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CPCRN: Overview and Cancer Registry Research

Kurt M. Ribisl, PhDUniversity of North Carolina at Chapel Hill

CPCRN Coordinating Center

CDC, Atlanta, GAMay 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’sMichelle Kegler, DrPH

Jennifer Allen, ScD, MPH, RN

Betsy Risendahl, PhD

Roshan Bastani, PhD

Cathy Melvin, PhD

Kurt Ribisl, PhD (Coord Ctr)

Maria Fernandez, PhD

Vicky Taylor, MD, MPH

Matthew Kreuter, PhD, MPH

Marcia Ory, PhD, MPH

James Hebert, ScD, MSPH

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Network Center Map

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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.

Novel use of Registry Data in SC

PrCA Incidence in Relation to Soil Metal Concentration:

Unique Use of Combining SCCCR & Environmental Data

ZincSelenium

LegendPrCA 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.

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• 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.

UCLA & California Cancer Registry

Most prior studies with cancer registries: observational research re: incidence and mortalityCancer registry represents method to recruit survivors and first-degree relatives (FDRs) into innovative effectiveness and dissemination studiesUCLA 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

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

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

Source: Optimizing NC Cancer Outcome Initiative (Nov 3, 2009)

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Johnston

Scotland

Guilford

Rockingham

Moore

AnsonUnionRichmond

Mecklenburg

Cabarrus

Stanly

SurryAshe

WilkesYadkin

Forsyth

Stokes

Davidson

RandolphRowan

Lincoln

ClevelandGaston

Iredell

Caldwell Alexander

Catawba

Burke

McDowellBuncombe

Rutherford

Polk

Madison

Yancey

Watauga

Cherokee

Graham

Clay

Macon

Jackson

Swain

Avery

Davie

Montgomery

Henderson

Transylvania

Haywood

Wake

Granville

Person

Orange

Lee

Hoke

Robeson

Columbus

Brunswick

PenderBladen

Sampson

Duplin

Onslow

Jones

LenoirWayneHarnett

Carteret

Craven

Pamlico

BeaufortHyde

TyrrellDare

Gates

Hertford

Bertie

Martin

Pitt

Greene

Wilson

NashFranklin

Warren

Halifax

Northampton

Edgecombe

Vance

DurhamAlamance

Cumberland

Washington

CurrituckCamden

Pasquotank

Perquimans

Chowan

NewHanover

Chatham

Caswell

Mitchell

Alleghany

2002-2006 Top 10 ALL Cancer Mortality Rates in NC

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)

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 impactof 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.)

Highestreach

Lowestreach

Highestspecificity

Lowestspecificity

Laundromats •

Public libraries •

Social services •• Churches

• Beauty salons

Health centers •

Reach and specificityCriteria for prioritizing among settings

Source: Kreuter et al.

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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; kurt_ribisl@unc.udu

• Contact Centers Directly on Specific Projects – please cc: Kurt/Kathi/Vicki