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Catchment Area Data Collection Tesha Coleman, MS Georgetown Lombardi Comprehensive Cancer Center Brian C. Springer, MHA H. Lee Moffitt Cancer Center & Research Institute Nathan L. Vanderford, PhD, MBA University of Kentucky Markey Cancer Center Agenda • Background • Defining • Data the catchment area collection • Tracking impact • Are there automated ways to collect this data? Please discuss anything, anytime Background • Expectation to demonstrate impact of science in catchment area • Expectation to match activities to needs of catchment areas • Overall and special populations Defining the Catchment Area • Moffitt • Markey • Lombardi Moffitt West Central Florida (15 counties) Current Population: 5,817,590 Charlotte Citrus De Soto Hardee Hernando Highlands Hillsborough Lake Lee Manatee Pasco Pinellas Polk Sarasota Sumter Rationale: Contiguous region 29.6% of the state’s population (19,653,079) Complements state efforts to develop other NCI CCCs Aligns with major traffic corridors (I-75, I-275, I-4, SR589) ≤2 hour driving distance Urban and rural populations 72.7% of Patients (Cancer Registry 2012, County at Presentation) Overall Cancer Incidence Rates Age-Adjusted Rates,* All Ages Catchment Area (1) Florida (1) United States (2) Overall Sex Female Male Age Groups 20–44 45–64 65+ Race Black White Other Ethnicity Hispanic Non-Hispanic 467.7 462.1 438.1 425.3 520.4 421.1 515.4 491.8 400.8 130.1 712.6 2,023.6 125.7 694.7 2,026.0 112.0 643.0 1,973.6 447.4 445.3 178.8 434.6 440.3 171.0 466.3 448.7 -- 480.1 325.3 478.6 364.5 -345.6 *Incidence rates per 100,000 Age-adjusted to the 2000 US standard population (1) FCDS Data, All Ages, 2008-2012 (2) SEER, All Ages, 2011, 13 registries Age and Race Distribution: Adults 20 years and older 20 to 44 years 45 to 64 years 100% 90% 80% 30.5% 26.0% 20.2% 9.4% 9.3% 9.1% 28.6% 29.8% 29.0% 34.2% 33.9% 35.3% 70% 37.5% 60% 50% 12.9% 12.5% 12.9% 65+ years 36.3% 36.4% 40% 30% 20% 42.3% 33.1% 37.5% 53.0% 53.6% 51.8% 62.0% 60.9% 62.0% 10% 0% Catchment FL US Catchment White Alone Source: United States Census, 2010, Tables P12A-P12G FL Black Alone US Catchment FL Other Races* US Top 20 Incident Cancers Catchment Area Overall^ Primary Cancer Site Florida Overall^ Rate* Rank Primary Cancer Site Lung & Bronchus Breast Prostate Gland Colorectal Melanoma of the Skin Urinary Bladder Other Non-Hodgkin's Nodal, Non-Hodgkin's Extra Nodal 96.72 86.67 76.30 54.19 31.50 30.11 28.95 1 2 3 4 5 6 7 24.25 8 Kidney & Renal Pelvis 20.03 9 Head & Neck Benign/Borderline- Brain, Cranial Nerves Other Nervous System, Other Endocrine including Thymus (Benign/Border) Corpus Uteri, Uterus, NOS Pancreas Thyroid Gland Liver, Intrahepatic Bile Duct Ovary Brain, Other Nervous System Acute Myeloid Leukemia, Chronic Myeloid Leukemia, Other Myeloid/Monocytic Leukemia, Acute Monocytic Leukemia Multiple Myeloma Stomach 19.10 ^Adults 20 years and older *Incidence rates per 100,000 Rate* 90.76 87.14 77.34 55.19 28.18 27.95 27.61 10 Lung & Bronchus Breast Prostate Gland Colorectal Urinary Bladder Other Melanoma of the Skin Non-Hodgkin's Nodal, Non-Hodgkin's Extra Nodal Benign/Borderline- Brain, Cranial Nerves Other Nervous System, Other Endocrine including Thymus (Benign/Border) Kidney & Renal Pelvis 18.63 11 Head & Neck 17.99 16.92 16.49 13.89 9.32 9.27 8.48 12 13 14 15 16 17 16.85 16.49 15.82 9.61 8.69 8.46 8.25 18 7.72 7.37 19 20 Corpus Uteri, Uterus, NOS Pancreas Thyroid Gland Liver, Intrahepatic Bile Duct Ovary Stomach Acute Myeloid Leukemia, Chronic Myeloid Leukemia, Other Myeloid/Monocytic Leukemia, Acute