1 CPCRN: Overview and Cancer Registry Research Kurt M. Ribisl, PhD University of North Carolina at Chapel Hill CPCRN Coordinating Center CDC, Atlanta, GA May 24, 2010

2 CPCRN Mission To accelerate the adoption of evidence- based cancer prevention and control in communities.

3 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

4 PI’s Michelle 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

5 Network Center Map

6 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: Novel use of Registry Data in SC

PrCA Incidence in Relation to Soil Metal Concentration: Unique Use of Combining SCCCR & Environmental Data Zinc Selenium 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:

8 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 mortality  Cancer registry represents method to recruit survivors and first-degree relatives (FDRs) into innovative effectiveness and dissemination studies  UCLA 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 TOTALWHITE LATINOAFR. AMASIAN N=1280N=351N=403N=284N= *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)

11 Johnston Scotland Guilford Rockingham Moore Anson Union Richmond Mecklenbur g Cabarrus Stanly Surry Ashe Wilkes Yadkin Forsyth Stokes Davidson Randolph Rowan Lincoln Cleveland Gaston Iredell Caldwell Alexander Catawba Burke McDowell Buncombe 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 Pender Bladen Sampson Duplin Onslow Jones Lenoir Wayne Harnett Carteret Craven Pamlico Beaufort Hyde Tyrrell Dare Gates Hertford Bertie Martin Pitt Greene Wilson Nash Franklin Warren Halifax Northampton Edgecombe Vance Durham Alamance Cumberland Washington Currituck Camden Pasquotank Perquimans Chowan New Hanover Chatham Caswell Mitchell Alleghany 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) Mortality Rates

12 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.

13 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)

14 Maximizing the social impact of cancer registry data Washington University

15 How can we do better? Broader goals New audiences Information design Technology and tools Strategic, proactive approach

16 This project Design & test new displays of cancer data Propose best practices Share with cancer registry community

17 Alternative Formats

18 Promoting Screening Hi-Risk Areas Promotion of screening through kiosks –Washington University (Matt Kreuter et al.)

Highest reach Lowest reach Highest specificity Lowest specificity Laundromats Public libraries Social services Churches Beauty salons Health centers Reach and specificity Criteria for prioritizing among settings Source: Kreuter et al.

20 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

21 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

22 Contact Us CDC Contacts –Kathi Wilson –Vicki Benard UNC Coordinating Center –Kurt M. Ribisl –(919) ; Contact Centers Directly on Specific Projects – please cc: Kurt/Kathi/Vicki