Laura Seeff MDChief, Comprehensive Cancer Control Branch

Division of Cancer Prevention and ControlNational Comprehensive Cancer Control Program Director's Meeting

June 7, 2010 Los Angeles, CA

CDC’s National ComprehensiveCancer Control Program (NCCCP):

2010 Prioritiesand New Program Opportunities

National Center for Chronic Disease Prevention and Health Promotion

CDC’s National Comprehensive Cancer Control (CCC) Program

65 programs in each US state, DC, 7 tribal organizations, 7

territories

69 cancer plans nationwide; 95% in implementation

Robust state-, tribal-, territorial-wide coalitions work with

diverse partners

All work across cancer continuum, policy interventions

Northwest Portland Area Indian Health Board

CA

ID

NM

TX

OK

NE

SD

ND

MN

WI

ILOH

KYVA

NC

GAALMS

LA

MI

PA

NY

CT

MA

VT

NH

ME

TN

SC

OR

NV

MT

WY

CO

UT

IA

MO

AR

KS

IN

WV

FL

NJ

2010 National Comprehensive Cancer ControlStatus of Cancer Plans

OR

Northwest Portland

Area Indian Health Board

South Puget Intertribal Planning Agency

Cherokee Nation

Fond Du Lac Reservation

Aberdeen Area Tribal Chairmen’s Health Board

AK

Alaska Native Tribal Health Consortium

HI

National Comprehensive Cancer Control ProgramDivision of Cancer Prevention and ControlNational Center for Chronic Disease Prevention and Health PromotionOffice of Noncommunicable Diseases, Injury and Environmental Health February 2010

MDDE

RI

DC

WA

AMERICAN SAMOA

FEDERATED STATES OF MICRONESIA

GUAM

COMMONWEALTH OF THE NORTHERN MARIANA ISLANDS

PUERTO RICO

REPUBLIC OF THE MARSHALL ISLANDS

REPUBLIC OF PALAU

AZ

Tohono O’Odham Nation

Creating New Plan

Current Plan or Updating Plan

Comprehensive Cancer Control (CCC) Priority Setting Process, 2010:

Why?

Developed priorities for CDC-funded CCC activities

Build on success of NCCCP

Emphasis on measurable outcomes, value of efforts, and

highest impact

Long standing focus areas

Resonate with cancer continuum framework

Comprehensive Cancer Control (CCC) Priority Implementation:

How?

CCC work may be broader in scope

Continue interventions under current plans

Continue to emphasize these priority areas

As plans updated, enhance priority areas

Implement through new funding opportunities

CDC-funded CCC Program Priorities2010

Emphasize Primary Prevention

Coordinate Early Detection and Treatment Interventions

Address Public Health Needs of Cancer Survivors

Implement Policies to Sustain Cancer Control

Eliminate Health Disparities to Achieve Health Equity

Use Evidence and Measure Impact through Evaluation

EMPHASIZE PRIMARY PREVENTION

Emphasize Primary Prevention:Strategies

Collaborate with tobacco, physical activity, nutrition, obesity, vaccine,

diabetes and other relevant partners to implement evidence-based

primary prevention interventions

Consider effective policy changes to guide primary prevention efforts

Develop and provide consistent primary prevention messages

Support collaborative primary prevention research activities

Emphasize Primary Prevention:Example Activities

Develop collaborative messaging and activities that address cancer

risk behaviors and link them to chronic disease outcomes

Provide evidentiary basis for effective primary prevention health

policies

Use coalition to:

Implement smoke-free policies and/or tobacco-free policies

Restrict tobacco sales (internet, to minors, at stores/events)

Implement of Human Papilloma Virus (HPV) and Hepatitis B Virus (HBV)

vaccine policy

Establish legislation to require daily quality PE in schools

Regulate use of indoor tanning devices by children and adolescents

COORDINATE EARLY DETECTION AND TREATMENT INTERVENTIONS

Coordinate Early Detection and Treatment Activities Using Coalition:

Strategies

Populate coalition with key cancer control representatives who can

be successful in implementing cancer control activities

Use CCC program and coalition to link cancer control programs and

clinical and public health systems

Support cancer patient navigator and community health worker

programs

Coordinate Early Detection and Treatment Activities Using Coalition:

Example Activities

Define the expectations and outcomes of the partnership/coalition,

and routinely evaluate success

Bridge clinical health and public health systems and include

members of these systems in coalition

Link cancer control with other chronic disease activities by integrating

patient navigator programs

ADDRESS PUBLIC HEALTH NEEDS OF CANCER SURVIVORS

0

2,000,000

4,000,000

6,000,000

8,000,000

10,000,000

12,000,000

1971 1976 1981 1986 1991 1996 2001 2006

Year

Nu

mb

er

11.4 Million Estimated Cancer Survivors in the U.S. in 2006

Address Public Health needs of Cancer Survivors:

