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Comprehensive Cancer Alliance for Idaho Comprehensive Cancer Alliance for Idaho (CCAI) WELCOME Stacey Carson Cancer Data Registry of Idaho Current President,

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Presentation on theme: "Comprehensive Cancer Alliance for Idaho Comprehensive Cancer Alliance for Idaho (CCAI) WELCOME Stacey Carson Cancer Data Registry of Idaho Current President,"— Presentation transcript:

1 Comprehensive Cancer Alliance for Idaho Comprehensive Cancer Alliance for Idaho (CCAI) WELCOME Stacey Carson Cancer Data Registry of Idaho Current President, CCAI

2 Comprehensive Cancer Alliance for Idaho VISION Every Idahoan deserves the opportunity for proper cancer prevention and detection, state of the art cancer treatment, and the highest possible quality of life which we are committed to provide through a data driven, coordinated comprehensive cancer plan.

3 Comprehensive Cancer Alliance for Idaho MISSION Strengthen and coordinate efforts to address cancer issues along the continuum of cancer prevention and care. Assess, define and monitor the burden of cancer in Idaho. Resources will be identified or developed and will be networked through collaborative efforts. Raise awareness among the general populations, health care professions, organizations, agencies and policymakers.

4 Comprehensive Cancer Alliance for Idaho Comprehensive Cancer Alliance for Idaho (CCAI) Board of Directors Skin Cancer Task Group Breast Cancer Task Group (Operation Pink Bag) Local Coalitions Cancer Surveillance & Evaluation Team Medical Advisory Committee Stakeholders and Partners

5 Comprehensive Cancer Alliance for Idaho

6 Comprehensive Cancer Alliance for Idaho Medical Advisory Committee

7 Comprehensive Cancer Alliance for Idaho Purpose of Medical Advisory Committee To guide the CCAI board’s strategic direction, professional education, and data distribution To act in advisory capacity to programs: –Cancer Data Registry of Idaho (CDRI) –Women’s Health Check – Breast & Cervical Cancer Early Detection –Comprehensive Cancer Program Engage your participation and find ways that we can be of value to you as you care for our communities

8 Comprehensive Cancer Alliance for Idaho Composition & Time Commitment WHO: Physicians with expertise and interest in cancer prevention, early detection, treatment, and quality of life Locations: Meetings will be virtual Time Commitment: 2 Web-based meetings (1 hour), and 2 responses per year

9 Comprehensive Cancer Alliance for Idaho Potential Topics New technology and how it relates to limited public funds for screening special populations Review practice guidelines and quality assurance for screening and diagnostic services Provide clinical consultation for guidelines relating to early detection and education Provide input for professional development Provide recommendations for data distribution

10 Comprehensive Cancer Alliance for Idaho Cancer Data Registry of Idaho Chris Johnson, MPH Epidemiologist

11 Comprehensive Cancer Alliance for Idaho Intro to Cancer Registries

12 Comprehensive Cancer Alliance for Idaho Cancer Data Registry of Idaho CDRI is a statewide cancer registry that collects incidence and survival data on all cancer patients who reside in the state of Idaho or who are diagnosed and/or treated for cancer in the state of Idaho. CDRI was established in 1969 and became population- based in Cancer is a reportable disease under state law, and operations of the registry are mandated by Idaho Code. Funding comes from three sources: – <1% of the Idaho tobacco tax. –CDC –Grants & contracts

13 13 CoC Hospital Registries Other Reporting Sources CDRI Other Hospital Registries WHO IARC CI5 NCDB United States Cancer Statistics NAACCR CDC - NPCRSEER Cancer Registry Data Flow

14 Comprehensive Cancer Alliance for Idaho Central Cancer Registries Consolidate and Disseminate 2 Flavors NCI – SEER – 10 states, 2 metro areas, 3 population groups CDC – NPCR – 45 states, the District of Columbia, Puerto Rico, and the U.S. Pacific Island Jurisdictions

15 Comprehensive Cancer Alliance for Idaho 15 Quality of Idaho Cancer Data NAACCR Gold Standard for Quality, Completeness, and Timeliness. Because we produce high quality cancer incidence data, we have been included in the combined cancer incidence sections of all United States Cancer Statistics (USCS) and Cancer in North America (CINA) publications to date (1993-current for CINA; 1999-current for USCS).

