Perception, Attention, and Cognition


Research on perception and attention is pertinent across the cancer control continuum. For example:

  • If you want to communicate probabilistic information (such as risks or benefits of certain behaviors) through visual images, you need to understand how the visual system processes quantitative information.
  • If you want to understand how the built environment influences people's propensity for physical activity, you need to understand spatial cognition.
  • If you want to improve the accuracy of cancer screening procedures, you need to understand the attentional limitations of the human reader.
  • If you want to understand how various cancer treatments may impair patients' cognitive functioning, you need to understand not only normal cognitive function, but also how perceptual deficits may reduce the quality of the information patients are taking in from their surroundings.

The BBPSB Perception and Attention initiative aims to promote basic research in perception and attention relevant to cancer control and prevention. Such research can inform our efforts to reduce the burden of cancer.

Basic Biobehavioral and Psychological Sciences at NCI: Bridging Visual Perception and Attention
BBPSB Program Director Dr. Todd Horowitz discusses basic research in perception and attention in the context of cancer control.

Funding Opportunity

Perception and Cognition Research to Inform Cancer Image Interpretation

Expiration Date
September 27, 2019

The purpose of this funding opportunity is to facilitate research on the perceptual and cognitive processes underlying the performance of cancer image observers in radiology and pathology in order to improve the accuracy of cancer detection and diagnosis.

Despite technical advances in many areas of diagnostic radiology, the detection and diagnosis of human cancer via imaging remains fallible. For example, data from the Breast Cancer Surveillance Consortium show false negative rates of approximately 13.1 percent and false positive rates of 11.1 percent for mammography. Although some of these errors might be due to the limitations of the images themselves, a large proportion are attributable the perceptual and cognitive faculties of the clinicians and other specialists who diagnose, stage, and treat cancer (a.k.a. “observers”). Some sources of perceptual and cognitive errors have been identified, but for the most part, errors in cancer image interpretation are still largely unexplained. Research in perception and cognition will uncover important factors that influence how observers perceive, remember, learn, and act upon the images they view.

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Related Events

RSNA Perception Laboratory

The NCI laboratory at the Radiological Society of North America (RSNA) annual meeting provides a shared facility for investigators to recruit and test radiologist observers for multiple experiments.

Cognition and Medical Image Perception Think Tank

September 12-13, 2019

Meeting Agenda (PDF 232 KB)
Speaker Biographies (PDF 817 KB)

Meeting Agenda (PDF 232 KB)

Medical image interpretation is central to the detection and diagnosis of many cancers. In an era of unprecedented technological advances in medical imaging and machine learning, it is critically important to understand the cognitive and perceptual functioning of the “human in the loop,” medical image specialists (e.g., radiologists, pathologists) who make the final decisions on cancer detection and diagnosis. However, medical image perception is a chronically understudied area of research. The Cognition and Medical Image Perception Think Tank brought radiologists and pathologists together with researchers working in medical image perception and adjacent fields of cognition and perception, to identify opportunities to advance the study of medical image interpretation through constructive discourse, idea generation, and problem-solving.


  1. Identify research gaps and critical unsolved problems in pathology and radiology, from the perspective of clinicians.
  2. Discuss ways to address these clinically informed questions through cognitive and perceptual research.
  3. Identify barriers that hinder collaborations between researchers and clinicians and identify potential solutions.
  4. Identify and discuss ways to elevate psychology’s profile within the medical image community.
  5. Pinpoint resources needed to facilitate transdisciplinary research.
  6. Identify future goals and identify strategies to evaluate progress.

Seeing the Science in Medical Imaging NCI Workshop in Vision Research

In 2014, NCI convened experts in medical imaging and vision science to discuss the current challenges in the perception of medical images by human observers, and to help advance the research agenda in cancer prevention and control. Visit the event page for recordings and transcripts of the event.


National Lung Screening Trial Datasets and Images

Download comprehensive datasets, CT images and pathology images from the NCI National Lung Screening Trial (NLST) and search a database of research projects and publications.

Learn about NLST

Cancer Imaging Program

Access The Cancer Imaging Archive, a collection of medical images of cancer available for public use, through the NCI Cancer Imaging Program website.

Explore more


Todd S. Horowitz, Ph.D.
Program Director


Many cancer survivors report cognitive changes — trouble with thinking, memory, and concentration — related to cancer and cancer treatments, particularly chemotherapy. Sometimes referred to as “chemobrain” or “chemofog,” the phenomenon formally referred to as cancer-related cognitive impairment has been an important concern for clinical practitioners and investigators. Overall, research findings have demonstrated changes in several domains of cognition, including working memory, new learning, executive function, and spatial abilities. However, questions remain in the areas of how to measure these changes, how to interpret findings across research studies, and whether neuropsychological test results can be generalized to everyday tasks. Moreover, not all cancer patients and survivors experience cognitive late effects, and determining susceptibility and identifying neural pathways remain important areas of exploration. Also, there are limited validated interventions available for patients suffering from these symptoms, and further work is needed to provide practitioners and patients with advice about accommodation strategies and empirically sound therapies.

The BBPSB focus expands across the cancer control continuum, examining cognition from pre-treatment through end of life, including in long-term survivors. The branch is interested in the problem of cancer-related cognitive changes from the perspectives of cognitive, clinical, and neurodevelopmental psychology and of neuroscience.

Articles and Publications

Horowitz TS, Trevino M, Gooch IM, Duffy KA. Understanding the Profile of Cancer-Related Cognitive Impairments: A Critique of the Meta-Analyses. J Natl Cancer Inst. 2019 May. doi: 10.1093/jnci/djz100.

Horowitz T. What You Need to Know About Cancer-Related Cognitive Impairment exit disclaimer.

Horowitz T, Suls J, Trevino M. A call for a neuroscience approach to cancer-related cognitive impairment. Trends Neurosci. 2018 Aug;41(8):493-496. doi: 10.1016/j.tins.2018.05.001. Epub 2018 Jun 12.

Understanding “Chemobrain” and Cognitive Impairment after Cancer Treatment. National Cancer Institute (2017).

Funding Opportunities

Leveraging Cognitive Neuroscience Research to Improve Assessment of Cancer Treatment-Related Cognitive Impairment

PAR-19-340/PAR-19-339 (R01/R21 Clinical Trial Optional)
Contact: Todd S. Horowitz, Ph.D.

Selected Grants Funded in Areas Relevant to Cancer-Related Cognitive Impairment

PI Name Organization Name Project Title Project Number
Ahles, Tim Sloan-Kettering Institute Cognition in Older Breast Cancer Survivors: Treatment Exposure, APOE, and Smoking 5R01CA172119-05
Ahles, Tim Sloan-Kettering Institute Assessment of Sensory Gating, Attention, and Executive Control in Breast Cancer 5R01CA218496-02
Chao, Herta Huey-An Yale University Neurocognitive Changes From Long-Term Androgen Deprivation Therapy in Prostate Cancer Patients 1R01CA218501-01A1
Mandelblatt, Jeanne Georgetown University Older Breast Cancer Patients: Risk for Cognitive Decline 5R01CA129769-09


Program Director: Todd S. Horowitz, Ph.D.

Todd S. Horowitz, Ph.D.
Program Director