It is often said that with great success comes great responsibility. This can certainly be applied when considering the topic of cancer survivorship, given the successes achieved in the diagnosis and treatment of cancer and the subsequent responsibility for the health and well-being of the ever-growing population of cancer survivors. This responsibility is placed on the shoulders of both the research and healthcare communities to (i) better understand the biological basis and clinical consequences of a cancer diagnosis and the associated therapeutic exposure; and (ii) propose, develop, and test strategies to avoid or minimize the adverse impact of cancer and its treatment. Regardless of how one might elect to define a cancer survivor, this large and heterogeneous population represents a broad spectrum of unique challenges and opportunities for the research community.
In this issue of CEBP, a series of articles have been compiled to highlight selected aspects within the survivorship research continuum (1). These topics not only provide a context for survivorship research but also highlight the key challenges and opportunities in this area of scientific investigation. Despite our objective to assemble a comprehensive range of research in this arena, we must acknowledge that there are numerous other important aspects of survivorship research that are not directly addressed in this special section.
The 12 peer-reviewed articles within this Focus section touch upon the key components of the survivorship research continuum (Fig. 1). Utilizing the SEER program data, Parry and colleagues provide a detailed description of the cancer survivor population in the United States, while emphasizing the present and future impact of the aging baby boomer population. The articles of Yabroff et al, and Given et al, address two additional aspects of the survivor population; specifically, the economic implications of cancer survivorship, and its impact on the caregivers and families of cancer survivors. In an era marked by limited resources, the research challenges and the salience of economic outcomes outlined by Yabroff and colleagues have implications across the survivorship continuum.
Defining populations at high-risk for adverse outcomes is critical when beginning to contemplate targeted intervention approaches. When considering research designed to identify and characterize groups of these high-risk survivors, it is essential to understand the methodologic strengths and limitations of various research strategies. The articles from Oeffinger and colleagues and Jacobson and Jim provide an assessment of methodologic approaches for investigation of health-related and quality of life outcomes, respectively. Carmack and colleagues provide an overview of current knowledge about psychologic and behavioral factors that define high-risk groups among survivors of cancer and opportunities for intervention. The ability to hone and deliver personalized therapies that can promise improved survival with less morbidity, via a better understanding of genetics and epigenetics, also represents fertile ground for discovery. The article from Bhatia provides a comprehensive review of studies designed to identify genetic susceptibility factors within the context of risk for treatment-related adverse events.
Translating research findings into prevention–intervention measures can take several paths. Clinically based research to define high-risk groups serves as a foundation for the development and testing of intervention strategies. The article by Harrop and colleagues provides a review of the literature and results of a survey designed to quantify and characterize survivorship-based research being conducted by National Cancer Institute–designated Cancer Centers. In addition, the article from Wolin and Colditz discusses issues relating to study design and conduct of intervention-based research within the context of cancer survivors. Often, the most immediate impact of research findings is to inform the development of clinical care guidelines. Hudson and colleagues address the many issues that must be considered when formulating clinical care guidelines for cancer survivors and how research can be utilized to serve as the evidence base for making recommendations. Finally, implementation and dissemination of efficacious interventions reflects an important, yet challenging, component of the cancer survivorship continuum. Pollack and colleagues, provide an overview of the issues relating to dissemination and translation of research findings, whereas Grunfeld and colleagues provide a framework for translation of survivorship research into policy.
This Focus section is intended to increase the visibility of cancer survivorship research and to highlight the broad spectrum of research opportunities that exist. CEBP is committed to serve as a key forum for high-quality and high-impact scientific articles that recognize the remarkably diverse nature of the survivor population, the potential for new biological insights derived from cancer-related exposures, the vast array of important clinical, behavioral, and psychosocial outcomes, and the need for additional survivorship research.
Disclosure of Potential Conflicts of Interest
No potential conflicts of interest were disclosed.