Scaling up Areas of Research: Centers of Excellence Initiatives
Growing an area of research requires intentional, guided efforts and significant investment. Over the decades, DCCPS has utilized centers initiatives to develop transdisciplinary research models that can more rapidly advance the science beyond earlier paradigms. By seizing on new opportunities such as Cancer MoonshotSM funding and leveraging key partnerships, we are able to elevate areas of emerging cancer control research even more effectively and quickly through these centers.
Transdisciplinary Tobacco Use Research Centers
The Transdisciplinary Tobacco Use Research Centers (TTURCs) were created by NCI, the National Institute on Drug Abuse (NIDA), and the Robert Wood Johnson Foundation through a funding announcement, released in 1998, inviting grant applications (P50) for a Specialized Program of Research Excellence (SPORE) in tobacco use research. The intent of this initiative was to support tobacco control and addiction research by scientists with expertise in diverse areas such as molecular biology, genetics, neuroscience, epidemiology, imaging, primary care, behavioral science, communication, health policy, economics, and marketing. Each TTURC was also required to provide career development opportunities for new and established investigators who wished to pursue active research careers in transdisciplinary tobacco use research. The ultimate goal was to generate evidence that would inform public health efforts to reduce the disease burden of tobacco use.
Breast Cancer and the Environment Research Program
The Breast Cancer and the Environment Research Program (BCERP), a joint effort co-funded by the National Institute of Environmental Health Sciences (NIEHS) and NCI, was renewed for a third phase in 2015. BCERP began with the Breast Cancer and the Environment Research Centers (BCERC) in 2003. The BCERP supports a multidisciplinary network of scientists, clinicians, and community partners to examine the effects of environmental exposures throughout a woman’s life that may predispose her to breast cancer. Each BCERP project comprises a biology study, a human study, and a community engagement component. The research focuses on adding to the growing knowledge of environmental and genetic factors that may influence breast cancer risk across the lifespan and reflects recommendations made by the Interagency Breast Cancer and Environmental Research Coordinating Committee (PDF, 6.1 MB) in 2013.
Centers of Excellence in Cancer Communications Research
The Centers of Excellence in Cancer Communication Research (CECCRs) initiative was the centerpiece of NCI’s “Extraordinary Opportunity in Cancer Communication” — a scientific and programmatic priority first outlined in NCI’s fiscal year (FY) 2001 budget proposal. The novelty and scope of the initiative reflected NCI’s recognition that effective communication can and should be used to reduce health disparities and narrow the gap between discovery and application. The RFA, released in 2001, used the P50 centers award mechanism to invite interdisciplinary research applications that addressed the increasing complexity of cancer communication, from the understanding of cancer itself, to the rapid evolution of new media, to the recognition of the manifold literacy and technology needs of diverse audiences. The goal of the CECCR initiative was to significantly increase the size of the cancer communication research enterprise and to better understand the mechanisms by which communication influences behavior across the cancer control continuum. The result would be both knowledge and practical strategies to enhance cancer communication and improve the control of cancer. Four P50 centers were awarded in the first round (2003–2008), and a fifth center was added after the reissuance of the RFA (2008–2013). The CECCRs initiative resulted in more than 550 peer-reviewed publications, including a journal supplement in Patient Education and Counseling in 2010. Importantly, the initiative trained 34 postdoctoral trainees and 97 pre-doctoral trainees, and produced numerous data-driven, evidence-based cancer communication programs and products spanning the domains of cancer prevention behaviors, cancer screening behaviors, tobacco prevention and cessation, cancer treatment and survivorship, and clinical communication in oncology.
