Noteworthy Reports

Monograph Spotlights Comparative Studies of Cancer Care and Economic Outcomes
Robin Yabroff and Angela Mariotto led the development of a Journal of the National Cancer Institute Monograph (No. 46; August 2013 ) entitled “Comparing Cancer Care and Economic Outcomes Across Health Systems:  Challenges and Opportunities.” Written by experts in health economics, epidemiology, health services research, health policy, and biostatistics, the papers in the monograph highlight the multiple benefits of comparing patterns of cancer care, costs, and outcomes across health systems, within a single country or across countries.  Measuring and projecting the economic burden associated with cancer and identifying effective policies for minimizing its impact are increasingly important issues for health care policy makers and health care systems at multiple levels.  The tremendous diversity in health care delivery, expenditures, and cancer outcomes—both internationally and regionally—suggests that comparative studies between health care systems and/or countries might inform evaluation, development, or modification of policies related to cancer screening, treatment, and programs of care delivery.

International Cancer Screening Network
Stephen Taplin coauthored a paper with Elsebeth Lynge (Denmark) and Antonio Ponti (Italy) for the International Cancer Screening Network that has been accepted to the European Journal of Cancer.  It is entitled “Detection of ductal carcinoma in situ (DCIS) in screening mammography: a survey within the International Cancer Screening Network (ICSN),” and includes data from 12 countries and 15 screening programs.

European-American Dialogues on Cancer Survivorship
A number of DCCPS staff contributed articles to the recently released special supplement to Cancer titled “European-American Dialogues on Cancer Survivorship: Current Perspective and Emerging Issues” (Volume 119, issue 11, June 1, 2013). Contributors included Catherine Alfano, Laura Forsythe, Erin Kent, Sandra Mitchell, and Julia Rowland.

In the wake of the publication in the above-cited supplement of the piece “Cancer survivorship research in Europe and the United States: Where have we been, where are we going, and what can we learn from each other?” (Rowland JH, Kent EE, Forsythe LP, et al. Cancer 2013), members of the Students for Global Oncology (GO!) initiative, a Harvard-affiliated organization dedicated to efforts in global oncology, invited Dr. Rowland to answer questions for their website: https://globalonc.org/dr-julia-rowland-cancer-survivorship-research-in-europe-and-the-united-states/.

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Meeting Reports

IV All-Russia Forum “Health or Tobacco”
Mark Parascandola participated and gave an invited presentation on tobacco control at the IV All-Russia Forum “Health or Tobacco” in Kazan, Russia, on May 31, 2013. This meeting was sponsored by the State Duma of the Federal Assembly of the Russian Federation, the Ministry of Health of the Russian Federation, the Russian Academy of Medical Sciences, the World Health Organization, and the Tatarstan Republic Cabinet of Ministers. He also met with tobacco control experts and partners in Russia to discuss potential areas of collaboration and research needs and opportunities. This included health staff at the US Embassy in Moscow, the WHO country office for the Russian Federation, and NCI-funded researchers in Kazan.

Forum on NCD Prevention and Healthy Lifestyles Promotion
Richard Troiano represented the NCI and NCI’s Center for Global Health (CGH) at the Second Forum on Noncommunicable Disease (NCD) Prevention and Healthy Lifestyles Promotion in Ekaterinburg, Russia, during the first week of June. Dr. Troiano gave a presentation on the role of diet and physical activity guidelines in reducing risk factors for chronic disease and participated in a roundtable discussion. Dr. Troiano has been invited to contribute a paper to a special international supplement issue on physical activity for the Russian journal Preventive Medicine to celebrate the Olympics in Sochi in 2014.

Knowledge Translation (KT) Canada Summer Institute
Gila Neta presented at the annual KT Canada Summer Institute on June 19, 2013, in Hamilton, Ontario, on NIH-sponsored funding and training opportunities for international investigators in dissemination and implementation research in health. The theme of the 2013 Summer Institute was “Challenges in the Science and Practice of Knowledge Translation.”

