The number of older adults in the United States is growing. Fueled by the growing aging population, cancer incidence is projected to increase. It is estimated that by 2040, 73 percent of cancer survivors will be 65 years and older. The anticipated demographic shift highlights the urgent need for attention to the geriatric oncology population. Older adults undergoing cancer treatments may be at increased risk for frailty, declines in physiologic reserves, accelerated aging, and functional impairments. Cancer treatments may also exacerbate and/or contribute to new and existing comorbid conditions for older adults. These clinical challenges are compounded by systems-related trends, including pressures to reduce hospital readmissions, low uptake of evidence-based comprehensive geriatric assessments to personalize care, and lack of resources to address assessment-identified problems.
To contribute to improving cancer care delivery for older adults with cancer, I dedicated my visiting scholar year to understanding the current state of the healthcare delivery research landscape in geriatric oncology. Through the visiting scholar program that is jointly sponsored by the NCI and AcademyHealth, I worked with Ashley Wilder Smith, PhD, MPH, Chief of the Outcomes Research Branch at the NCI’s Healthcare Delivery Research Program. Our first project was a 10-year portfolio search of NIH-funded healthcare delivery research in older adults with cancer. We identified geriatric assessment as the most common topic funded in the last 10 years. Several gaps in research were also identified, including healthcare delivery research on cognitive functioning, palliative care and cancer caregiving. The portfolio search project helped me gain valuable knowledge on areas for improvement in healthcare delivery research for older adults with cancer, which will help with designing future research projects.
The second project of my visiting scholar year involved the development of a healthcare delivery research framework in geriatric oncology. The proposed framework covers five key domains to be considered when designing cancer care delivery research and projects in geriatric oncology, and they include patient/family characteristics, healthcare team characteristics, organizational/healthcare systems characteristics, community characteristics, and policy/guidelines. Design of healthcare delivery research could focus on multilevel (e.g. patient/family, healthcare team, healthcare systems) stakeholders, with strategies and interventions designed for each level to catalyze the field of geriatric oncology. Outcomes for each level could be assessed to understand the benefits of the multilevel interventions.
As part of the visiting scholar program, I had the opportunity to participate in several AcademyHealth events, including the 2021 Health Policy Orientation, the annual conference on the Science of Dissemination and Implementation in Health, and the 2022 Annual Research Meeting, where I presented a poster on the portfolio search project. As an oncology nurse scientist with limited exposure to health policy, these events were incredibly valuable for my professional growth, specifically with understanding the impact of health policies on the quality of cancer care delivery. I look forward to participating in AcademyHealth events for many years to come. To learn more about the projects described in this blog, I invite you to click on the link below to view the webinar “Healthcare Delivery Research and Opportunities in Older Adults with Cancer.”
I highly encourage mid-career investigators to apply for the NCI/AcademyHealth Healthcare Delivery Research Visiting Scholar Program. There are few professional development programs for mid-career cancer researchers like this one that is focused on healthcare delivery research. Applications are now open through March 20 at 5pm ET.