1. CT CANCER PLAN 2014-2017 Co-chairs Committee Presentation February 27, 2013

2. Initial meeting with all committees Continuum Committees Prevention Early Detection Treatment and Survivorship Palliative and Hospice Cross-cutting Committees Advocacy Communication Data and Surveillance Disparities Education Evaluation

3. CDC Priorities Emphasize primary prevention Support early detection and treatment activities Address public health needs of suvivors Implement policy, systems, and environmental changes to guide sustainable cancer control Promote health equity as it relates to cancer control Demonstrate outcomes through evaluation

4. Common Themes Plan as a whole should be streamlined compared with previous plans Committees should focus on one or two objectives Goals and objectives should reflect CT Cancer Partnership as a whole Cross-cutting committee goals should be integrated into overall goals and objectives Plan should link to ACA and CT Chronic Disease Plan

5. Committees asked to consider… How do current plan goals and activities look today? Feedback provided from survey What challenges have the committee faced with respect to activities connected to goals and objectives? Review of committee reports Look at evaluation findings What data do you have? What data do you need? Updated tracking sheet (more recent data, additional data elements) Discussion of data sources What do you need to develop goals and objectives for the 4-year period 2014-2017?

6. Prevention Committee Has reached preliminary agreement to focus on 4 areas: Healthy Living Healthy eating Physical activity Tobacco Cessation Infectious agents including HPV and HIV Sun exposure Data sources include: BRFSS Regional Action Councils CHC Inc. Others (Chronic disease plan, CARE)

7. Early Detection New screening guidelines have been reviewed and adopted by CT Cancer Partnership Agreement that most, if not all, of the major screening tests will be covered under ACA Focus will be on disparities in access Efforts to be coordinated with Disparities Committee and Education Committee

8. Treatment and Survivorship Treatment Current goals/objectives are good, but general and not easily measured ACOS CoC Standards are a good way to assure quality treatment but not all hospitals are working towards accreditation Cancer care increasingly complex Clinical trial website is used, but possibly redundant Is CT moving toward a state IRB? Survivorship Current goals/objectives need updating Priorities for healthy living for survivors also in other parts of plan Treatment summaries in use at major cancer centers Progress on reimbursement for survivor services

9. Palliative and Hospice Care Palliative care is broader than just cancer which fits into idea of linking with chronic disease plan Palliative care is broader than end-of-life, yet still often linked to it There is limited disparities data on access to palliative and hospice care Potential data sources include: Center for Advanced Palliative Care CMS We Honor Veterans Need to broaden committee membership Invite planned for meeting in March

10. Cross-cutting Committees Advocacy Complex and hard to forecast for next 4 years e.g. 94 or so bills being tracked currently, ongoing coalition building Want to support priorities of Committees and Partnership Communication Serve advisory role as many functions now carried on by staff Have helped with plan dissemination and ready to do so again Data and surveillance Working on burden section Available to assist on as needed basis

11. Cross-cutting Committees (cont’d) Disparities Representative meets with each of continuum committees Principles have been articulated Education Education is key activity for CT Cancer Partnership Many experts across committees provide education Seeking a more focused role Evaluation Principles have been articulated Will review objectives to ensure they are “SMART” (i.e. help with objectives that are Specific, Measureable, Attainable, Relevant and Timely

12. Cancer Incidence Table 1: All Cancer Sites Combined. Age-Adjusted Invasive Cancer Incidence Rates by Race and Ethnicity, Connecticut, 2005-2009. * Cancer Site All RacesWhiteBlackHispanic MalesFemalesMalesFemalesMalesFemalesMalesFemales All Cancer594.1462.5589.7468.3617.3393.7564.2445.6 Breast-137.3-139.2-114.6-126.1 Prostate165.2-158.1-236.0-159.9- Lung and Bronchus78.561.078.662.681.147.567.446.2 Colon and Rectum55.341.154.640.561.947.759.743.8 Melanoma of the Skin30.520.632.222.3--4.16.2 Cervix Uteri-6.1-6.0-7.6-10.7 * Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Standard population. 95% confidence Intervals by U.S. Census Races and Ethinicity.

13. Cancer Mortality Table2: All Cancer Sites Combined. Age-Adjustd Invasive Cancer Mortality Rates by Race and Ethnicity, Connecticut, 2005- 2009. * Cancer Site All RacesWhiteBlackHispanic MalesFemalesMalesFemalesMalesFemalesMalesFemales All Cancer212.0149.6211.6150.2239.3156.3142.090.8 Breast-22.5-22.4-27.2-11.5 Prostate24.8-23.9-43.5-16.0 Lung and Bronchus55.938.856.039.861.331.028.415.3 Colon and Rectum17.313.017.212.921.216.19.511.4 Melanoma of the Skin4.01.74.31.9---- Cervix Uteri-1.6- -2.4-3.2 Pancreas14.710.214.710.117.712.29.56.5 * Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. Standard population. 95% confidence Intervals by U.S. Census Races and Ethinicity.

14. Adults aged 50+ who have ever had a sigmoidoscopy or colonoscopy (2010) Income: YesNo Less than $15,000 % 61.538.5 CI (53.9-69.0)(31.0-46.1) n 207119 $15,000- 24,999 % 66.333.7 CI (61.0-71.6)(28.4-39.0) n 350170 $25,000- 34,999 % 73.226.8 CI (67.1-79.2)(20.8-32.9) n 30296 $35,000- 49,999 % 74.525.5 CI (69.4-79.6)(20.4-30.6) n 357122 $50,000+ % 8020 CI (77.6-82.4)(17.6-22.4) n 1504330

15. Women aged 40+ who have had a mammogram within the past two years (2010) Income: YesNo Less than $15,000 % 68.531.5 CI (60.5-76.4)(23.6-39.5) n 19778 $15,000- 24,999 % 74.125.9 CI (67.4-80.8)(19.2-32.6) n 30593 $25,000- 34,999 % 81.518.5 CI (75.9-87.2)(12.8-24.1) n 24754 $35,000- 49,999 % 84.215.8 CI (79.3-89.1)(10.9-20.7) n 30456 $50,000+ % 83.316.7 CI (80.7-85.8)(14.2-19.3) n 1246217

16. Next round of committee meetings Committees continue to work toward articulating new goal/objectives Bringing data to the discussion Preliminary goals/objectives articulated prior to regional meetings More “pairing” of meetings for efficiency e.g. Early Detection and Disparities More virtual interaction

17. Regional meetings Five meetings scheduled in April Held in each “corner” of state plus middle corrider Invitations in preparation Partnerships important for bringing more input and voices to this plan Agenda Brief presentation on the plan and the process Organizations/individuals can share thoughts Discussion as time allows Minutes prepared for each regional meeting and distributed to participants

18. Developing the plan Preliminary outline developed See handout Preliminary “look” under development

19. Review of process SPAG meeting (March) Committees continue to discuss goals/objectives (March) JSI drafts goals objectives including relevant input from regional meetings (late April, early May) Reviewed by evaluation committee (mid-May) Brought back to co-chairs, committees and SPAG (late May) for editing Back and forth for final editing over summer Draft plan in early/mid August for review Plan finalized in September, printed in October, released in November

20. Questions? Discussion