Harnessing Evidence and Capacity to Affect Tobacco Control Policy in Low- and Middle-Income Countries
Michele Bloch and Mark Parascandola participated and gave an invited presentation on NIH tobacco control research at the Fogarty International Center (FIC) workshop “Harnessing Evidence and Capacity to Affect Tobacco Control Policy in Low- and Middle-Income Countries” on June 24 and 25, 2013. Along with FIC, other parts of NIH helped plan the meeting, including the Office of Behavioral and Social Sciences Research (OBSSR), NCI, and the National Institute on Drug Abuse (NIDA). The purpose of the meeting was two-fold: 1) share the program evaluation of International Tobacco and Health Research and Capacity Building Program (TOBAC) – an initiative that has spanned over 10 years and trained more than 3,500 tobacco control investigators; and 2) convene almost 80 participants, including tobacco control program funders and investigators, to establish the next generation of research needs, translation of research into policy, and capacity building priorities in low- and middle-income countries.

Asian Quitline Consortium
NCI supported two speakers at the Asian Quitline Consortium in Bangkok, Thailand, on June 27-29, 2013. The Tobacco Control Research Branch provided travel support to Sharon Cummins, University of California, San Diego, and Kenneth Wassum,, Alere Well Being, who both presented their research and participated in discussions.  The purpose of the conference, sponsored by the Ministry of Health, Korea, was to bring together quitline operators and government officials from Asia Pacific countries, as well as the US and UK, to discuss progress with these countries in developing, promoting, and assessing smoking cessation quitlines. The attendees made progress toward creating a common intake and follow-up assessment questionnaire, as well as continued refinement of the technological needs associated with the development of a database to allow effective data sharing.

GIScience Application in Public Health Workshop
Li Zhu, of SRP, gave a webinar presentation, “NIH’s Research and Funding Opportunities in the Area of GIScience,” at the GIScience Application in Public Health Workshop held in Beijing on June 27-29, 2013. The workshop was organized by the China Center for Disease Control and Prevention, the International Association of Chinese Professionals in Geographic Information Sciences, and ESRI China, to promote Sino-America collaboration on GIS application in the field of public health.

International Conference on Self-Determination Theory
Heather Patrick presented the keynote presentation “Scaling Up: Taking Self-Determination Theory into Population and Public Health” at the 5th International Conference on Self-Determination Theory on June 28, 2013, in Rochester, New York.

CARF International Standards Advisory Committee Meeting
Julia Rowland participated as a member of an International Standards Advisory Committee sponsored by the Commission on Accreditation of Rehabilitation Facilities (CARF), June 30 - July 2, 2013, in Tucson, Arizona, to assist in the development of standards for Cancer Rehabilitation Programs. This new set of standards, once vetted more broadly, is expected to become available July 2014.

Update:  Folate Exposure Study with China CDC
Nancy Potischman traveled to China July 7-17, 2013, to discuss progress regarding several aspects of this research effort. She debriefed the field sites about data collection and management to date and discussed what worked well and what procedures could be improved/lessons learned. She also presented general study results to field site staff and asked questions pertaining to her own study and that of Martha Linet (NCI Division of Cancer Epidemiology & Genomics). Dr. Potischman gave presentations to China CDC staff regarding new technologies for diet and physical activity assessment, cohort studies, and the role of nutrition in fetal programming.  She met with the National Center for Chronic Noncommunicable Disease Control and Prevention group to discuss progress on data cleaning and analysis plans, and with the Nutrition Institute group to move the linkage with their nutrient database forward and to also discuss data cleaning and analysis. Part of the effort will be to facilitate collaboration between the two groups (noncommunicable diseases and nutrition) and build capacity in epidemiologic methods.

Virtual Research Network to Examine Economics of Cancer
Robin Yabroff gave a keynote address on the economic burden of cancer in the US at a symposium on the Economics of Cancer Research on September 2, 2013, at the National University of Galway, Ireland. She also discussed research resources in this domain. The symposium is part of the All-Ireland NCI Cancer Consortium’s Health Economics initiative and is funded by Health Research Board (HRB) Ireland in affiliation with NCI’s international fellowship in health economics. The initiative has created a virtual network of researchers, launched at this symposium, examining various aspects of the economics of cancer. The network is intended to facilitate communication and knowledge exchange among and between the research community and other stakeholders including policy makers, the media, advocacy groups, and clinicians. The network will provide an opportunity for ongoing dialogue that will facilitate the conduct and dissemination of policy-relevant research as well as help to shape future research agendas in the economics of cancer.