Monocytic Leukemia Multiple Myeloma Brain, Other Nervous System 24.92 21.62 19.51 8.20 8.07 7.85 Markey - Appalachian Kentucky 73% rural 25.1% below poverty level 26.3% without high school diploma Cancer Smoking Obesity Poverty Appalachian county economic status (2013-14) Markey Catchment Area 96% of patient population 93% clinical trial accruals OHIO WEST VIRGINIA INDIANA ILLINOIS UK VIRGINIA TENNESSEE NORTH CAROLINA Significant Burden of Cancer in Kentucky 1st in the nation in overall cancer mortality rate 1st in the nation in incidence rate for all cancer sites - Lung and bronchus (1st); colon and rectum (1st); larynx (1st); kidney and pelvis (2nd); oral cavity and pharynx (3rd); brain (7th); non-Hodgkin’s lymphoma (7th); skin (8th); cervix (9th) Cancer incidence and mortality are highest in Appalachia Age-adjusted cancer mortality rates, 2006 - 2010 All Cancers Lung Colorectal Larynx U.S. 180.2 51.3 16.8 1.2 Kentucky† 209.5 73.2 19.3 1.5 Appalachian Kentucky* 227.9 83.4 21.2 1.7 † p<0.01 vs U.S. as a whole; * p<0.05 vs non-Appalachian Kentucky. SEER and Kentucky Cancer Registry. Lombardi - Background Capital Breast Care Center (CBCC) was founded in 2004 to ensure that all women in the Washington, D.C. area have access to needed breast health services. Washington, D.C. has the highest rates of breast cancer mortality in the nation. Mission: Provide culturally sensitive breast cancer screening services and health and wellness education guided by evidence-based practices to all women in the Washington, DC area, regardless of their ability to pay. Catchment Area 3.9 million individuals District of Columbia & adjacent counties 41% cancer patients in Lombardi’s catchment area are underrepresented minorities Data Collection - Examples • Markey • Lombardi • Moffitt Markey - Catchment Area Data Collection Manual surveillance of: - Grants - Manuscripts Automated surveillance of: - Clinical trial accruals Catchment Area Data Collection - Grants Appalachian-Focused Projects – Currently Funded Department of Defense Susanne Arnold $64,630 Lung cancer and environmental carcinogens NCMHHD Ann Coker $273,116 Violence against women and cancer care disparities NCCDPHPI Richard Crosby $750,000 Rural Cancer Prevention Center NCI Mark Dignan $1,088,516 Appalachian Community Cancer Network II NIDCR Jamie Studts $173,573 Dental point-of-care smoking cessation tool ARC Mark Dignan $305,513 Patient navigator training in Appalachia NCI / U. of Miami Jamie Studts $44,991 Lung cancer screening decision aid KLCR Eric Durbin $75,000 Automated identification of lung cancer trial recruits APPALACHIA NIDA Brady Reynolds $357,563 Web-based management for adolescent smoking KLCR Tadahide Izumi $75,000 DNA damage biomarkers related to tobacco use BMSF Jamie Studts $4,057,881 Kentucky lung cancer survivorship program KLCR Isabel Mellon $75,000 Nucleotide excision repair and lung cancer Foundation for Healthy Ky. Ellen Hahn $50,000 Smoke and tobacco free policy adoption NCATS / UK CCTS Bin Huang $41,200 Relative survival rates – Appalachia vs. non NIEHS Ellen Hahn $420,326 FRESH home screening for lung cancer prevention NCI Jessica Burris $153,747 Smoking Cessation after Cancer Diagnosis Catchment Area Data Collection – Publications Andrykowski MA, Steffens RF, Bush HM, Tucker TC. Disparities in mental health outcomes among lung cancer survivors associated with ruralness of residence. Psycho-Oncology 23:428-436, 2014. Arias A, Rigalli JP, Villanueva SSM, Ruiz ML, Luquita MG, Perdomo VG, Vore M, Catania VA, Mottino AD. Regulation of expression and activity of multidrug