The Cancer Prevention and Control Program at the Hollings Cancer Center

Transcription

The Cancer Prevention
and Control Program
at the Hollings Cancer
Center
SCCA Quarterly Meeting
January 30th, 2009
Anthony J. Alberg, PhD, MPH
(alberg@musc.edu)
Hollings Cancer Center
Cancer Prevention & Control
Hollings Cancer Center Update
Application for NCI Cancer Center
designation:
– submitted and reviewed
– rated excellent
– optimistic of funding
– will know status in a few weeks
Long-term goal:
Comprehensive Cancer Center:
Excellent Prevention & Control
Cancer Prevention & Control
Program Goals
Research Goal
Advance the science of cancer
prevention and control.
Public Health Goal
Contribute to reducing the burden
of cancer in South Carolina.
Our goals are closely aligned
with SC Cancer Plan, but with
research focus.
Cancer Prevention and Control
Vision & Future Plans
Statewide partnerships
Recruit, cultivate interdisciplinary team
Disparities as a cross-cutting theme
Promote translational and
interdisciplinary research
Develop infrastructure for populationbased research studies
Contributing to Statewide Initiatives
South Carolina (SC) Cancer Alliance
– Prevention Force
– Early Detection Task Force
– Research Task Force
SC Tobacco Collaborative
SC Cancer Control Advisory Council
SC Cancer Surveillance Committee
Cancer Prevention and Control Continuum
Cross-cutting theme: disparities
Epidemiology
Primary
Prevention
Early
Detection
Survivorship
Cancer control research has been defined as "the
creation and application of knowledge and strategies to
prevent and detect cancer, and to increase survival and
quality of life for those who develop cancer.“
Best et al. Cancer Epidemiol Biomarker Prev 2003.
Cancer Prevention and Control Program
Epidemiology
Primary
Prevention
Early
Detection
Survivorship
HCC’s Leader in the Fight Against
Cancer Disparities
Marvella E. Ford, PhD
Associate Director of Cancer
Disparities
Co-Leader, Cancer Prevention
& Control Program
Associate Professor of
Biostatistics, Bioinformatics &
Epidemiology
Expertise in community-based observational and
interventional studies; barriers to minority
recruitment
CoEE in Prostate Cancer Disparities Research
University
of
South
Carolina
Medical
University
of South
Carolina
South
Carolina
State
University
Factors Associated With Lower
Likelihood of Surgical Resection
Patients with localized, non-small cell lung cancer
OR (95% CI)
European American
African American
Not living in poverty
Living in poverty
1.0 (referent)
0.4 (0.3-0.6)
1.0 (referent)
0.7 (0.5-0.9)
Adjusted for age, marital status, comorbidity, insurance status.
Esnaola NF, et al. Ann Thorac Surg. 2008
Train the Trainer Program
Statewide Training
– SCCA Cancer
Education Guide
– SCCA Staff
Participation
– Community
Involvement
– Healthcare
Partnerships
Addressing Sociocultural Barriers
Embracing Hope
Forums
Garden Parties
Cultural/Contextual
Competency
Trainings
Epidemiology
Primary
Prevention
Early
Detection
Survivorship
RR of Other Cancers in NMSC vs No NMSC Groups
Adj. RR (95% CI)
No NMSC
1.0 (referent)
NMSC
2.0 (1.7-2.3)
BCC
2.0 (1.7-2.4)
SCC
2.0 (1.5-2.6)
Adjusted for age, sex, education, smoking, BMI
Source: Chen J, et al JNCI 2008; 100: 1215-Hollings Cancer Center
RR of Specific Types of Cancer
in NMSC vs No NMSC Groups
Type of Cancer
Melanoma
Lung
Colorectal
Breast
Prostate
All other
combined
Adj. RR (95% CI)
7.9 (4.1-15.4)
1.9 (1.3-2.9)
1.8 (1.1-2.8)
1.6 (1.0-2.7)
1.3 (0.9-1.8)
2.0 (1.5-2.7)
Source: Chen J, et al JNCI 2008; 100: 1215--Hollings Cancer Center
Ratio of Breast Cancer Incidence Rates by
Race, South Carolina, 1996-2004
African American/
European American
ER-/Grade 1
ER-/Grade 2
ER-/Grade 3
ER+/Grade 1
ER+/Grade 2
ER+/Grade 3
0.5 (0.2-1.2)
1.1 (0.8-1.6)
1.6 (1.4-1.8)
0.5 (0.4-0.6)
0.6 (0.5-0.8)
1.0 (0.8-1.2)
Joan Cunningham, et al (Submitted)
Dr. Kristin Wallace
 Assistant Professor, DBBE
 Doctoral/Postdoctoral Training:
Dartmouth Medical College
 Cancer epidemiologist, expertise in
colorectal neoplasia
 Hypothesis: different etiologic pathways
may contribute to racial disparity
 Current projects:
– “Relationship of race with decisions to undergo
systemic therapy for Stage IV colorectal
adenocarcinoma” (MUSC Center for Health
Disparities, with Drs. Ford, Thomas, Sterba,
Zapka, Hill)
– “The influence of exercise on inflammatory
markers in patients at high risk of CRC” (in
development)
Epidemiology
Primary
Prevention
Early
Detection
Survivorship
Tobacco Control in South Carolina
Collaborating with DHEC
Tobacco Control Program
to analyze statewide
Youth Tobacco Survey data
SHS Exposure in South Carolina Youths, 2006
 40% of non-smoking SC middle and high school
students exposed to secondhand smoke (SHS)
 Of these, 85% were exposed to SHS in cars
