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The Common Scientific Outline

The Common Scientific Outline, or CSO, is a classification system organized around seven broad areas of scientific interest in cancer research:
 
 Biology
 Etiology (causes of cancer)
 Prevention
 Early Detection, Diagnosis, and Prognosis
 Treatment
 Cancer Control, Survivorship, and Outcomes Research
 Scientific Model Systems
 
The development of the CSO is laying a framework to improve coordination among research organizations, making it possible to compare and contrast the research portfolios of public, non-profit, and governmental research agencies.
 
 

Biology

1.1 Normal Functioning

Examples of science that would fit:
  • Developmental biology (from conception to adulthood) and the biology of aging.
  • Normal functioning of genes, including their identification and expression, and the normal function of gene products, such as hormones and growth factors.
  • Normal formation of the extracellular matrix.
  • Normal cell to cell interactions.

1.2 Cancer Initiation: Alterations in Chromosomes

Examples of science that would fit:
  • Abnormal chromosome number.
  • Aberration in chromosomes and genes (e.g., in chronic myelogenous leukemia).
  • Damage to chromosomes and mutation in genes.
  • Failures in DNA repair.
  • Aberrant gene expression.
  • Epigenetics.

1.3 Cancer Initiation: Oncogenes and Tumor Suppressor Genes

Examples of science that would fit:
  • Genes and signals involved in growth stimulation or repression, including oncogenes (Ras, etc.), and tumor suppressor genes (p53, etc.).
  • Effects of hormones and growth factors and their receptors such as estrogens, androgens, TGF-beta, GM-CSF, etc.

1.4 Cancer Progression and Metastasis

Examples of science that would fit:
  • Latency, promotion, and regression.
  • Expansion of malignant cells.
  • Interaction of malignant cells with the immune system or extracellular matrix.
  • Cell mobility including detachment, motility and migration in the circulation.
  • Invasion.
  • Malignant cells in the circulation including penetration of the vascular system and extrasavation.
  • Systemic and cellular effects of malignancy.
  • Tumor angiogenesis and growth of metastases.
  • Role of hormone or growth factor dependence/independence in cancer progression.

1.5 Resources and Infrastructure

(Note: grants coded as 1.2 in previous versions of the CSO become 1.5)
Examples of science that would fit:
  • Informatics and informatics networks.
  • Specimen resources.
  • Epidemiological resources pertaining to biology.
  • Reagents, chemical standards.
  • Education and training of investigators at all levels (including clinicians).

1.6 Cancer Related Biology

(Historical Code; for internal use only by CSO Partners. For crosswalk purposes previous 1.1 codes become 1.6)
 
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Etiology

2.1 Exogenous Factors in the origin and cause of cancer

Examples of science that would fit:
  • Lifestyle factors such as smoking, chewing tobacco, alcohol consumption, parity, diet, sunbathing, and exercise.
  • Environmental and occupational exposures such as radiation, second-hand smoke, radon, asbestos, organic vapors, pesticides, and other chemical or physical agents.
  • Infectious agents associated with cancer etiology, including viruses (Human Papilloma Virus-HPV, etc.) and bacteria (helicobacter pylori, etc.).
  • Viral oncogenes and viral regulatory genes associated with cancer causation.

2.2 Endogenous Factors in the Origin and Cause of Cancer

Examples of science that would fit:
  • Free radicals such as superoxide and hydroxide radicals.
  • Genes known to be involved or suspected of being mechanistically involved in familial cancer syndromes; for example, BRCA1, Ataxia Telangiectasia, and APC.
  • Genes and signals involved in growth stimulation or repression, including oncogenes (RAS, etc.) and tumor supressor genes (P53, etc.) as well as hormones and growth factors such as estrogens, androgens, TGF-Β, and GM-CSF.
  • Genes suspected or known to be involved in "sporadic" cancer events; e.g., polymorphisms and/or mutations that may affect carcinogen metabolism (CYP, NAT, glutathione transferase, etc.).