Middle East and North Africa Cancer Control Leadership Forum
Cindy Vinson participated as faculty and helped plan the Middle East and North Africa Cancer Control Leadership Forum held in Ankara, Turkey, September 9th -10, 2013. Leaders from Israel, Jordan, Lebanon, and Turkey attended the forum, which focused on the development and implementation of evidence-based national cancer control plans.

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Upcoming Events

Communication Session to Focus on Multiple Chronic Illnesses
Neeraj Arora, along with Ronald Epstein from the University of Rochester, will lead a Special Interest Group session titled “Facilitating patient engagement within the context of multiple chronic illnesses: developing a research agenda,” at the International Conference on Communication in Healthcare to be held in Montreal, Canada, September 29-October 2, 2013.  Researchers attending this interactive session will enhance their understanding of health care challenges and communication needs of individuals living with multiple chronic illnesses, identify indicators of patient engagement within the context of multiple chronic illnesses, and develop a research agenda for future communication research needed to facilitate patient engagement.

Tomatelo a Pecho International Seminar
At the invitation of Felicia Knaul, secretariat co-director of the Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries at Harvard, and founder of the non-profit Tomatelo a Pecho, Julia Rowland will be a speaker at the latter organization’s annual international seminar, October 8, 2013, in Mexico City. This year’s theme for the meeting will be survivorship. She will also attend and speak at a seminar being held on October 10 on access to pain control and palliative care, scheduled to mark international palliative care day, and meet with Mexican Health Officials on behalf of NCI’s Center for Global Health.

5th Annual International Cancer Control Congress
Cindy Vinson is participating in planning for the scientific session at the 5th Annual International Cancer Control Congress to be held in Lima, Peru, in November 2013.

Fall Asia Cohort Consortium Meeting
The 2013 Fall Asia Cohort Consortium Meeting will be held at the University of Tokyo in Tokyo, Japan, November 11-12, 2013. This year’s symposium covers various topics on cancer epidemiology. Meeting information can be found here:  https://www.asiacohort.org/accmeetings/individual.html?entry_id=16.

NCI Cohort Consortium Annual Meeting
Registration is now open for the 2013 NCI Cohort Consortium Annual Meeting to be held November 18-19, 2013. It will take place at the NCI Shady Grove Campus, Room TE406. Interested parties can view the agenda and register at https://www.cmpinc.net/cohort/registration.aspx.

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Ongoing Global Health Projects

SEER-Medicare Data Informing Cost of End-of-Life Care Treatment
Robin Yabroff and Joan Warren are collaborating with investigators in Ontario to compare the cost of end-of-life care between the US and Ontario. Using data from SEER-Medicare and Ontario’s claims, the analysis focuses on specific types of health services provided to lung cancer patients in the last 6 months of life. The Toronto investigators are from the University of Toronto, Toronto General Research Institute, Institute of Clinical Evaluative Sciences, and Toronto Regional Cancer Center.

DCCPS Advising on Canadian Health Services Research
Joan Warren serves on the Scientific Advisory Board for the Health Services Research Program of the Ontario Institute for Cancer Research (OICR) and Cancer Care Ontario (CCO). The board meets every spring to provide feedback on the progress of research activities, the focus of which changes each year. Dr. Warren has provided particular input on work relating to data linkages. To support cancer-related health services research, the OICR has linked the Ontario Cancer Registry to provincial health claims, using SEER-Medicare as their model.

DCCPS Participating in Reporting Standardization for Studies Using Health Claims
Joan Warren is a member of the Reporting of Studies Conducted using Routinely-collected Data (RECORD) working group. RECORD is an international collaborative initiative whose purpose is to develop reporting guidelines for observational studies using health data routinely collected for non-research purposes. The working group is composed of international experts in the use of observational health claims data. The group will meet in Lutry, Switzerland, October 22-24, 2013, to reach consensus on requirements for reporting findings from observational studies in scientific journals.