Centers for Population Health and Health Disparities
The Centers for Population Health and Health Disparities (CPHHD) Program — sponsored jointly by NCI, the National Heart, Lung and Blood Institute (NHLBI), and NIH Office of Behavioral and Social Sciences Research (OBSSR) — solicited grant applications designed to promote transdisciplinary research in the area of health inequities, with the purpose of contributing directly to improved health outcomes and quality of life for populations with a higher disease burden. The focus was on both understanding the pathways that result in disparate health outcomes and developing comprehensive models of how various social, economic, cultural, environmental, biologic, behavioral, physiological, and genetic factors affect individual health outcomes and their distribution in populations. Under the 2008 funding announcement, DCCPS supported centers focused on the differences in incidence, prevalence, mortality, and burden of cancer and related adverse health conditions that exist among specific population groups in the United States. These multilevel interventions, across 10 centers in the US, focused on only a few social determinants of health but had a ripple effect on the implementation of interventions to improve health outcomes and quality of life. One of the studies showed that the level of neighborhood disadvantage was strongly associated with diagnosis of late-stage breast cancer (Cho et al). The researchers state, “Breast cancer patients residing in neighborhoods that became relatively more disadvantaged over the 1990–2000 decade experienced an additional risk of late-stage diagnosis.” Furthermore, they noted that the benefits of immigrant enclaves are counterbalanced by the lack of structural capacity and, specifically, quality healthcare resources to improve access to healthcare for breast cancer patients. The program was developed with the recognition that achieving health equity requires multidisciplinary, multilevel, and multi-factorial research efforts that identify and account for the roles of multiple, complex, and interacting factors simultaneously. The program was able to illustrate how these disparities in health span from cells to society and delineate how the complex interactions among various determinants, including genetic, biological, behavioral, socioeconomic, and environmental factors, get “under our skin.”
Transdisciplinary Research on Energetics and Cancer Centers
The Transdisciplinary Research on Energetics and Cancer Centers (TREC) initiative fosters collaboration across multiple disciplines and encompasses projects that range from the biology, genomics, and genetics of energy balance to behavioral, sociocultural, and environmental influences upon nutrition, physical activity, weight, energetics, and cancer risk. It also provides training opportunities for new and established scientists who can carry out integrative research on energetics and energy balance. Established in 2005, the TREC initiative and the Training Workshops complement NCI’s energy balance research endeavors including the Trans-NCI Obesity and Cancer Working Group and the efforts of the NIH Obesity Research Task Force. TREC has trained 188 early-career researchers through annual transdisciplinary workshops on energy balance and cancer. To date, more than 1,200 peer-reviewed publications have resulted from TREC. The outcome from TREC training activities was an enhanced research network with a common focus on using transdisciplinary science to address problems related to energetics, obesity, and cancer. The TREC Training Workshop continues to promote transdisciplinary information exchange and problem solving and ensures that cross-discipline relationships are built on trust and mutual respect.
Tobacco Centers of Regulatory Science
The Tobacco Centers of Regulatory Science (TCORS) generate critical research to inform FDA’s regulation of the manufacture, marketing, and distribution of tobacco products. The TCORS are multidisciplinary; principal investigators (PIs) and their research teams have a broad range of expertise — including epidemiology, economics, toxicology, addiction, communication, and marketing — and they conduct research projects around an integrative theme. TCORS grantees conduct research pertaining to the landscape of different tobacco products, including e-cigarettes. In addition to primary research projects, these center grants include components for rapid response and pilot research and cores that offer mentored research in tobacco regulatory science. In 2013, 14 centers (TCORS 1.0) were funded, and in 2018, nine centers (TCORS 2.0) received funding. NCI programmatically manages four of the nine TCORS 2.0 centers. These TCORS are funded through NCI, as a participating institute in the Tobacco Regulatory Science Program (TRSP), an interagency partnership to foster research that informs FDA’s tobacco regulatory activities. This significant investment by the FDA and NIH has been highly effective in fostering the development of a new discipline of tobacco control research — tobacco regulatory science — and a new cadre of tobacco regulatory scientists. The TCORS’s substantial scientific contributions have informed FDA’s tobacco regulatory activities, state and local tobacco control policy efforts, and advanced tobacco control more broadly. An analysis conducted in 2019 found that the TCORS program had produced over 1,000 published journal articles and eight themed journal issues. Approximately 150 of the publications involved multiple centers, reflecting the high level of collaborative work among the TCORS.
Implementation Science Centers in Cancer Control
The Implementation Science Centers in Cancer Control (ISC3) Program supports the rapid development, testing, and refinement of innovative approaches to implement a range of evidence-based cancer control interventions. Centers all feature “implementation laboratories” with clinical and community sites. These laboratories will engage in implementation research across the cancer control continuum to advance methods of studying implementation and to develop and validate reliable measures of key implementation science constructs. The ISC3 Program comprises seven centers funded by RFA-CA-19-005 and RFA-CA-19-006, released in 2018. Over the course of this 5-year initiative, over 70 pilot studies in implementation science and cancer control will be conducted. Researchers are developing capacity-building tools for practitioners and a set of implementation science pilot studies that integrate social determinants of health or social needs to advance health equity.
Cho YI, et al. Neighborhood changes in concentrated immigration and late stage breast cancer diagnosis. J Immigr Minor Health. 2011;13:9–14.