Smith Center for Healing and the Arts, Washington, DC.
Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD.
J Natl Cancer Inst. 2019 Feb 1;111(2):109-117. doi: 10.1093/jnci/djy208.
Federal investment in survivorship science has grown markedly since the National Cancer Institute's creation of the Office of Cancer Survivorship in 1996. To describe the nature of this research, provide a benchmark, and map new directions for the future, a portfolio analysis of National Institutes of Health-wide survivorship grants was undertaken for fiscal year 2016. Applying survivorship-relevant terms, a search was conducted using the National Institutes of Health Information for Management, Planning, Analysis and Coordination grants database. Grants identified were reviewed for inclusion and categorized by grant mechanism used, funding agency, and principal investigator characteristics. Trained pairs of coders classified each grant by focus and design (observational vs interventional), population studied, and outcomes examined. A total of 215 survivorship grants were identified; 7 were excluded for lack of fit and 2 for nonresearch focus. Forty-one (19.7%) representing training grants (n = 38) or conference grants (n = 3) were not coded. Of the remaining 165 grants, most (88.5%) were funded by the National Cancer Institute; used the large, investigator-initiated (R01) mechanism (66.7%); focused on adult survivors alone (84.2%), often breast cancer survivors (47.3%); were observational in nature (57.3%); and addressed a broad array of topics, including psychosocial and physiologic outcomes, health behaviors, patterns of care, and economic/employment outcomes. Grants were led by investigators from diverse backgrounds, 28.4% of whom were early in their career. Present funding patterns, many stable since 2006, point to the need to expand research to include different cancer sites, greater ethnoculturally diverse samples, and older (>65 years) as well as longer-term (>5 years) survivors and address effects of newer therapies.
联邦政府对生存研究的投资自 1996 年国立癌症研究所成立癌症生存办公室以来显著增长。为了描述这项研究的性质，提供一个基准，并为未来规划新的方向，对 2016 财年国立卫生研究院范围内的生存研究赠款进行了投资组合分析。应用与生存相关的术语，使用国立卫生研究院信息管理、规划、分析和协调赠款数据库进行了搜索。根据使用的赠款机制、资助机构和主要研究者特征对确定的赠款进行了审查，以确定是否符合纳入标准。经过培训的编码员对每个赠款进行了分类，分类依据是重点和设计（观察性与干预性）、研究人群和研究结果。确定了 215 项生存赠款；7 项因不符合要求而被排除，2 项因非研究重点而被排除。41 项（占 19.7%）代表培训赠款（n=38）或会议赠款（n=3），未进行编码。在其余 165 项赠款中，大多数（88.5%）由国家癌症研究所资助；使用大型、由研究者发起的（R01）机制（66.7%）；仅关注成年幸存者（84.2%），通常是乳腺癌幸存者（47.3%）；研究性质为观察性（57.3%）；并涉及广泛的主题，包括心理社会和生理结果、健康行为、护理模式和经济/就业结果。赠款由背景各异的研究者领导，其中 28.4%的研究者处于职业生涯早期。目前的资金模式自 2006 年以来基本保持稳定，这表明需要扩大研究范围，纳入不同的癌症部位、更多具有不同文化背景的样本，以及年龄较大（>65 岁）和生存时间较长（>5 年）的幸存者，并研究新疗法的影响。