DCCPS Lends Expertise in Canadian Nutritional Epidemiology
Amy Subar is a member of the International Scientific Advisory Board for the Canadian Partnership for Tomorrow Project (CPTP), a prospective cohort study that is enrolling Canadians between the ages of 35 and 69 years to explore how genetics, environment, lifestyle, and behavior interact and contribute to the development of cancer and other chronic diseases. The project consists of five separate cohort studies, each with its own principal investigator and history of initial funding.  At the May 2013 meeting, the International Scientific Advisory Board reviewed progress on recruitment, especially with respect to respondents with biological specimens, data harmonization, and analysis and maintenance of biospecimens. In addition, a newly initiated project to enrich the cohort with cardiovascular risk factor data was reviewed and discussed. Finally, the board discussed the plan for making cohort data available as a population laboratory in Canada and the enrichment of the cohort data with diet and activity data.

NCI-Europe Collaboration Focuses on GVHD
In 2012, a NCI initiative sponsored by the NCI Center for Global Health launched a European Group for Blood and Marrow Transplantation (EBMT) -wide (55 countries) effort focused on advancing education and training in graft versus host disease (GVHD), with a particular emphasis on chronic GVHD (cGVHD), the most prominent late effect in cancer survivors after allogeneic transplant. The ultimate goal is to develop a mechanism that will facilitate the understanding and overcoming of great disparities in post-transplant care and research across Europe as well as advance research in this area by fostering collaborations on both sides of the Atlantic. Post-allogeneic transplant survivorship is an attractive model to study cancer survivorship due to the abundant medical and quality-of-life issues in these patients.

Since the December 2012 project development meeting, in which experts from NCI participated, including Julia Rowland, Russ Glasgow, Sandra Mitchell, and a representative from the Chronic Graft Versus Host Disease Consortium (which receives funding and/or programmatic support from NCI’s DCTD and the NIH Office of Rare Diseases Research), the NCI-Europe collaborative group has conducted a descriptive study of the uptake and use of recommendations for diagnosis, severity scoring, and management of chronic GVHD; this publication will be forthcoming. Building on the project development meeting and the study findings, an R21 grant application is currently in development to study the international dissemination and implementation of guideline-concordant care for people with chronic GVHD, with Stephanie Lee, Fred Hutchinson Cancer Research Center, as principal investigator.  Sandra Mitchell continues to be involved as an NCI expert.

Cancer Detection, Diagnostic and Treatment Technologies for Global Health
Mukesh Verma has been involved in the global health RFA “Cancer Detection, Diagnostic and Treatment Technologies for Global Health (UH2/UH3)” (see NOT-CA-13-015 Notice of Intent to Publish a Funding Opportunity Announcement:  https://grants.nih.gov/grants/guide/notice-files/NOT-CA-13-015.html). The estimated publication date of the announcement is fall 2013, and the first estimated application due date is winter 2014.  The FOA will support the development of cancer-relevant technologies that would be suitable for global health environments with limited resources. Specifically, the FOA will solicit applications for the development of new technologies/devices and/or adaptation of existing technologies/devices for cancer detection/diagnosis and treatment to be tested and ultimately implemented in low- and middle-income countries, as listed by World Bank.

National Trends Survey in China (HINTS China)
The Behavioral Research Program (BRP), represented by Sylvia Chou, Alex Persoskie, and Brad Hesse, continues to participate in the Health Information National Trends Survey in China (HINTS China) sponsored by China’s Ministry of Health.  A pilot survey from Beijing and Hefei, Anhui Province, was completed in early 2013, and several scientific manuscripts are being prepared to report preliminary findings, including profiles of cancer information seekers and perceived cancer risks among smokers.  During October’s HINTS Data Users Conference, a panel on Special Populations will include presentations on HINTS China.  In addition, NCI continues to work with Renmin University, the Ministry of Health in China, and George Mason University to plan the full-scale, biennial national survey.