Andrea Dwyyer Call-on Congress panel speaker

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  • 1. Cancer Survivorship Research-The Public Health and PopulationBased ApproachAndrea (Andi) Dwyer, Program DirectorCancer Prevention and Control Research NetworkUniversity of Colorado Center
  • 2. Bench to BedsideBasic Preclinical Translational Clinical Dissemination Adoption Research Research ResearchManyIdeas Population Affected by Cancer
  • 3. Cancer Prevention & Control Research Network• The CPCRN was initiated in October 2002, with funding from the Centers for Disease Control and Prevention (CDC) & National Cancer Institute (NCI)• It is a thematic research network of the CDC Prevention Research Centers (PRCs)• The mission of CPCRN is to accelerate the adoption, implementation, translation, and dissemination of evidence-based cancer prevention/control strategies• Several workgroups; Marcia Ory-Texas, Betsy Risendal and Andrea Dwyer Survivorship Workgroup co-chairs-Colorado
  • 4. CPCRN Network Center Map
  • 5. Examples of Public Healthand Population BasedSurvivorship Research1. Transitioning from active cancer treatment to survivorship2. Managing long term cancer symptoms and side effects in the community3. Registry of colorectal cancer survivors
  • 6. A Novel Primary Care CLINICAL Group Visit Intervention for Cancer Survivors: What Is Next (WIN)
  • 7. WIN Pilot Series Results• Group visit model provides strategy to focus on targeted health behaviors• Group visits are feasible and acceptable to survivors (and caregivers)-80% Retention• Engages primary care providers/practices into survivorship phase of care• Dissemination planned to other areas/clinic sites• Improvements in physical activity, nutrition and communication with providers and family
  • 8. Cancer-Thriving and Surviving (CTS) Wait-Listed Randomized Control Trial1. Self-management is one of the few evidence-based strategies for self- management support is the Chronic Disease Self-Management Program (CDSMP).2. The CDSMP is a six week, NOT MEDICALLY BASED - community-led, high fidelity group problem-solving/ educational intervention delivered through trained peer leaders (Stanford Patient Education Center).Research Goal:1. Describe the adaptations made to the CDSMP for the CancerThriving and Surviving Program, and evaluate the perceivedsatisfaction and utility of these adaptations among survivors. 2. Demonstrate the feasibility/ acceptability of the deliveryand evaluation of the Cancer Thriving and Surviving Program
  • 9. Recruitment Goal: 300 peopleCurriculum Revision Achievement: 323!!! What It Took: 2 Years (6 months longer than planned) • Community partner who actively recruited for trial at $70,000 • Television-Radio and Newspaper • Flyer distribution and outreach at physician offices and treatment centers Interim Results: • Improvements in Outcomes (pending as not final analysis) • Able to reach recruitment goals • 15% Colorectal Cancer Survivors
  • 10. *Family Cancer Registries *Cancer is a reportable disease and in most US States Tumor Registries are funded by CDC• Colon Cancer Family Registry (CCFR)• Cancer Genetics Network (CGN)• Rare Cancer Genetics Registry (RCGR) • NCI-funded • Multi-institutional • Population and clinic-based recruitment • Central data collection • Multiple Outcomes • Long-term follow-up • Consent for re-contact • Goal: facilitate research
  • 11. Colon Cancer Family Registries Table 6. Survey Data Collected by Participant TypeSince 1997 Participant Type Baseline 5-yr follow-up 10-yr follow-up survey (to date)* (to date)*• 35,300 enrolled – 12 centers• 10,225 families Colorectal Cancer 11,635 6,233 (7,224) 2,539 (2,973)• Status: long-term follow-up Sub-cohort Other Cancer Sub- 3,629 2,361 (2,805) 992 (1,062)Data available cohort• Family cancer history Unaffected Sub- 20,033 13,370 (16,048) 4,726 (6,077) cohort• Risk factors – diet, exercise, hormone use, alcohol, screening TOTAL 35,297 21,964 (26,077) 8,257 (10,112) history, NSAIDs• Clinical data – tumor stage, grade, histology• Biospecimens – blood, tumor – MSI, IHC, methylation, BRAF, MMR sequencing
  • 12. As An Advocate…• Find a Trial• Join a Trial• Spread the Word• Research Does NOT Stop after Treatment Agencies and Organizations to Contact for Population and Public Health- Survivorship Research LIVESTRONG: Programs and Partnerships www.livestrong.org NCI: Office of Cancer Survivorship www.dccps.nci.nih.gov ACS: Survivorship Trials and Behavioral Research www.cancer.org Community Cancer Centers-Research http://ncccp.cancer.gov NCI Designated Cancer Centers http://www.cancer.gov
  • 13. What Does a Budget Cut Mean... Does Even A 10% Cut Make a Difference? Total CPCRN Budget $300K CCFR Funding Was Decreased for the Colon Cancer Family Minus 10%=$270K Registry Project During Biggest Phase of Reaching Rural Communities in $30,000 Less Colorado – this impactedrepresentation of populations. Research Assistant time reduced from 100% to 40% CTS Wait List Opportunity Might Not Be WIN Program Possible in CTS halted for several months-was Trial…Changing the only survivorship program Research Design available at time at University of Colorado Cancer Center
  • 14. Opportunities… Patient Protection and Affordable Care Act• Better accessibility to health care• Person centered care-improved coordination• Emphasis on primary care• Greater Attention to Survivorship The Message!• There are nearly 13 million Cancer Survivors in the United States… • Survivorship Research and Improving Care is vital for the health of our nation!