2.3 Interactions of Genes and/or Genetic Polymorphisms with Exogenous and/or Endogenous Factors

Examples of science that would fit:
  • Gene-environment interactions.
  • Interactions of genes with lifestyle factors, environmental, and/or occupational exposures such as variations in carcinogen metabolism associated with genetic polymorphisms.
  • Interactions of genes and endogenous factors such as DNA repair deficiencies and endogenous DNA damaging agents such as oxygen radicals or exogenous radiation exposure.

2.4 Resources and Infrastructure Related to Etiology

Examples of science that would fit:
  • Informatics and informatics networks; e.g., patient databanks.
  • Specimen resources (serum, tissue, etc.).
  • Reagents and chemical standards.
  • Epidemiological studies pertaining to etiology.
  • Statistical methodology or biostatistical methods.
  • Centers, consortia, and/or networks.
  • Education and training of investigators at all levels (including clinicians).
 
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Prevention

3.1 Interventions to Prevent Cancer: Personal Behaviors that Affect Cancer Risk

Examples of science that would fit:
  • Research on determinants of personal behaviors that affect cancer risk, such as diet, physical activity, sun exposure, and tobacco use.
  • Interventions to change personal behaviors that affect cancer risk.

3.2 Nutritional Science in Cancer Prevention

Examples of science that would fit:
  • Quantification of nutrients and micronutrients.
  • Studies on the effect(s) of nutrients or nutritional status on cancer incidence.
  • Dietary assessment efforts including dietary questionnaires and surveys.
  • Development, characterization, and validation of dietary/nutritional assessment instruments.

3.3 Chemoprevention

Examples of science that would fit:
  • Chemopreventive agents and their discovery, mechanism of action, development, testing in model systems, and clinical testing.

3.4 Vaccines

Examples of science that would fit:
  • Vaccines for prevention, their discovery, mechanism of action, development, testing in model systems, and clinical testing.

3.5 Complementary and Alternative Prevention Approaches

Examples of science that would fit:
  • Discovery, development, and testing of complementary/alternative prevention approaches such as diet, herbs, supplements, or other interventions that are not widely used in conventional medicine or are being applied in different ways as compared to conventional medical uses.
  • Hypnotherapy, relaxation, transcendental meditation, imagery, spiritual healing, massage, biofeedback, etc., used as preventive measures.

3.6 Resources and Infrastructure Related to Prevention

Examples of science that would fit:
  • Informatics and informatics networks; e.g., patient databanks.
  • Specimen resources (serum, tissue, etc.).
  • Epidemiological studies pertaining to prevention.
  • Clinical trials infrastructure.
  • Statistical methodology or biostatistical methods.
  • Centers, consortia, and/or networks.
  • Education and training of investigators at all levels (including clinicians).
 
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Early Detection, Diagnosis, and Prognosis

4.1 Technology Development and/or Marker Discovery

Examples of science that would fit:
  • Discovery of markers (e.g., proteins, genes) and/or imaging methods that are potential candidates for use in cancer detection, diagnosis, and/or prognosis.

4.2 Technology and/or Marker Evaluation with Respect to Fundamental Parameters of Method

Examples of science that would fit:
  • Development, refinement and preliminary evaluation (e.g., animal trials and Phase I human trials).
  • Preliminary evaluation with respect to laboratory sensitivity, laboratory specificity, reproducibility, and accuracy.

4.3 Technology and/or Marker Testing in a Clinical Setting

Examples of science that would fit:
  • Evaluation of clinical sensitivity, clinical specificity and predictive value (Phase II or III clinical trials).
  • Quality assurance and quality control.
  • Inter- and intralaboratory reproducibility.
  • Testing of the method with respect to effects on morbidity and/or mortality.
  • Study of screening methods including compliance, acceptability to potential screenees, and receiver-operator characteristics.

4.4 Resources and Infrastructure Related to Detection, Diagnosis, or Prognosis

Examples of science that would fit:
  • Informatics and informatics networks; e.g., patient databanks.
  • Specimen resources (serum, tissue, images, etc.).
  • Clinical trials infrastructure.
  • Epidemiological studies pertaining to risk assessment, detection, diagnosis, or prognosis.
  • Statistical methodology or biostatistical methods.
  • Centers, consortia, and/or networks.
  • Education and training of investigators at all levels (including clinicians).
 
