The future of healthcare delivery across the cancer continuum holds great promise and challenge. U.S. cancer mortality across all cancers combined decreased ~2% annually from 2015 to 2019 thanks to a range of factors including clinical and delivery innovations in cancer prevention, control, treatment, supportive care, and efforts to improve clinical trial access [1]. However, long-standing cancer health disparities remain. Accelerated progress is vital to reduce cancer deaths for all Americans and achieve National Cancer Plan goals [2-4]. Additionally, COVID-19 impacts on cancer are still emerging [5, 6] and the long-term cancer survivor population is growing—increasing sustained surveillance for recurrence, new cancers, late effects, and other long-term health concerns [7]. These and other individual, institutional, and societal trends are shaping cancer care delivery, treatment, and research. Cancer health services research has a role in tracking and understanding how such trends influence health service design, delivery, and outcomes, to inform care approaches, health system decisions, and policy innovation across the cancer continuum. Such trends also beg the question, what measurement and methodological innovations are needed for timely, valid evaluation of their impact on cancer-related health services and outcomes important to patients, caregivers, healthcare professionals, payers, and policy makers? Continued measurement and methodological development only stand to improve scientific quality, reproducibility, and practical impact. Therefore, in this commentary, we briefly summarize 10 trends in cancer care delivery, treatment, and research and explore potential implications for health services research measurement and methods. Our intent is not to comprehensively address all possible opportunities or ideas presented here, but to highlight pressing, foundational needs and promising directions for measurement and methods focused science. Our focus is cancer health services research. However, the challenges and opportunities discussed clearly have broader implications. Rededication to strengthening our research methods and measures is an investment in the foundational T0 basic science [8] of cancer health services research and, therefore, essential to generating and translating future evidence into practice and policy. A universe of trends influences health services at-large at any given moment, however, we highlight 10 trends elevating the necessity of methods and measures research in cancer-focused health services research, including: (1) precision oncology; (2) whole-person perspectives; (3) health technologies (e.g., artificial intelligence (AI), mobile health, telehealth); (4) expanding in-home and community-based services; (5) health system integration and efforts addressing care fragmentation; (6) workforce capacity and evolving roles; (7) population aging; (8) improving safety, quality, value and access while controlling costs and addressing financial toxicity; (9) addressing social drivers of health; and (10) leveraging data oceans with unstructured, semi-structured, and structured elements. Deep discussion of each is beyond our scope, but we discuss several of these trends with examples and then give focused attention to measurement and methodological implications. One trend with significant measurement and methodological implications is the rapid advancement of precision oncology paradigms. Precision paradigms are fundamentally changing the understanding of cancer risk, diagnosis, disease profiling, treatment monitoring, therapeutic development, trial eligibility, and have birthed new health services (e.g., genetic counseling, in-house molecular pathology) [9-11]. Precision approaches highlight potential pitfalls of analyses by organ site (e.g., lung, breast) that lump together variations in genetic or social risks, different genomic signatures, treatments, and implications for prognosis and quality of life (QOL) [12-14]. Population aging and movement toward whole-person health similarly underscore opportunities to assess and model a broader constellation of factors (e.g., multiple chronic conditions, functional status, degrees of caregiver support) and understand the effects of incentivizing wholistic care approaches on cancer-related outcomes [15, 16]. Paralleling rapid clinical advancements is increasing attention on controlling costs, including addressing financial toxicity and financial distress [17, 18]. Cancer care costs increasingly outpace other areas; for example, they comprised 43% of 2020 Medicare Part B spending [19]. Additionally, recent analyses found cancer survivors were nearly 4 times more likely to declare bankruptcy and experienced credit score declines persisting up to nearly 10 years post-diagnosis [20]. Financial distress is associated with higher symptom burden, worse QOL, and lower adherence to recommended care [21-23]. Challenges quantifying costs or balancing cost with access to high-quality care and clinical innovations are certainly not new [24]. However, the scope and duration of cancer care costs at individual, family, and population levels beget opportunities for multilevel measure development, innovative modeling approaches, and data linkages, as well as interventions that integrate financial considerations into goals of care discussions and financial navigation [25-27]. The speed of cancer care innovation is also matched by rapid transformations in the healthcare system landscape across the cancer continuum. For example, in 2017 more oncology physician practices (50%–55%) reported vertical integration with a hospital or health system compared with any other specialty, up from ~20% in 2007 [28, 29]. Trends toward greater health system integration, new affiliation models, expansion of non-traditional players into the care delivery sector, and pervasive care fragmentation underscore opportunities to develop and adopt richer measures of organizational structure, functioning, policies, norms, and coordination across the cancer continuum [30]. Similarly, evolving roles and approaches to care are arising from clinical innovation (e.g., home-based screening, oral anti-cancer agents) paired with patient volumes rapidly outpacing oncology workforce capacity. For example, some care delivery models, state policies, and billing guidelines are enabling Advanced Practice Professionals, community health workers, patient navigators, home care, and other care team members to practice at the top of their license or certification [16]. These trends challenge future research to more precisely assess where and who is delivering care and to advance methods suitable for evaluating contributions of a growing constellation of collaborators and settings to cancer-related outcomes of interest. Additionally, the field has seen increased