population, but there is a lack of emphasis on certain tumor sites, prevention and early detection, late effects and translational research."

According to Paskett, findings indicated that "quality of life" as a specific research focus more than doubles that of prevention, early detection and late effects of treatment. Most cancer survivorship research focuses on psychological or quality of life issues, exercise and psychosocial issues. In addition, several topics important to survivors were found to be the least likely to be studied, including radiation effects, hot flashes, fertility, complementary and alternative medicine use and dental issues.

Although survivorship research has increased in the past three decades, the study found a recent shift to an observational approach as compared to interventional research, which is supported by clinical trials. Researchers found a total of 111 ongoing observational studies, including case control and cohort studies, and 72 interventional studies currently underway nationwide.

"The number of randomized controlled trials has remained relatively constant in the last decade, which is surprising with the growing emphasis on evidence-based practice," said Paskett. "Research on coping and tobacco and alcohol use has declined, though the problems remain important for survivors."

Researchers conducted a literature review and surveyed National Cancer Institute-designated cancer centers about the types of ongoing survivorship studies. Researchers reviewed all published survivorship studies, which addressed quality of life issues, late effects of treatment, and prevention and early detection of secondary cancers.

The survey of NCI Cancer Centers was coupled with a search of an online database, the NIH RePORTER tool, to obtain information about ongoing research. Studies were categorized by the study design used, the site of cancer and the focus of the research.

"Addressing other areas will continue to make life better for all survivors, by reducing side effects from treatments and lessening the risk of new tumors," said Paskett. "Pediatric research has been an area of survivorship research that has flourished, and may serve as a model for adult survivorship research."

Current OSUCCC-James survivorship studies are focusing on prevention of lymphedema, chemoprevention, diet, exercise, stress reduction and yoga, as well as studies in childhood survivorship.

Other Ohio State researchers involved in the study were J. Phil Harrop and Julie A. Dean.

The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute strives to create a cancer-free world by integrating scientific research with excellence in education and patient-centered care, a strategy that leads to better methods of prevention, detection and treatment. Ohio State is one of only 41 National Cancer Institute (NCI)-designated Comprehensive Cancer Centers and one of only seven centers funded by the NCI to conduct both phase I and phase II clinical trials. The NCI recently rated Ohio State's cancer program as "exceptional," the highest rating given by NCI survey teams. As the cancer program's 210-bed adult patient-care component, The James is a "Top Hospital" as named by the Leapfrog Group and one of the top 20 cancer hospitals in the nation as ranked by U.S. News & World Report.

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Click here for a high quality photo of Electra Paskett.

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