Strategies

Define the scope, needs, and health behaviors of the cancer survivor

population

Enhance survivorship surveillance

Define health risks from cancer treatment and disseminate clinical

management guidelines for cancer survivors

Ensure that cancer survivors have access to a medical home

Assess capacity to support survivorship interventions

Address Public Health needs of Cancer Survivors:Example Activities

Utilize and maintain the BRFSS survivorship module

Use cancer registry data to define interventions for follow-up

treatment and care among cancer survivors

Develop evaluation measures for survivorship interventions

Conduct research to assess health risks associated with cancer

treatment

Continue primary and secondary prevention efforts for survivors

Monitor and track progress of cancer survivors’ health, economic,

psychosocial issues

CROSS-CUTTING PRIORITIESPOLICY

DISPARITIES

IMPACT

Develop and Implement a Cancer Control Policy Agenda:

Strategies

Provide evidentiary basis for effectiveness of health policies

Include coalition members who can effectively implement evidence

based cancer control policies to increase primary, secondary and

tertiary prevention of cancer

Use coalition to implement evidence based policy interventions with

well defined goals and outcomes

Develop and Implement a Cancer Control Policy Agenda:

Example Activities

Maintain staff with competency in issue framing and policy analysis &

formulation

Develop and implement strategy to support policy interventions

Engage community in supporting policy interventions

Use coalition to engage policy makers

Eliminate Health Disparities to Achieve Health Equity:

Strategies

Enhance data collection and reporting of incidence, prevalence, and

mortality, and related adverse conditions among subpopulations.

by age, gender, race/ethnicity, income, education level, health literacy level,

health insurance status, geographic location, language, or other socio-

demographic factors

Maintain diversity within coalition

Collaborate with partners on activities to eliminate health disparities

Eliminate Health Disparities to Achieve Health Equity:

Example Activities

Assess/monitor coalition structure

Support workforce development and training opportunities to

diversify the public health workforce

Identify existing data resources to measure disparate disease burden of cancer and related adverse conditions

Expand existing or develop new data resources

Track progress in eliminating health disparities using periodic status reports

Conduct health disparities research

Use Evidence and Measure Impact Through Evaluation:

Strategies

Ensure that all comprehensive cancer control interventions are

evidence-based or contribute to the evidence base

Ensure that all CCC interventions and activities reflect cancer

surveillance data

Develop capacity to implement quality evaluations

Use Evidence and Measure Impact Through Evaluation:

Example Activities

Utilize NPCR and other cancer surveillance data to develop cancer

interventions

Maintain current knowledge of cancer control evidence base

Conduct routine evaluation of all CCC activities and disseminate and

translate evaluation findings to improve programmatic efforts

Focus on reducing the burden of the top 3-4 cancers in each

state/tribe/territory/jurisdiction

New Program Opportunities2010

New Policy Implementation Funding Announcement

Comparative Effectiveness Research project with Tobacco

Quitline Programs

New 2010 Funding Opportunity:Demonstrating the Capacity of Comprehensive Cancer Control

Programs to Implement Policy and Environmental Cancer Control

Interventions

CDC-RFA–DP10-1017

New 5-year program designed for NCCCP grantees

To demonstrate the enhancement and expansion of existing recipient

activity under DP07-703 entitled “Effect Policy Change”

Eligible applicants are CCC programs funded under DP07-703

Technical assistance calls with dial-in information in amended FOA

Monday, June 21, 2010 from 9:30 a.m. to 11:30 a.m. (east coast)

Tuesday, June 22, 2010 from 3:30 p.m. to 5:30 p.m. (east coast)

Application submission date July 26, 2010

Background

Demonstrate ability of CCC programs to fully develop and implement

cancer-specific policy agenda to advance policy, environmental, and

systems changes to improve cancer control

Enhance primary, secondary, and tertiary prevention of cancer and

have broad population reach

Should address decreased tobacco use, increased physical activity,

healthier diets, increased access to screening tests, improved

screening among survivors to reduce the risk of recurrent or new

cancers, and improved delivery of high quality cancer care

Select Recipient Activities

Retain appropriate staff

Obtain state and local support for policy and environmental change

using CCC coalition as foundation

Develop a policy agenda

Implement activities to advance 3-5 policy or environmental changes

to improve cancer control within the 5-year program period

Collaborate and coordinate with appropriate ARRA-funded partners

Evaluate and monitor progress

New Program Opportunities2010

New Policy Implementation Funding Announcement

Comparative Effectiveness Research with Tobacco

Quitline Programs

Thank you!

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.