Transcript Slide 1

CPCRN: Overview and Cancer
Registry Research
Kurt M. Ribisl, PhD
University of North Carolina at Chapel Hill
CPCRN Coordinating Center
CDC, Atlanta, GA
May 24, 2010
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CPCRN Mission
To accelerate the adoption of evidence-
based cancer prevention and control in
communities.
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Organization
• One of five Thematic Research Networks in the
Prevention Research Centers (PRCs)
– Only Thematic Network focused on dissemination and
translation
• Collaboration with two Federal Agencies
– CDC – Division of Cancer Prevention and Control
– NCI – Division of Cancer Control and Population
Sciences
• Ten Network Centers at major research institutions
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PI’s
Michelle Kegler, DrPH
Jennifer Allen, ScD, MPH, RN
Marcia Ory, PhD, MPH
Betsy Risendahl, PhD
Roshan Bastani, PhD
James Hebert, ScD, MSPH
Cathy Melvin, PhD
Kurt Ribisl, PhD (Coord Ctr)
Maria Fernandez, PhD
Vicky Taylor, MD, MPH
Matthew Kreuter, PhD, MPH
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Network Center Map
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Novel use of
Registry Data in SC
Hebert JR, Daguise VG, Hurley DM, Wilkerson RC, Mosley C, Adams SA, Puett R, Burch JB,
Steck SE, Bolick-Aldrich Sl. Mapping cancer mortality-to-incidence ratios to illustrate racial and
gender disparities in a high-risk population. Cancer 2009;115:2539-52.
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PrCA Incidence in Relation to Soil Metal
Concentration:
Unique Use of Combining SCCCR & Environmental Data
Selenium
Zinc
Legend
PrCA and Soil Overlay Categories
Low SIR and High Concentration
Middle Levels
High SIR and Low Concention
No data
Wagner SE, Burch JB, Hussey J, Temples T, Bolick-Aldrich S, Mosley C, Liu Y,
Hebert JR. Soil zinc content, groundwater usage, and prostate cancer incidence in
South Carolina. Cancer Causes Control 2009;20:345-53.
• Texas Cancer Information
– Texas Cancer Information
can connect patients,
caregivers, the general
public, health care policy
planners, physicians and
other health professionals
with reliable online cancer
information.
– Dr. Fernandez is on the
advisory committee.
– Dr. Fernandez is working
with Lewis Foxhall on
developing a logic model for
the TCI.
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Most prior studies with cancer registries:
observational research re: incidence and
mortality
UCLA & California
Cancer Registry
Cancer registry represents method to recruit
survivors and first-degree relatives (FDRs) into
innovative effectiveness and dissemination
studies
UCLA conducted series of studies with breast,
colorectal, prostate, and melanoma FDRs
•Used CCR to contact cancer cases and
invited them to refer FDRs to study
Ethnically-tailored Recruitment Brochures
Recruitment Through CCR Enhances Ability to Conduct Research with Multi-Ethnic Samples
Results of Randomized Trial to Increase CRC Screening in Ethnically-Diverse FDRs in CA
TOTAL
WHITE
LATINO
AFR. AM
ASIAN
N=1280
N=351
N=403
N=284
N=242
1.95*
1.69*
3.65*
1.13 (NS)
2.60*
Intervention increased CRC screening in all ethnic groups except African Americans
Source: Optimizing NC Cancer Outcome Initiative (Nov 3, 2009)
2002-2006 Top 10 ALL Cancer
Mortality Rates in NC
Northampton
Alleghany
Ashe
Surry
Wilkes
Watauga
Alexander
Madison
Buncombe McDowell
Haywood
Swain
Graham
Jackson
Cherokee
Macon
Transylvania
Clay
Perquimans
Bertie
Franklin
Chowan
Nash
Durham
Washington
Edgecombe
Martin
Randolph
Rowan
Pitt
Johnston
Lee
Cabarrus
Greene
Lenoir
Wayne
Montgomery
Hyde
Craven
Pamlico
Mecklenbur
g
Union
Beaufort
Harnett
Moore
Stanly
Dare
Wilson
Chatham
Lincoln
Gaston
Cleveland
Tyrrell
Wake
Davidson
Catawba
Henderson Rutherford
Polk
Alamance
Davie
Iredell
Burke
Pasquotank
Halifax
Orange
Camden
Currituck
Hertford
Vance
Person
Granville
Guilford
Forsyth
Caldwell
Gates
Warren
Yadkin
Mitchell Avery
Yancey
Rockingham
Caswell
Stokes
Cumberland
Anson
Richmond
Hoke
Jones
Sampson
Duplin
Top 10 ALL Cancer Mortality Rates in NC
1.Tyrrell (245.3)
2.Camden (243.6)
3.Granville (241.0)
4.Edgecombe (238.0)
5.Bertie (237.6)
6.Hertford (235.5)
7.Vance (226.9)
8.Scotland (225.5)
9.Hyde (222.5)
10.Franklin (219.5)
Scotland
Robeson
Onslow
Bladen
Carteret
Pender
New
Hanover
Columbus
Brunswick
NC Central Cancer Registry (2010). 2002-2006 Mortality Rates
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Overview
• H-e-NC is a platform for delivering and
testing interventions to reduce cancer
related morbidity and mortality
• Priority cancers are breast, colon, and
lung
• Priority behaviors linked to tobacco use;
obesity; lack of regular cancer screening,
referral, and follow-up.
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Interventions
1. Interactive telephone, web-based, and mobile
interventions
2. Decision support interventions
3. Health care provider and system interventions
4. Social network, organization, and community
participatory approaches to reaching minority
and underserved populations
5. Investigation of and interventions to address
racial inequities in cancer health care
Source: Optimizing NC Cancer Outcome Initiative (Nov 3, 2009)
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Maximizing the social impact
of cancer registry data
Washington University
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How can we do better?
• Broader goals
• New audiences
• Information design
• Technology and tools
• Strategic, proactive approach
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This project
• Design & test new displays of cancer data
• Propose best practices
• Share with cancer registry community
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Alternative
Formats
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Promoting Screening
Hi-Risk Areas
• Promotion of screening through kiosks
– Washington University (Matt Kreuter et al.)
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Reach and specificity
Criteria for prioritizing among settings
Highest
reach
Laundromats •
Health centers •
Lowest
specificity
Public libraries •
Social services •
• Churches
• Beauty salons
Lowest
reach
Source: Kreuter et al.
Highest
specificity
Using technology to connect rarely and
never screened women to mammography
• kiosks equipped with telephones and wireless
technology
•placed in Laundromats and public libraries to reach
high volumes of rarely or never screened women
•kiosk-administered survey identifies women
needing mammograms
•instant connection to nearby, free mammography
programs directly from the kiosk
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CPCRN Strengths
• Advancing science for implementation and
translation research
• Strong community partnerships
• Focus on underserved populations
• Broad geographic outreach
• Research focus that complements CDC priorities
• Infrastructure funding provides impetus to focus
beyond discovery and be opportunistic
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Contact Us
• CDC Contacts
– Kathi Wilson
– Vicki Benard
• UNC Coordinating Center
– Kurt M. Ribisl
– (919) 843-8042; [email protected]
• Contact Centers Directly on Specific
Projects – please cc: Kurt/Kathi/Vicki
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