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Treatment

5.1 Localized Therapies - Discovery and Development

Examples of science that would fit:
  • Discovery and development of treatments administered locally that target the organ and/or neighboring tissue directly, including but not limited to surgical interventions and radiotherapy.
  • Therapies with a component administered systemically but that act locally (e.g., photodynamic therapy, radioimmunotherapy and radiosensitizers).
  • Drug delivery methods.

5.2 Localized Therapies - Clinical Applications

Examples of science that would fit:
  • Clinical testing and application of treatments administered locally that target the organ and/or neighboring tissue directly, including but not limited to surgical interventions and radiotherapy.
  • Clinical testing and application of therapies that act locally but have a component administered systemically (e.g., photodynamic therapy and radiosensitizers).
  • Phase I, II, or III clinical trials of promising therapies administered locally

5.3 Systemic Therapies - Discovery and Development

Examples of science that would fit:
  • Discovery and development of treatments administered systemically such as cytotoxic or hormonal agents, novel systemic therapies such as immunologically directed therapies (vaccines, antibodies), gene therapy, angiogenesis inhibitors, apoptosis inhibitors, and differentiating agents.
  • Defining molecular signatures of cancer cells.
  • Identifying molecular targets for drug discovery. Includes mechanistic studies of cellular metabolism, combinatorial chemical synthesis, drug screening, development of high-throughput assays, and testing in model systems.
  • Drug delivery methods.

5.4 Systemic Therapies - Clinical Applications

Examples of science that would fit:
  • Clinical testing and application of treatments administered systemically such as cytotoxic or hormonal agents, novel systemic therapies such as immunologically directed therapies (vaccines, antibodies), gene therapy, angiogenesis inhibitors, apoptosis inhibitors, and differentiating agents.
  • Phase I, II, or III clinical trials of promising systemic therapies administered systemically.

5.5 Combinations of Localized and Systemic Therapies

Examples of science that would fit:
  • Development and testing of combined approaches to treatment.
  • Clinical application of combined approaches to treatment such as systemic cytotoxic therapy and radiation therapy.

5.6 Complementary and Alternative Treatment Approaches

Examples of science that would fit:
  • Discovery, development, and clinical application of complementary/alternative treatment approaches such as diet, herbs, supplements, natural substances or other interventions that are not widely used in conventional medicine or are being applied in different ways as compared to conventional medical uses.

5.7 Resources and Infrastructure Related to Treatment

Examples of science that would fit:
  • Informatics and informatics networks; e.g., clinical trials networks and databanks.
  • Mathematical and computer simulations.
  • Specimen resources (serum, tissue, etc.).
  • Clinical trial groups.
  • Statistical methodology or biostatistical methods.
  • Drugs and reagents for distribution and drug screening infrastructures.
  • Centers, consortia, and/or networks.
  • Education and training of investigators at all levels (including clinicians).
 
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Cancer Control, Survivorship, and Outcomes Research

6.1 Patient Care and Survivorship Issues

Examples of science that would fit:
  • Quality of life.
  • Pain management.
  • Psychological impacts of cancer survivorship.
  • Rehabilitation.
  • Reproductive issues.
  • Long term morbidity.
  • Symptom management, including nausea, vomiting, lymphedema, and neuropathies.
  • Prevention of treatment-related toxicities and sequelae including symptom management, prevention of mucosities, and prevention of cardiotoxicities.

6.2 Surveillance

Examples of science that would fit:
  • Epidemiology and end results reporting (e.g., SEER).
  • Surveillance of cancer risk factors such as diet, body weight, physical activity, sun exposure, and tobacco use.
  • Analysis of variations in risk factor exposure by demographic or other factors.
  • Registries that track incidence, morbidity, and/or mortality related to cancer.
  • Trends in use of interventional strategies.
  • Method development for risk factor surveillance.

6.3 Behavior Related to Cancer Control

Examples of science that would fit:
  • Behavioral medicine research and interventions.
  • Influence of social factors, such as community, policy, education, and legislation, on behaviors related to cancer control.
  • Attitudes and belief systems and their influence on psychological health and on behaviors related to cancer control. For example, how beliefs can alter attempts to seek screening, detection, and treatment.
  • Interventions to change attitudes and beliefs that affect behavior related to cancer control and cancer outcomes.
  • Influences of attitudes and beliefs on compliance with treatment and prevention protocols.
  • Psychological or educational interventions to promote behaviors that lessen treatment-related morbidity and promote psychological adjustment to the diagnosis of cancer and to treatment effects.
  • Burdens of cancer on family members/caregivers and psychological/behavior issues.

