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Comprehensive Cancer Alliance for Idaho (CCAI)

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Comprehensive Cancer Alliance for Idaho (CCAI) WELCOME Stacey Carson Cancer Data Registry of Idaho Current President, CCAI scarson_at_teamiha.org * The National ... – PowerPoint PPT presentation

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Title: Comprehensive Cancer Alliance for Idaho (CCAI)


1
Comprehensive Cancer Alliance for Idaho (CCAI)
  • WELCOME
  • Stacey CarsonCancer Data Registry of Idaho
  • Current President, CCAI
  • scarson_at_teamiha.org

2
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
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 (CCAI)
Stakeholders and Partners
5
www.ccaidaho.org
6
Medical Advisory Committee
7
Purpose of Medical Advisory Committee
  • To guide the CCAI boards strategic direction,
    professional education, and data distribution
  • To act in advisory capacity to programs
  • Cancer Data Registry of Idaho (CDRI)
  • Womens 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
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 Email responses per year

9
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
Cancer Data Registry of Idaho
Chris Johnson, MPHEpidemiologistcjohnson_at_teamiha
.org
11
Intro to Cancer Registries
12
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 1971.
  • Cancer is a reportable disease under state law,
    and operations of the registry are mandated by
    Idaho Code.
  • Funding comes from three sources
  • lt1 of the Idaho tobacco tax.
  • CDC
  • Grants contracts

13
Cancer Registry Data Flow
WHO IARC CI5
United States Cancer Statistics
NAACCR
CDC - NPCR
SEER
NCDB
CDRI
CoC Hospital Registries
Other Reporting Sources
Other Hospital Registries
14
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
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
(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
CDRI Data Used in Population-Based Epidemiologic
Studies
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
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
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 IdahoStrategic
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 19923569-579.
22
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
    2006-2010

23
A Tale of Two Cities
24
Cancer Mortality
  • Cancer is 1 cause of death in Idaho.
  • 2,559 cancer deaths in 2011.

25
Female Breast Cancer Mortality
26
Melanoma Mortality
27
Colorectal Cancer Incidence
28
Clinical Trial Participation
29
Cancer Screening
30
Tobacco Use
31
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
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 Idahos medical community?

33
Women's Health Check
Susan Bordeaux, RNClinical CoordinatorBordeauS_at_d
hw.idaho.gov
34
Womens Health Check
  • Program serves nearly 5,000 women yearly.
  • Low-income, uninsured and underinsured, aged
    50-64 for breast screening, aged 40-64 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 51st 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
Breast Cancer in Idaho
  • Screening and Diagnostic Referral Guidance
  • May 2012
  • Caroline Sobota, MD
  • Gem State Radiology
  • http//www.ccaidaho.org/docs/B20Ca20in20ID20le
    ctureW07.pdf

39
www.ccaidaho.org
40
Cervical Cancer Screening Update
May 2012 Lee Parsons, MD OB/GYN Associates Boise
and Treasure Valley, Idaho http//www.ccaidaho.or
g/professional.html
41
Cancer Screening Intervals, Algorithms, and
Information
  • Breast Cancer
  • http//www.operationpinkbag.org/Professional.cfm
  • California State Breast Cancer Algorithms
  • Mammography screening intervals comparison fact
    sheet
  • Breast Cancer in Idaho fact sheet
  • Cervical Cancer
  • http//www.ccaidaho.org/ 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/ CMEs
  • 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 2nd among cancer mortality
(2011 222)
  • Pros
  • Increase early detection Idaho screening ranked
    47th
  • Decrease late-stage dxs
  • 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 Womens Health Check
  • bordeaus_at_dhw.idaho.gov
  • Phone (208) 334-5971
  • Minnie Inzer Muniz, MEd, Idaho Womens Health
    Check
  • inzerm_at_dhw.idaho.gov
  • Phone (208) 332-7311

46
Idaho Comprehensive Cancer Program (ICCCP)
  • Patti Moran, MHS
  • Manager
  • 208-332-7344
  • moranp_at_dhw.idaho.gov

47
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
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
CDC DirectionDomain 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
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
MAC Input
  • Needed Input on development of a cancer policy
    agenda for Idaho
  • Survey

52
Discussion
Thank you for your time
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