Download Markey Cancer Center Overview

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