6.4 Cost Analyses and Healthcare Delivery

Examples of science that would fit:
  • Analyses of the cost effectiveness of methods used in cancer prevention, detection, diagnosis, prognosis, treatment, and survivor care/support.
  • Development and testing of health service delivery methods.
  • Interventions to increase the quality of health care delivery.
  • Impact of organizational, social, and cultural factors on access and quality of care.
  • Studies of providers, such as geographical or care-setting variations in outcomes.
  • Effect of reimbursement and/or insurance on cancer control, outcomes, and survivorship support.
  • Access to care issues.

6.5 Education and Communication

Examples of science that would fit:
  • Development of communication tools and methods.
  • Education of patients, healthcare providers, at-risk populations, and the general population about cancer.
  • Communication with patients regarding therapeutic options.
  • Educational interventions to promote self care and symptom management.
  • Communicating cancer risk to underserved populations, at-risk populations, and the general public.
  • Alternative teaching methods to communicate therapeutic options and risk reduction behavior to patients and the general public.
  • Communication of lifestyle models that reduce cancer risk, such as nutritional interventions.
  • Communicating smoking and tobacco cessation interventions.
  • Special approaches and considerations for underserved and at-risk populations.
  • Education, information, prevention/screening/assessment systems for the general public, primary care professionals or policy makers.
  • Training, predictive cancer models, pain management, and surveillance systems for primary care professionals; telehealth/telemedicine applications.
  • Communication regarding cancer genetics, managed oncology care, communicating with survivors.
  • Barriers to successful health communication.

6.6 End-of-Life Care

Examples of science that would fit:
  • End-of-Life care issues, including palliative care, psychological interventions with families at end of life, hospice care, and pain management for terminally ill patients.

6.7 Ethics and Confidentiality in Cancer Research

Examples of science that would fit:
  • Informed consent modeling and development.
  • Quality of Institutional Review Boards (IRBs).
  • Protecting patient confidentiality and privacy.
  • Research ethics.

6.8 Complementary and Alternative Approaches for Supportive Care of Patients and Survivors

Examples of science that would fit:
  • Hypnotherapy, relaxation, transcendental meditation, imagery, spiritual healing, massage, biofeedback, etc., as used for the supportive care of patients and survivors.
  • Discovery, development, and testing of complementary/alternative approaches in such areas as diet, herbs, supplements, or other interventions that are not widely used in conventional medicine or are being applied in different ways as compared to conventional medical uses.

6.9 Resources and Infrastructure Related to Cancer Control, Survivorship, and Outcomes Research

Examples of science that would fit:
  • Informatics and informatics networks.
  • Clinical trial groups related to cancer control, survivorship, and outcomes research.
  • Statistical methodology or biostatistical methods.
  • Surveillance infrastructures.
  • Centers, consortia, and/or networks.
  • Education and training of investigators at all levels (including clinicians).
  • Psychosocial, economic, political and health services research frameworks and models.
 
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Scientific Model Systems

7.1 Development and Characterization of Model Systems

Examples of science that would fit:
  • Development of model systems, including but not limited to:
    • Computer-simulation model systems and computer software development.
    • In vitro models systems.
    • Cell culture model systems.
    • Organ and tissue model systems.
    • Animal model systems such as drosophila and c. elegans, zebra fish, mouse.

7.2 Application of Model Systems

Examples of science that would fit:
  • Characterization of model systems, including but not limited to:
    • Computer simulation model systems and computer software development.
    • In vitro models systems.
    • Cell culture model systems.
    • Organ and tissue model systems.
    • Animal model systems such as drosophila and c. elegans, zebra fish, mouse.

7.3 Resources and Infrastructure Related to Scientific Model Systems

Examples of science that would fit:
  • Models made available for distribution to the scientific community.
  • Centers, consortia, and/or networks.
  • Education and training of investigators at all levels (including clinicians).
 
 
Last Revised: November 2003
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