Assessing the Catchment Area to Identify and Pursue Unmet Research Needs Maryann Donovan, PhD, MPH...
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Assessing the Catchment Area to Identify and Pursue Unmet Research Needs Maryann Donovan, PhD, MPH Associate Director for Research Administration University
Assessing the Catchment Area to Identify and Pursue Unmet
Research Needs Maryann Donovan, PhD, MPH Associate Director for
Research Administration University of Pittsburgh Cancer
Institute
Slide 2
PAR 11-005 Stage II, Community Service, Outreach and
Dissemination: Process for evaluation of the impact of outreach and
dissemination activities on clinical and public health systems
within the centers catchment area PAR 12-298 and 13-386 Six
Essential Characteristics, Organizational Capabilities: In addition
to research/scientific questions of broad applicability, [a Center]
should use its available expertise and resources to address cancer
research within the catchment area. Senior Leadership: Discuss how
the senior leaders have worked together to: Enable a focus on
cancer problems applicable to the catchment area served by the
Center Research Strategy (Research Programs): For each program
briefly discuss the following: In addition to questions of broader
applicability, and as appropriate to the type of Program, briefly
describe how the cancer research relevant to the catchment area is
addressed. This may include, for example, a discussion of research
focused on cancer health disparities (e.g., problems affecting
racial and ethnic minorities, rural residents, women, children,
elderly, persons of low socioeconomic status), cancer sites of high
incidence/mortality, environmental exposures, behavioral factors,
or other issues. Changing CCSG Requirements: Focus is Now on
Research, Not Outreach UPCI Outreach Activities Community Cancer
Screening Clinics Health & Wellness Events Cultivation of
Community Navigators for the Medically Underserved Healthcare for
the homeless Primary Prevention Education Healthy Choices for
Students during School Year and Summer
Slide 3
UPCIs Response to Changing Requirements: A New Internal
Advisory Committee Committee for Cancer Research in Western PA
(CCRwPA) Established in 2013 to identify needs and plan and monitor
research Meets monthly Chaired by the UPCI Director and includes:
UPCI Deputy Director UPCI Associate Director for Cancer Control and
Population Sciences Leader of UPCIs Biobehavioral Oncology Program
UPCI Associate Director for Health Equity, Education, and Advocacy
UPCI Associate Director for Research Administration Technical and
administrative support provided by PhD scientists from UPCIs Office
of Research Administration
Slide 4
UPCIs Catchment Area 29 Western Pennsylvania Counties (shown in
green)
Slide 5
UPMC CancerCenter Network
Slide 6
Sources for Defining the Cancer Problems in UPCIs Catchment
Area Public Websites: NCI-CDC State Cancer Profiles
(http://statecancerprofiles.cancer.gov) Pennsylvania Department of
Health PubMed Intra-Institutional: Department of Environmental and
Occupational Health Department of Behavioral & Community Health
Sciences UPMC CancerCenter Registry
Slide 7
Tools on http://statecancerprofiles.cancer.gov Demographics
Screening and Risk Factors Cancer Knowledge Prevalence
Mortality
Slide 8
Sample Interface on http://statecancerprofiles.cancer.gov
Age-adjusted Incidence of All Cancers (2006-2010) Lung Cancer
Mortality (2006-2010) Ever Smoking Rate (2000-2003) Incidence of
Breast Cancer in African American Women (2006-2010) Data for
Preparing Maps Tools on http://statecancerprofiles.cancer.gov
Slide 9
Tools on State Department of Health Website Detailed Maps
Slide 10
Examples of What Was Learned Highest Incidence Cancers (per
100,000) Lung: 17/29 counties > US (65) Breast: 15/29 counties
> US (120) Colorectal: 27/29 counties > US (44) Prostate:
16/29 counties > US (144) Cancer Risk Factors Smoking
prevalence: 22/29counties > US (19.0%) Obesity: 27/29 counties
> US (27.9%) Aging (> 65 years): 29/29 counties > US
(13.0%)
Slide 11
BOP: Regulated Reduction of Cigarette Nicotine Content BOP:
Strategies to Avoid Returning to Smoking (STARTS) Randomized
clinical trial of an intensive support program to prevent post-
partum smoking relapse through cognitive-biobehavioral techniques
focused on mood, stress, and weight 300 local women (target of 40%
African American) who stop smoking for at least 1 month during
pregnancy Cancer Problem: Smoking-related Lung Cancer Smoking is
the causative factor in approximately 90% and 80% of lung cancer
deaths in men and women, respectively. In 22 of the 29 counties in
UPCIs catchment area, smoking prevalence is higher than the U.S.