16 Comprehensive Cancer Alliance for Idaho 16 (Some) Uses of Idaho Cancer Data CDRI data are used for many purposes: –Surveillance of cancer incidence rates –Quality assurance of hospital registry data –Responding to requests for information from hospitals, media, and the public –Public health practice –Comprehensive Cancer Alliance for Idaho planning and evaluation –Comparative Effectiveness Research

17 Comprehensive Cancer Alliance for Idaho 17 CDRI Data Used in Population- Based Epidemiologic Studies

18 Comprehensive Cancer Alliance for Idaho 18 CDRI Data Used in Population- Based Epidemiologic Studies ABHACUS Supplement –Journal CANCER, produced by American Cancer Society 23 articles: –Baseline burden –Overview of HPV –Federal initiatives –Data from 39 states used in analysis Human Papillomavirus Virus Vaccines Gardasil – 2006 FDA approved Quadrivalent HPV Vaccine (HPV 6, 11, 16,18) Prevents cervical, vaginal, vulvar precancers Cervarix - Bivalent HPV Vaccine (HPV 16, 18) undergoing FDA approval

19 Comprehensive Cancer Alliance for Idaho Comparative Effectiveness Research “CER …compares the benefits and harms of alternative methods to prevent, diagnose, treat and monitor a clinical condition, or to improve the delivery of care.” – IOM 10 states funded as specialized registries –Expansion of electronic data collection –Develop datasets for researchers to address CER-related questions 2011 cases, project ends Sept 2013

20 Comprehensive Cancer Alliance for Idaho Examples of CER Questions Are colorectal cancer patients tested for K-RAS and are the results used appropriately to determine treatment? What impact does K-RAS testing have on 2-3 year survival among colorectal cancer patients? Are rectal cancer patients receiving radiotherapy and what is the timing of radiotherapy? Are disparities apparent in the appropriate neo-adjuvant use of radiotherapy among these patients?

21 Comprehensive Cancer Alliance for Idaho Comprehensive Cancer Alliance for Idaho Strategic Plan Objectives 2011 ‐ 2015 Outcome Measures Used in Cancer Control * Outcome measures in decreasing order of utility for monitoring and evaluating components of cancer control. Adapted from: Armstrong BK. The role of the cancer registry in cancer control. Cancer Causes and Control 1992;3:

22 Comprehensive Cancer Alliance for Idaho Where did we get these objectives? Healthy People 2020 Cancer Objectives –“Healthy People provides science-based, 10- year national objectives for improving the health of all Americans.” Agency for Healthcare Research and Quality (AHRQ) –“the lead Federal agency charged with improving the quality, safety, efficiency, and effectiveness of health care for all Americans.” Idaho Comprehensive Cancer Strategic Plan

23 Comprehensive Cancer Alliance for Idaho A Tale of Two Cities

24 Comprehensive Cancer Alliance for Idaho Cancer is #1 cause of death in Idaho. 2,559 cancer deaths in Cancer Mortality

25 Comprehensive Cancer Alliance for Idaho Female Breast Cancer Mortality

26 Comprehensive Cancer Alliance for Idaho Melanoma Mortality

27 Comprehensive Cancer Alliance for Idaho Colorectal Cancer Incidence

28 Comprehensive Cancer Alliance for Idaho Clinical Trial Participation

29 Comprehensive Cancer Alliance for Idaho Cancer Screening

30 Comprehensive Cancer Alliance for Idaho Tobacco Use

31 Comprehensive Cancer Alliance for Idaho CDRI and MAC What we can do for you: –Provide information for decision making What you can do for us: –Provide guidance for measuring treatment Comparative Effectiveness Research

32 Comprehensive Cancer Alliance for Idaho Questions/Discussion In terms of information on cancer burden in Idaho/statistics, was any of this news to you? If yes, what ideas do you have for disseminating this information to Idaho’s medical community?