Source: Cartmell K, Miner C, et al (Submitted)
SC Youth Tobacco Survey 2005-2007
Teens who smoke minimally resemble
chronic smokers in several key ways:
– Beliefs (smokers have more friends, smoking
looks cool, it is safe to smoke in short-term
and then quit)
– Even more likely than heavier smokers to be
motivated to quit and to engage in quit
attempts
Source: Carpenter MJ, et al Nicotine Tobacco Res (In press)
Translating Effective Smoking Cessation
Aids to Underserved Populations
Common themes among AAs and EAs:
– Motivation to quit needed for medications to work
– Concerns about safety
– Desire for more information
 Themes predominant among AAs:
– Strong suspicions of the pharmaceutical industry
– Power of doctor’s advice
– Supremacy of quitting “cold turkey”
Source: Carpenter MJ, et al (In preparation)
Dr. Matthew Carpenter
Assistant Professor
Dept. of Psychiatry & Behavioral Sciences
PhD (Clinical Psychology) University of Vermont
 Research Interests: Smoking cessation, tobacco
control
 Current Projects:
• A Novel Treatment to Boost Quit Attempts and
Cessation Among Unmotivated Smokers (NIDA R01)
• Stimulus Control and Trajectories of Adolescent
Smoking (NIDA K23)
• A Pilot RCT to Examine a Potentially Reduced
Exposure Tobacco Product (Prevent Cancer
Foundation)
• Use and perceptions of nicotine replacement therapy
among racial and ethnic minorities (HCC seed money)
Translational Primary Prevention Research:
HPV Vaccines for the Control of Cervical Cancer
Sharon Bond, PI (Mentors: Alberg/ Ford)
Dr. Heather Brandt (USC) Co-investigator
African
Americans
Latinos
European
Americans
Adult
Stakeholders
Adult
Stakeholders
Adult
Stakeholders
(n=2 focus groups)
(n=2 focus groups)
(n=2 focus groups)
Teen/Pre-teen
females
Teen/Pre-teen
females
Teen/Pre-teen
females
(n=2 focus groups)
(n=2 focus groups)
(n=2 focus groups)
Center for Botanical Medicine
Institute for Nutraceutical Research
South Carolina
Department of Agriculture
NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION
UNITED STATES DEPARTMENT OF COMMERCE
Department of Natural Resources
“SC Grown”
Fruits and Vegetables
“SC Grown”
Culinary Herbs
Traditional Medicinal
Plants
Epidemiology
Primary
Prevention
Early
Detection
Survivorship
Dragon Boat Racing
Survivorship Research
The impact of dragon boat racing on
cancer survivorship
Cindy Carter, PI (Mentor: Alberg)
– Compare Dragon Boat Racing Team versus
Walking Program on quality of life in cancer survivors
Dragon
Boat Team
Cancer
Survivors
Informational
Program
?
Walking
Program
QoL
Team
Spiritual
Physical
Dr. Katherine Regan Sterba
 Assistant Professor, DBBE
 PhD in Behavioral Science: UNC School
of Public Health; Postdoctoral fellowship
University of Texas
 Methodologic expertise in measurement
 Interest in the role of social support
(couples, families) on quality of life in
cancer survivors
 Current projects:
– “Life after treatment for breast cancer among
African-American women” (Gelman Foundation)
With Drs. Heiney, Ford, and Zapka
– “Racial disparities in psychosocial functioning
following a breast cancer diagnosis” (MUSC Center
for Health Disparities). With Drs. Ford, Baker,
Madan, Zapka, Borkhardt, Onicescu)
HCC Outreach Program
Outreach program growing rapidly
Working to integrate research
initiatives within outreach programs
Outreach Program Areas
Cancer Prevention
– Health promotion materials for use with all
outreach efforts
– Smoking cessation
• SC Tobacco Collaborative
funding
Early Detection
– Mobile Health Unit
Screening
Outreach Program Areas
Follow-Up
– Patient Navigation Program
Survivorship
– Volunteer
– Resource Center
– The Looking Glass
– Education Sessions
Research Symposium
You are invited! Friday, March 13th
http://hcc.musc.edu/education/springsym2009.htm
Contact: Tonya Hazelton (hazelto@musc.edu) 843-792-4477
Cancer Disparities: Scope of the Problem
and Steps Toward the Solutions
 Cancer Disparities: Surveying the Landscape
 Chemoprevention: Preventing Colorectal Cancer and
Investigating Disparities
 Colorectal Cancer: Why is the Burden Higher in
African Americans?
 Submit abstracts for poster session: prizes awarded
Research Symposium Faculty
Faculty participants include:
– USC: Drs. Pastides, Glover, Berger, Burch
– National:
• Dr. Rick Kittles (University of Chicago)
• Dr. Paul Godley (UNC)
• Dr. William Blot (Vanderbilt University)
• Dr. Vickie Shavers (NCI)
• Dr. Chinthalapally Rao (University of
Oklahoma)
The Cancer Prevention
and Control Program
at the Hollings Cancer
Center
SCCA Quarterly Meeting
January 30th, 2009
Anthony J. Alberg, PhD, MPH
(alberg@musc.edu)

The Cancer Prevention and Control Program at the Hollings Cancer Center

Transcription

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