Emerging Issues in Cancer Control

Roshan Bastani PhD & Vicky Taylor MD, MPH

Emerging Issues HPV – cervical cancer

FDA approved HPV vaccine in 2007

Hepatitis B – liver cancerCDC recommended hepatitis B testing of

immigrants from endemic areas in 2008HPV vaccine has been available since 1982

Colorectal cancer screeningUptake remains relatively low and health

disparities persist

There are many projects across the network in these areas but we

will only report on those that represent collaboration among sites.

Emerging Issues

Physical activity and healthy nutrition for Obesity

Control

Obesity among children and adults is a major public health issue

Linked to many cancers Wide disparities are present Structural or environmental approaches are

scarce, often ill-conceived or not well implemented, and minimally evidence-based

Should this issue be included in the manuscript?

Does the CPCRN have relevant collaborative projects?

HPV Workgroup Activities

Ongoing activities• Survey measures paper (all CPCRN sites)• ASPO presentation and conceptual framework

paper (Harvard, UT, & Washington University)

Proposed activities• Policy paper • Cognitive testing project• Survey project• Educational materials project• 2009 SBM meeting participation

HPV Project: UT & Washington University

Sustainable strategies for increasing CIS use among

African Americans and Hispanics (Matthew Kreuter, Maria Fernandez)

Distributing culturally appropriate information about cervical cancer and the HPV vaccine in St. Louis and the Lower Rio Grande Valley

Quasi-experimental study to evaluate the effectiveness of the intervention in increasing use of CIS resources

Hepatitis B Testing Intervention Studies:UCLA & University of Washington

Project Study Design

Study Site

Intervention

Hepatitis B ESL education for Chinese (Vicky Taylor, Shin-Ping Tu, Roshan Bastani)

Group-randomized trial

Vancouver

ESL curriculum

Increasing hepatitis B screening among Korean church attendees (Roshan Bastani, Vicky Taylor)

Group-randomized trial

Los Angeles

Small group discussion

Evaluation of a hepatitis B outreach intervention for Cambodians (Vicky Taylor, Roshan Bastani)

Randomized trial

Seattle Lay health worker home visit

CRC Screening Study: Emory & UNC

Increasing colorectal cancer screening in health plan members (Karen Glanz, Michael Pignone)

Conducted in Georgia and North Carolina health practices

Cluster-randomized trial to evaluate a video-based decision aid for patients combined with an academic detailing intervention for providers

CRC Screening Study: Harvard & UCLA

A sustainable approach to increasing cancer screening in community health centers (Karen Emmons, Roshan Bastani)

Conducted in Boston and Los Angeles clinics

Quasi-experimental study to increase uptake of breast, cervix, and colorectal cancer screening through implementation of an automated telephone prompt/reminder followed with contact by a medical assistant

CRC Screening Studies: UCLA & University of Washington

Colorectal cancer screening in Chinese Americans (Shin-Ping Tu, Vicky Taylor, Roshan Bastani)

Randomized trial to evaluate the effectiveness of a clinic-based health educator intervention for Chinese patients in Seattle

Cancer control dissemination to Asian Americans (Shin-Ping Tu, Vicky Taylor, Roshan Bastani)

Quasi-experimental study to evaluate the dissemination of an evidence-based educational intervention to Vietnamese patients in Seattle

UT CRC Study Advisory Board Participation

Assessing the reliability and validity of core questions to measure colorectal cancer screening behaviors (PI – Sally Vernon)

All CPCRN sites are represented on the advisory board

Trial of interventions to increase utilization of colorectal cancer screening and informed decision-making about colorectal cancer screening among Hispanic men and women (PI – Maria Fernandez)

Harvard & University of Washington are represented on the advisory board

Technical Assistance to CRC Screening Demonstration Program

CDC funded five areas in 2005•Baltimore, Maryland•St. Louis, Missouri•Suffolk County, New York•King, Clallum, and Jefferson

Counties, Washington•Nebraska

University of Washington & Washington University provide technical assistance to their local sites

Papers in Medical Care Supplement

Improving colorectal cancer screening through research

in primary care settings

Tu SP, Bastani R, Taylor V, et al. Development ofintervention materials for individuals with limited Englishproficiency: lessons learned from CRC screening inChinese Americans (UCLA & University of Washington)

Vernon S, et al. Evaluating approaches to increaseuptake of CRC screening: lessons learned from pilotprojects in diverse primary care settings (UT)