resistance proteins MRP2 and MDR1 by estrogenic compounds in Caco-2 cells. Role in prevention of xenobiotic-induced cytotoxicity. Toxicology 320:46-55, 2014. Burikhanov R, Shrestha-Bhattarai T, Hebbar N, Qiu S, Zhao YM, Zambetti GP, Rangnekar VM. Paracrine Apoptotic Effect of p53 Mediated by Tumor Suppressor Par-4. Cell Reports 6:271-277, 2014. Burikhanov R, Sviripa VM, Hebbar N, Zhang W, Layton WJ, Hamza A, Zhan CG, Watt DS, Liu C, Rangnekar VM. Arylquins target vimentin to trigger Par-4 secretion for tumor cell apoptosis. Nature Chemical Biology 10:924-926, 2014. Butler KM, Begley K, Riker C, Gokun Y, Anderson D, Adkins S, Record R, Hahn EJ. Smoke-Free Coalition Cohesiveness in Rural Tobacco-Growing Communities. Journal of Community Health 39:592-598, 2014. Butler KM, Rayens MK, Adkins S, Record R, Langley R, Derifield S, McGinn C, Murray D, Hahn EJ. Culturallyspecific Smoking Cessation Outreach in a Rural Community. Public Health Nursing 31:44-54, 2014. Heidary DK, Glazer EC. A Light-Activated Metal Complex Targets both DNA and RNA in a Fluorescent in Vitro Transcription and Translation Assay. Chembiochem 15:507-511, 2014. Elliott VA, Rychahou P, Zaytseva YY, Evers BM. Activation of c-Met and Upregulation of CD44 Expression Are Associated with the Metastatic Phenotype in the Colorectal Cancer Liver Metastasis Model. Plos One 9:e97432, 2014. Hollis CP, Weiss HL, Evers BM, Gemeinhart RA, Li TL. In Vivo Investigation of Hybrid Paclitaxel Nanocrystals with Dual Fluorescent Probes for Cancer Theranostics. Pharmaceutical Research 31:1450-1459, 2014. Catchment Area Data Collection – Clinical Trials Catchment Area Data Collection – Desired State Automated surveillance of: - Grants - Manuscripts - Clinical trial accruals Lombardi - CBCC-Data Collection Methods Foundation Grants Avon Foundation CareFirst Research Studies/Publications Clinical Service Data Patient Demographics Screening Behaviors Clinical Outcome Percentage of patients returning for annual screening Median time to follow-up Time intervals between the screening and diagnostic workup (additional imaging and biopsies) CBCC-Data Collection Tools • National Breast & Cervical Cancer Program Guidelines • Electronic Medical Record Audit • Community Needs Assessment Resources • Community Partnerships • Membership with Community Coalitions & Networks • Community Setting Screening Services Moffitt - Catchment Area Data Collection • Grants • Publications • Clinical trial accruals • Queries by program leaders • Program meetings/presentations • Retreats/symposia Moffitt – Publication Tracking Tools (similar to this) Moffitt – Meetings/Retreats Tracking Impact • Lombardi • Moffitt • Markey Sample Data Collection CBCC Patient Demographics 2014 Ethnicity Insurance Uninsured Asian Other White Black Hispanic N=1703 Commercial Insurance Medicare Medicaid Programs Sample Data Collection CBCC Patient Demographics 2014 State 23% 38% Age 39 & Under Virginia Maryland DC 39% N=1703 40-49 50-59 60-69 70 & Over Tracking Impact-Example Tracking Impact-Example Tracking Impact-Example CBCC as a Resource for Enrolling Minority Participants in Research Studies Potential Research Participants at CBCC Lombardi’s Office of Minority Health and Health Disparities Research CBCC “Clients” Demographic & Socioeconomic Characteristics •40% between 40-50 years of age •90% minorities (45% Black, 45% Hispanic) •>50% uninsured, 25% on Medicaid Women (And Their Relatives / Partners) Present At CBCC for Screening Capital Breast Care Center CBCC Magazine Research Coordinators Information On Ongoing Studies The “Research Corner” with