focus on understanding and addressing adverse social drivers of health, financial hardship, and social risks (e.g., transportation, food, housing instability) and their influence on persistent cancer health disparities [31]. For example, eliminating cancer health disparities was one of eight goals in the 2024 National Cancer Plan [32, 33]. NCI has a long history of supporting efforts to improve cancer health disparity measurement [34] given quantifying heterogeneity in cancer incidence and mortality is part of the Annual Report to the Nation on Cancer. However, efforts to address social risks and drivers of health via the healthcare system—as well as related measures and approaches for tracing impact on cancer outcomes—are still nascent. Collectively, these trends and others noted at the opening of this section underscore numerous opportunities for cancer health services scientists to address persistent and emerging measurement and methodological challenges. We highlight several opportunities for future measurement and methods development or refinement below. We simultaneously encourage the field to identify and pursue numerous others not discussed here. Many trends above may necessitate new measurement paradigms (e.g., whole-person cancer care, measurement-based care). Others underscore the need for dedicated attention toward solving persistent, yet fundamental measurement challenges (e.g., evolving care delivery settings, usual care, organizational characteristics). Given these trends, we discuss five example areas for measurement-focused research attention below. Evidence exists for the benefit of whole-person care models, yet defining components of whole-person cancer care requires conceptual elaboration, refinement, and standardization [35]. Both new measures and novel person-centered methods are essential to designing and optimizing whole-person focused systems of cancer care. In 2024, building from work in primary care, the Integrative Oncology Leadership Collaborative (IOLC) defined whole-person cancer care as an approach that integrates conventional cancer treatments with evidence-based complementary therapies and/or lifestyle interventions, addresses the physical, emotional, social, and spiritual aspects of a person's life, and focuses on what matters most to the patient [36, 37]. The IOLC definition and related minimal-required elements are based on the Two-Circle Model of Whole-Person Care [38], which reframes current disease-focused approaches toward one that is person-centered, relationship-based, and recovery and health-promotion focused. An emphasis on person-centered care, coordination, continuity and integration, and relationships are distinguishing characteristics of the whole-person paradigm and are conceptualized as features most likely to improve population health, access, quality, and lower costs. The Two-Circle framework also highlights roles, services, and workforce changes needed to implement, scale up, and sustain this type of care. New payment models are also important to support and incentivize a transition to whole-person care. Many health services measurement and methodological approaches developed or operationalized around a single disease, organ system, specific health care setting, or payer will continue to be useful in evaluating models of whole-person cancer care (e.g., cancer registries, Consumer Assessment of Healthcare Providers & Systems [CAHPS]) [39-41]. However, person-centered measures of unmet needs, experiences of care involving larger care teams, well-being (physical, emotional, social), care costs, and medical financial hardship will require further conceptual, lexical, and methodologic development in the context of whole-person care [42]. Ensuring such measures are accessible and meaningful for all patients, and interpretable as predictors and moderators of whole-person health outcomes will require mixed methods studies that go beyond traditional psychometric approaches to establish validity and interpretation [43]. Measurement of whole-person outcomes also requires accommodating, sometimes simultaneously, for within-person and group-level change, and methods able to address differences between individuals on a collection of measures or scale dimensions (e.g., almost matching exactly methods) [44]. The NIH National Center for Complementary and Integrative Health's 2021 Workshop on Methodological Approaches for Whole Person Research discussed several such measurement and methodological opportunities [45]. Measurement-based care (MBC) is an emerging approach in chronic disease management, including cancer care [46], generally defined as “systematic evaluation of patient symptoms before or during an encounter to inform” [47](p324) care-related decisions. Patient-reported outcomes (PROs) form MBC's foundation, providing critical tools for assessing targeted needs for distinct populations (e.g., older adults, adolescents), tumor and treatment types, and care phase [48]. Well-validated instruments essential for MBC in oncology exist (e.g., needs assessment, symptoms, functional status, social risks) [49-51]. However, some domains remain underdeveloped, including measurement of treatment burden, patient engagement, and care experiences. Both existing and newly developed measures also require adaptation and validation to meet accessibility needs of all patients, including groups understudied in measure development research such as older adults and people with differing degrees of English language proficiency. Additionally, integrating these measures into feasible, efficacious MBC interventions and coupling them with evidence-based decision support necessary to prioritize and comprehensively address the constellation of needs identified, requires further development. Alternative settings of care beyond traditional inpatient-outpatient distinctions are also rapidly arising, including: telehealth, remote patient monitoring, home-based care (e.g., hospital-in-the-home, self-management support), distributed clinical trials, and consumer-oriented platforms (e.g., Amazon Care, CVS MinuteClinic). These settings offer new opportunities for interdisciplinary collaboration, improved efficiency, and access. However, the field lacks screening measures to match these settings to patient needs and resources, risk stratify, and predict clinical complications. Also needed are bespoke measures demonstrating solid measurement properties in these settings for care quality, safety, clinical outcomes, budget impact, costs, value, and experiences of patients, caregivers, and staff [52-54]. Measuring strategies and contextual factors contributing to the adoption and sustainment of delivery models employing alternative care settings are also important for dissemination and adaptation [54, 55]. 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