title: Knowledge, ignorance and priorities for research in key areas of cancer survivorship: findings from a scoping review.
abstract: BACKGROUND
  Patients who have completed initial cancer treatment (cancer survivors) have been relatively neglected. We need data to help us better understand the needs of this group and to underpin evidence-based service development.
  
  
  METHODS
  Scoping reviews of research published in the last two decades focussing on the problems faced by cancer survivors, and the effectiveness of interventions for these problems were undertaken. The aim was to identify what we know, what we do not know and opportunities where research could provide new information. We searched for, retrieved and rapidly appraised systematic reviews sourced from the most common electronic databases supplemented by more recently published individual studies.
  
  
  RESULTS
  The research evidence is surprisingly limited. We have some knowledge of the prevalence and nature of depression, pain and fatigue in cancer survivors. We know much less about cognitive and physical impairment, employment, financial well-being and relationships. Even where we have evidence, it is mostly of only moderate quality, is most often only for breast cancer and focuses almost exclusively on the early phase of survivorship. We have good evidence for the effectiveness of drug treatments for pain and moderate evidence for fatigue and depression, but not for other symptoms. Interventions based on rehabilitative and self-management approaches remain in the early stages of evaluation.
  
  
  CONCLUSIONS
  There has been a substantial amount of research describing many of the problems experienced by the cancer survivors. This is strongest in the area of symptoms in the period soon after treatment. However, the quality of the evidence is often poor, and some topics have been little examined. We urgently need data on the natural evolution and scale of the problems of cancer survivors obtained from well-designed, large-scale cohort studies and the robust testing of interventions in clinical trials. Given the current financially constrained research funding environment, we suggest areas in which strategic investment might give findings that have the potential to make a major impact on patient well-being in a 5-year time scale.
authors: Faculty of Health Sciences, University of Southampton, Building 67, Highfield, Southampton, UK. alison.richardson@soton.ac.uk
authors: A
authors: A
authors: Richardson
authors: J
authors: J
authors: Addington-Hall
authors: Z
authors: Z
authors: Amir
authors: C
authors: C
authors: Foster
authors: D
authors: D
authors: Stark
authors: J
authors: J
authors: Armes
authors: S G
authors: SG
authors: Brearley
authors: L
authors: L
authors: Hodges
authors: J
authors: J
authors: Hook
authors: N
authors: N
authors: Jarrett
authors: Z
authors: Z
authors: Stamataki
authors: I
authors: I
authors: Scott
authors: J
authors: J
authors: Walker
authors: L
authors: L
authors: Ziegler
authors: M
authors: M
authors: Sharpe
mesh_terms: D035843:Biomedical Research; D006801:Humans; D019359:Knowledge; D009369:Neoplasms / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D011787:Quality of Health Care / Q000706:statistics & numerical data; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data*