Identifying unmet needs in cancer survivorship by linking patient-reported outcome measures to the International Classification of Functioning, Disability and Health

Purpose: Advances in cancer detection and treatment have extended cancer survivors' (CSs) life expectancy, but their evolving health needs remain unmet. This study analyzes 14 patient-reported outcome measures (PROMs) for CSs with non-cutaneous cancers using the International Classification of Functioning, Disability and Health (ICF) framework. These 14 PROMs are derived from a recent review focusing on the implementation of the routine assessment of unmet needs in cancer survivors. Methods: Each PROM was examined for correspondence to ICF health and functioning dimensions. Two independent reviewers extracted meaningful concepts from each PROM item, linking them to ICF categories. Discrepancies were resolved through discussion with a third expert reviewer. Results: PROMs varied in ICF component correspondence, with "Activities and Participation" (37.2%) and "Environmental Factors" (31.8%) most frequently represented, highlighting their significance. "Body Structures" (1%) received minimal attention, suggesting its limited relevance to CSs' needs. The results of the linking process show the differences between the various PROMs: Candi and eHNA were primarily linked to "Body Function" (53.4% and 51.4%, respectively), NEQ and SUN to "Activities and Participation," and CaSUN and PNI to "Environmental Factors" (51.7% and 50%, respectively), while eHNA had the highest percentage of items linked to "Body Structures" (8.1%). Conclusions: This evaluation of PROMs enhances the understanding of CSs' diverse needs so as to address them, thereby improving these individuals' quality of life. Implications for cancer survivors: The study underscores the importance of addressing "Activities and Participation" and "Environmental Factors" in PROMs for CSs. These insights support developing comprehensive PROMs and help healthcare providers prioritize critical areas of survivorship care, ultimately enhancing CSs' well-being.