Priority Areas for Applied Cancer Screening Research
Ten priority areas for applied cancer screening research identified through strategic planning are grouped into four thematic areas: Risk Communication, Health Services Research, Unscreened Populations, and Theory and Methods. A few priority areas overlap between clusters, and therefore are identified in more than one cluster. Figure 17 delineates which cluster regions are finite and which overlap. For instance, some of the clusters represent research focused at the individual level, while others address research focused on the community level. Similarly, some of the clusters emphasize behavioral research, and others health services research. Because the field of cancer screening is rapidly evolving, these four cluster regions may be considered as core research interests to guide the direction of cancer screening research. Click on a priority area to display individual site-specific statements, and to examine the "importance" and "feasibility" of a specific statement within the context of the priority area.
Priority Area and Objectives: Communication
- Identify similarities and differences of effective cancer risk messages among subgroups (e.g., ethnic, gender, and income) and support development of effective and appropriate messages related to cancer screening.
- Support research on the potential of mixed media and new communication channels (including the Internet).
- Support development of effective strategies for improving patient/provider communications and decision making regarding cancer screening.
Priority Area and Objectives: Decision Making
- Encourage research on provider decision making, patient decision making, and shared decision making as well as preferences for different tests with specific population groups.
- Encourage research on decision making when screening, follow-up, and/or treatment recommendations are uncertain or unproven (e.g., PSAs, spiral CT, genetic testing).
- Encourage research on how persons and providers deal with changes in screening technology.
Priority Area and Objectives: Genetic Risk
- Identify screening issues associated with first-degree relatives and cancer survivors.
- Expand applied cancer screening research to incorporate risk assessment, genetic susceptibility, genetic risk information, and biological risk.
Priority Area and Objectives: Cost Effectiveness
- Determine cost effectiveness of strategies that promote use of cancer screening.
- Determine cost effectiveness of strategies that package cancer screening for multiple cancer sites, or with other preventive health services.
Priority Area and Objectives: Decision Making (see above)
Priority Area and Objectives: Health Services
- Develop health system strategies to improve cancer screening prevalence.
- Access the potential for increasing cancer screening using strategies such as packaged screening with other preventive services, and encourage opportunistic screening.
Priority Area and Objectives: Policy
- Understand the impact of policy (e.g., insurance coverage, co-payments and deductibles) on cancer screening behavior.
Priority Area and Objectives: Communication (see above)
Priority Area and Objectives: Determinants
- Ascertain which determinants are the same across screening modalities and populations, which ones differ, and why.
- Understand determinants of post-screening behavior; impact of false positives on future screening; completing timely follow-up of abnormal results; and returning for annual screening.
- Understand the ecological, community-level, and contextual influences on screening behavior.
Priority Area and Objectives: Disparities
- Identify characteristics of individuals and populations who are never or rarely screened and develop strategies that target these individuals and populations.
- Explore the potential of new media technologies for reducing disparities in screening and follow-up.
- Investigate population disparities and loss to follow-up after receipt of abnormal screening results.
Priority Area and Objectives: Methodology
- Improve and standardize methods, measures, and data collection protocols used in applied cancer screening research.
- Encourage qualitative and developmental research at multiple levels of interventions (e.g., individual, organizational, and community).
Priority Area and Objectives: Theory
- Encourage development of theory-testing interventions.
- Encourage development and testing of theories that have not been generally applied in cancer screening research, including macro-level theories that address community, ecological, and economic factors that influence screening behavior.