… Working together to conquer cancer

Cancer Control in Iowa Overview of ICCCC Strengths, Weaknesses, Opportunities and Threats (one person’s opinion – not the official policy of the Holden Comprehensive Cancer Center, University of Iowa or Iowa Consortium for Comprehensive Cancer Control)

COMPREHENSIVE CANCER CONTROL An integrated and coordinated approach to reducing cancer incidence, morbidity, and mortality through:  Prevention  Early detection  Treatment  Enhancing quality of life

 House File 726 in 2001 required a study of cancer burden in Iowa  “Faces of Cancer” published - quantified burden  “Changing Faces of Cancer” plan implemented  Many strategies for cancer control proposed  High priority strategies identified  Support from  Iowa DPH  CDC  In kind contributions from participating organizations  Revised plan established in late Included document that outlined budget that would be required to “fully implement cancer control”  Cancer treatment itself not included in budget ICCCC Timeline

Estimated costs of fully implementing cancer control in Iowa Total Cost Goal 1 – Prevention$27,136,556 Total Cost Goal 2 – Screening$28,787,894 Total Cost Goal 3 – Treatment (educational efforts)$2,004,735 Total Cost Goal 4 - Quality of Life$3,122,028 Overarching Goals Including Research$38,575,458 Total Cost Comprehensive Cancer Budget 2007$99,626,671

ICCCC Top Priorities Tobacco Control Increase the excise tax on cigarettes by $1/pack Eliminate exposure to secondhand smoke Increase funding for Iowa’s tobacco prevention program Screening/early detection Educate health care providers about appropriate screening Increase awareness about cancer screening among Iowans Decrease the financial barriers to screening Increase resources for early detection cancer screenings Access to treatment Identify gaps in treatment options for underserved cancer patients Encourage coverage for clinical cancer trial participation Holistic view of cancer Increase health care providers’ awareness of quality of life issues Increase the awareness of the link between nutrition/physical activity and cancer Maintain and expand the ICCCC website as an information resource

State support New this session $8.9M increase in tobacco control budget $200K increase in support for colorectal and cervical cancer screening $500K to support other initiatives of the ICCCC Consortium manager New colorectal screening programs

Strengths “A small body of determined spirits fired by an unquenchable faith in their mission can alter the course of history” - Gandhi Joint vision Dedication of participants Collaborative spirit Supportive state government Growing state and national profile

Weaknesses “Because that is where the money is” (Not!) - Willie Sutton Funding for cancer control remains inadequate Lack of financial reward to private sector for cancer control “Them’s the rules” - My grandfather Bureaucracy and “good governmental practices” can interfere with “Working together to conquer cancer”

Opportunities “Discontent is the first step in the progress of a man or a nation” – Oscar Wilde Growing recognition of the value of prevention and early detection Building of trust within the Iowa cancer control community, and between the Iowa cancer control community and state government Tobacco tax Slow but real decreases in cancer mortality Focus of state government on health care

Threats “If at first you don’t succeed, redefine success” – poster in Spencer’s Gifts Frustration with slow pace of progress Frustration with administrative and bureaucratic obstacles Tendency to want to declare victory prematurely or be satisfied with limited pace of success

Next steps Work with local, statewide and national partners to strengthen cancer control Demonstrate investment to date has paid off Use cancer control plan and budget as basis for obtaining additional support 501(c)(3) with goal of identifying additional sources of support for cancer control Work towards line item support for ICCCC activities or multiyear contract Agree on bold vision

A bold vision “Iowa should have the nation’s lowest age- adjusted death rate from cancer” Out of the 50 states, Iowa currently ranks 18th with respect to age-adjusted mortality rate from cancer. We can and must do better. Our goal is to decrease the age-adjusted mortality rate in Iowa so that Iowa will have one of 5 lowest death rates by 2010, and the lowest rate in the nation by 2020.