SynthesisJournal of the National Cancer Institute2026
Stepped-care models for cancer symptom management: a systematic review of efficacy and cost-effectiveness.
Synthesis in Journal of the National Cancer Institute, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Operationalizing fear of cancer recurrence care: a modified Delphi study establishing a consensus-based clinical pathway for Danish cancer survivors.Acta oncologica (Stockholm, Sweden) · 2026Article
- Commentary: The distress of psychological adaptation in nutritional management among people after esophagectomy: an interpretative phenomenological study.Frontiers in nutrition · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe delivery of clinical care services using personalized health approaches is an integral component of cancer care. This review synthesized evidence on the efficacy and cost-effectiveness of stepped-care interventions delivered to manage therapy-related symptoms in cancer populations compared with care as usual (CAU).
methodsSystematic searches were conducted in MEDLINE, PsycINFO, Embase, Web of Science, Cochrane Library, National Health Service Economic Evaluation Database, and EconLit to identify studies published from January 2010 to November 2024. Peer-reviewed studies that reported outcomes of stepped interventions and CAU were included, and quality appraisal was performed using the Cochrane Risk of Bias 2 and the Risk of Bias in Non-Randomised Studies-of Interventions tools.
resultsThe review summarizes a total of 22 studies, involving 4588 unique adult cancer survivors. Fourteen studies identified statistically significant improvements in symptom severity and clinical outcomes comparable to those of CAU. The stepped-care group showed reduced mean severity scores for distress, insomnia, and fatigue, as well as improved stress reactions and emotional reactivity, and fewer palliative care visits. The low uptake of the intervention and inadequate assessment of comorbid symptoms have hindered the ability to draw conclusive recommendations across several studies. Four studies evaulated the cost-effectiveness of stepped-care interventions compared to CAU. Two of these studies reported significant cost savings of approximately €19 991 for each point improvement on the distress scale and lower incremental costs of approximately €3950 associated with stepped-care interventions.
conclusionsThis review highlights the potential clinical and economic benefits of implementing stepped-care interventions to reduce the severity of cancer-related symptoms. Further research is warranted to assess the long-term effectiveness, cost-effectiveness, and implementation feasibility of stepped-care interventions in real-world clinical care settings serving cancer populations with diverse needs.
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