average. Lung and bronchus cancer mortality is higher than the
national average in 19 of the counties. LCP: Pittsburgh Lung
Screening Study (PLuSS) Screened 3,642 smokers with low-dose CT in
western PA and found 275 lung cancer cases (36% early stage)
Resource for biomarker discovery and validation for early detection
Supported by Lung Cancer SPORE Contributed to new USPSTF Screening
Guidelines Cancer Biomark, 2011; J Thorac Oncol, 2011; J Thorac
Oncol, 2012; Clin Proteomics, 2014 Nic Tob Res, 2013, 2014 Lung
Cancer Mortality (2006-2010) Ever Smoking Rate (2000-2003) Lung
Cancer Incidence (2006-2010)
Slide 12
Cancer Problem: Using the UPMC Network to Reduce Melanoma
Mortality by Early Detection 2014: Trained >500 primary care
clinicians throughout the network via UPMC uLearn CME system
Target: 86,000 patients 35 years will be screened 50,000 screened
in first 8 months Research Plan: Thickness-specific melanoma
incidence and mortality will be compared for screened group vs.
overall thickness-specific incidence in an 18-county area Melanoma
Incidence (2006-2010) MP: Primary Care Physicians Taught Melanoma
Screening
Slide 13
Cancer Problem: HPV+ Cancers HNCP: Extent of regional increase
in HPV+ head and neck cancer over the last 50 years HPV P16
staining of oropharyngeal squamous cell carcinomas tissue blocks
from UPMC pathology archives from 1956-1969 (n=43) vs. 2007-2009
(n=53) revealed an increase in the proportion of HPV+ cases (from
35% to 72%) CEPP: Quality of life in 177 UPMC CancerCenter patients
with HPV+ head and neck cancer HPV16+ head and neck cancer patients
have better overall quality of life (both before and after
treatment) BOP: Knowledge and health behaviors related to HPV
infection Assessing knowledge of HPV infection and prevention
measures and documenting health and personal behaviors of
individuals in underserved areas Implementing low-literacy
educational sessions about HPV Partnering with Jewish Healthcare
Foundation to increase HPV vaccination rates Laryngoscope, 2014 Hum
Pathol, 2012
Slide 14
Cancer Problem: Care and Survival Disparities in African
American Patients CEPP: Race-based Disparities in Head and Neck
Cancer Survival African Americans are more likely than Whites to be
diagnosed with late stages of oral cavity and laryngeal cancer
African American patients with laryngeal cancer, showed a
significant difference in relapse-free survival BOP/BOCP:
Attitudes, Communication, Treatment, and Support (ACT) Intervention
led by an African American breast cancer survivor Improved
initiation of chemotherapy, adherence, and completion of total dose
BOP: Accountability for Cancer Care through Undoing Racism and
Equity (ACCURE) Collaboration with University of North Carolina
Intervention to improve completion of treatment for early stage
breast/lung 138/150 patients enrolled in Pittsburgh (31% African
American) Head and Neck, 2011 ACT Intervention Wins a 2014
Pittsburgh YMCA Racial Justice Award Oncology Nurses Forum,
2011
Slide 15
Committee for Cancer Research in Western PA at Work: Planning
New Research Initiatives BRAINSTORMING SESSIONS PILOT FUNDING
OPPORTUNITIES NEW COLLABORATIONS Mitochondria, Aging and Metabolism
Request for Pilot Proposals 2014-2015