33 Comprehensive Cancer Alliance for Idaho Women's Health Check Susan Bordeaux, RN Clinical Coordinator

34 Women’s Health Check Program serves nearly 5,000 women yearly. Low-income, uninsured and underinsured, aged for breast screening, aged for cervical screening 138 women diagnosed with cancer in FY12 – 77 Breast, 3 Cervical, 58 Pre-cervical Most of these diagnosed women are referred to BCC Medicaid for the duration of their active treatment. 10 contractors coordinate over 400 providers Program oversees quality assurance and improvement for best care by national standards

35 Medical Advisory Committee (MAC) Professional Education – – Idaho Ranks 51 st in mammography screening – Promote early detection through increasing physician mammography referrals – Best format, methods, CME strategies Clinical Breast Exam (CBE) – – Importance in breast cancer screening Colorectal Cancer Screening Program (future) – Consider issues for Idaho, pros and cons

36 Professional Education – Prevention – physical activity, diet, tobacco cessation, public education- backed by professional recommendations – Early detection – support clinical breast exams and screening mammography – Increase referrals = increase mammograms, increase regular Pap testing

37 Operation Pink B.A.G. (Bridging the Access Gap)

38 Screening and Diagnostic Referral Guidance May 2012 Caroline Sobota, MD Gem State Radiology 0ID%20lectureW07.pdf

39

40 Cervical Cancer Screening Update May 2012 Lee Parsons, MD OB/GYN Associates Boise and Treasure Valley, Idaho

41 Cancer Screening Intervals, Algorithms, and Information Breast Cancer org/Professional.cfm org/Professional.cfm California State Breast Cancer Algorithms Mammography screening intervals comparison fact sheet Breast Cancer in Idaho fact sheet Cervical Cancer resources.htm resources.htm New USPSTF cervical cancer screening intervals ASCCP, ACOG, ACS Cervical diagnostic algorithms follow ASCCP

42 Professional Education for Referral Promotion Professional development targets – Who refers?, How do we reach them? – Algorithms, resources – posted to CCAI and Operation Pink B.A.G. websites, other ideas? Format – Webinars w/ CME’s – Brown bags, conference calls – Best format w/ limited $

43 Clinical Breast Exam (CBE) The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination (CBE) beyond screening mammography in women 40 years or older. Grade: Insufficient Evidence CDC requires CBE as part of a “complete breast screening exam” – Not offered at all mammography centers – USPSTF recommendation may influence future direction/cost-cutting measures What does this mean? – – MAC opinions – Possible statement of support for CBEs Questions to MAC on first survey in early 2013

44 Colorectal Cancer Screening Program (not funded at this time) ranks 2 nd among cancer mortality (2011 = #222) Pros – Increase early detection Idaho screening ranked 47 th – Decrease late-stage dx’s – Decrease mortality – Use WHC as a model for data recovery, reporting, and QA – Increase quality cancer preventive/patient navigation services Cons – No $ for treatment costs – Screen using FOBT or FIT – Colonoscopy only after suspicious results Questions to MAC on first survey in early 2013

45 MAC Discussion What can we do to educate and encourage primary care providers to refer for mammograms? Survey early in 2013 (CBE and Colorectal Program) Contacts: Susan Bordeaux, RN, Idaho Women’s Health Check Phone (208) Minnie Inzer Muniz, MEd, Idaho Women’s Health Check Phone (208)

46 Comprehensive Cancer Alliance for Idaho Idaho Comprehensive Cancer Program (ICCCP) Patti Moran, MHS Manager

47 Comprehensive Cancer Alliance for Idaho Population Based Program No funds allowed for research, screening or other clinical services CCC Cancer Spectrum: Prevention, Early Detection, Diagnosis, Tx, Quality of Life (Palliative Care, Survivorship), End of Life Priorities: Colorectal and skin cancer; some breast & cervical cancer and oral cancer partnership promotion work

48 Comprehensive Cancer Alliance for Idaho ICCCP, cont. Surveillance, Public Education, Awareness/Communication/Outreach, Professional Education, Some Policy Contract with the seven local health districts to maintain a local cancer coalition and do promotion and education

49 Comprehensive Cancer Alliance for Idaho CDC Direction Domain 2: Policy and Environmental Supports Policy Note: Policy here refers to organizational level, local level, or legislative policy. Examples: –Increase tobacco tax –Coverage for care if enrolled in a clinical trial –Tanning bed restrictions –Physical education in schools –Smoke free environments- parks, housing, worksite, etc. –Sun safety policies- schools

50 Comprehensive Cancer Alliance for Idaho Policy/Environment, cont. Environmental Support Strategies Creating conditions that promote health and support and reinforce healthful behaviors (statewide in schools, worksites, and communities). Examples: –Nutrition standards –Accessible foods –Pricing strategies –Built environments- walkability, sun safety

51 Comprehensive Cancer Alliance for Idaho MAC Input Needed: Input on development of a cancer policy agenda for Idaho Survey

52 Comprehensive Cancer Alliance for Idaho Discussion Thank you for your time


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