a dedicated hotline Participants Enroll in Ongoing Research Studies at the Lombardi Comprehensive Cancer Center 2012 Opening of Office of Minority Health & Health Disparities Research in SE DC DC Mayor Gray, Congresswoman Holmes Norton, GU President DeGioia, Adams-Campbell & Weiner FIERCE POWER ENGAGED Focused Intervention on Exercise to Reduce CancEr Preventing Obesity in Women with Exergaming Routine RCT on exercise among obese, metabolically unhealthy Black women at high-risk of breast cancer RCT on the effects of exergaming among overweight / obese Black women ExperieNces With MammoGrAphy ScreeninG and BrEeast Density] [NIMHD P60MD006920; PI: AdamsCampbell] [NCI R21CA165067; PI: AdamsCampbell] A survey among women who have had a recent screening mammogram regarding their awareness of mammographic breast density as a breast cancer risk factor and their awareness of their personal breast cancer risk HPV Health Communication Intervention Study Educational intervention among Black mothers with daughters aged 9-17 years about Human Papilloma Virus (HPV) and the HPV vaccine Minority Biospecimen / Biobanking Survey Survey on biospecimen knowledge and donation intent among minorities [NCI K01 CA155417; PI: Wallington] [NCI GMap/BMaP 3P30CA051008-17S3; PI: Adams-Campbell] Cancer Prevention and Control Program Cancer Prevention and Control Program QUIT & FIT A 12-week RCT among Black women to investigate the effectiveness of an exercise intervention in addition to nicotine patches on smoking cessation [Lombardi institutional support, PI: AdamsCampbell] [Prevent Cancer Foundation, PCF Grant #1105; PI: O’Neill] Cancer Prevention and Control Program Cancer Prevention and Control Program Breast Cancer Program Molecular Oncology Program Cancer Prevention and Control Program Time to Diagnosis After Abnormal Mammogram Analysis of factors affecting time to diagnostic imaging and biopsy after an abnormal screening mammogram [Avon Foundation for Women 05-2012-012; Komen Foundation NR-1133344; CareFirst BlueCross BlueShield 2011, 2012; PI: Oppong] Breast Cancer Program Cancer Prevention and Control program Task Force 1: Educate & Enhance Knowledge Base of Local Referring Physicians & Partners on Clinical Intervention Trials, to foster patient accruals at Moffitt Hammon (VP Planning), Adkins (Planning), Soliman (Faculty CBMM) Minority catchment area by zip code Map Key: 51% - 90% 25% - 50% 13% - 24% 6% - 12% 1% - 5% Task Force 2: Patient Navigation at Moffitt Cancer Center Gwede (Faculty HOB), Newman (Dir. Patient Relations), Morehouse (CTO), Wadhwa (CTO) Sandra Morehouse Minority Patient Navigator MOFFITT CLINICAL Total New Pts Hispanic New Pts AA New Pts PROGRAM FY09 Percent FY09 Percent FY09 Percent BMT 1.9 3.9 2.3 CUTANEOUS 13.2 2.8 0.8 ENDOCRINE 3.0 6.7 5.4 GI 12.5 11.0 12.3 GU 11.2 15.2 13.4 HEAD & NECK 5.9 3.5 3.4 MALIGNANT HEME 7.2 8.1 7.7 MOFFITT SOUTH 7.7 7.1 11.9 NEURO 4.0 2.5 2.7 RADIATION ONCOLOGY 3.1 3.5 1.9 SARCOMA 4.6 4.9 6.1 SENIOR ADULT 2.3 1.8 0.8 THORACIC 6.9 2.8 4.6 WOMENS - BREAST 7.4 13.4 11.1 WOMENS - GYN 8.5 12.4 15.7 Task Force 3: Enhancing Moffitt’s Communication with Minority Communities Antonia (Faculty CBE), Quinn (Faculty HOB), Meade (Faculty HOB), Hice (VP PR&M) Markey - Environmental Factors and Cancer Xianglin Shi, PhD (RR) Zhou Zhang, PhD (CP) Arsenic ppm 0 - 100 100 - 250 OH WV 250 - 2200 KY David Orren, PhD (RR) Mary Vore, PhD (RR) Bituminous coal beds in southeastern Kentucky VA TN As, Cd, Cr Funding sources: RO1 ES015518; RO1 ES020870; RO1 ES018883; RO3 CA171604 >25% of Appalachians get drinking water from wells or streams