The Cancer Prevention and Control Program at the Hollings Cancer Center SCCA Quarterly Meeting January 30th, 2009 Anthony J. Alberg, PhD, MPH ([email protected]) 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 Hollings Cancer Center 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. Hollings Cancer Center 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 Hollings Cancer Center Cancer Prevention and Control 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 Hollings Cancer Center Cancer Prevention and Control 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. Hollings Cancer Center Cancer Prevention and Control Cancer Prevention and Control Program Cross-cutting theme: disparities Epidemiology Primary Prevention Hollings Cancer Center Early Detection Survivorship Cancer Prevention and Control 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 Hollings Cancer Center Cancer Prevention and Control CoEE in Prostate Cancer Disparities Research University of South Carolina Medical University of South Carolina Hollings Cancer Center South Carolina State University Cancer Prevention and Control 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 Hollings Cancer Center Cancer Prevention and Control Train the Trainer Program Statewide Training – SCCA Cancer Education Guide – SCCA Staff Participation – Community Involvement – Healthcare Partnerships Hollings Cancer Center Cancer Prevention and Control Addressing Sociocultural Barriers Embracing Hope Forums Garden Parties Cultural/Contextual Competency Trainings Hollings Cancer Center Cancer Prevention and Control Cancer Prevention and Control Program Cross-cutting theme: disparities Epidemiology Primary Prevention Hollings Cancer Center Early Detection Survivorship Cancer Prevention and Control 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 Cancer Prevention and Control 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 Cancer Prevention and Control 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) Hollings Cancer Center Cancer Prevention and Control 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) Hollings Cancer Center Cancer Prevention and Control Cancer Prevention and Control Program Cross-cutting theme: disparities Epidemiology Primary Prevention Hollings Cancer Center Early Detection Survivorship Cancer Prevention and Control Tobacco Control in South Carolina Collaborating with DHEC Tobacco Control Program to analyze statewide Youth Tobacco Survey data Hollings Cancer Center Cancer Prevention and Control 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) Hollings Cancer Center Cancer Prevention and Control 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) Hollings Cancer Center Cancer Prevention and Control 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) Hollings Cancer Center Cancer Prevention and Control 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) Hollings Cancer Center Cancer Prevention and Control 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) Hollings Cancer Center Cancer Prevention and Control 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 Cancer Prevention and Control Program Cross-cutting theme: disparities Epidemiology Primary Prevention Hollings Cancer Center Early Detection Survivorship Cancer Prevention and Control Dragon Boat Racing Hollings Cancer Center Cancer Prevention and Control 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 Hollings Cancer Center Cancer Prevention and Control 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) Hollings Cancer Center Cancer Prevention and Control HCC Outreach Program Outreach program growing rapidly Working to integrate research initiatives within outreach programs Hollings Cancer Center Cancer Prevention and Control 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 Hollings Cancer Center Cancer Prevention and Control Outreach Program Areas Follow-Up – Patient Navigation Program Survivorship – Volunteer – Resource Center – The Looking Glass – Education Sessions Hollings Cancer Center Cancer Prevention and Control Research Symposium You are invited! Friday, March 13th http://hcc.musc.edu/education/springsym2009.htm Contact: Tonya Hazelton ([email protected]) 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 Hollings Cancer Center Cancer Prevention and Control 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) Hollings Cancer Center Cancer Prevention and Control The Cancer Prevention and Control Program at the Hollings Cancer Center SCCA Quarterly Meeting January 30th, 2009 Anthony J. Alberg, PhD, MPH ([email protected]) Hollings Cancer Center Cancer Prevention and Control