Implementing strategies to prevent cancer
Thursday 9 June - 17:40-18:10
Deputy Director, Institute for Public Health; Chief, Division of Public Health Sciences; Niess-gain Professor of Surgery, School of Medicine; and Associate Director, Prevention & Control, Siteman Cancer Center, Washington University in St. Louis, USA
Dr Colditz is an internationally recognized leader in cancer prevention. As an epidemiologist and public health expert, he has a longstanding interest in the preventable causes of chronic disease, particularly among women. he focuses his research on early life and adolescent lifestyle, growth, and breast cancer risk. He is also interested in strategies to speed translation of research findings into prevention strategies that work. D. Colditz developed the award-winning your Disease Risk website (www.yourdiseaserisk.wustl.edu) which communicates tailored prevention messages to the public. He has published over 975 peer-reviewed publications, six books and six reports for the Institute of Medicine, National Academy of Sciences. In October 2006, on the basis of professional achievement and commitment to public health, Dr Colditz was elected to membership of the Institute of Medicine, an independent body that advises the U.S. Government on issues affecting public health. In 2011, he was awarded the American Cancer Society Medal of honor for cancer control research. In 2012 he received the AACR-American Cancer Society Award for Research excellence in Cancer epidemiology and Prevention. He also received awards in 2014 for cancer prevention research from ASCO and from AACR.
Implementing strategies to prevent cancer
Over 12 Million new cases of cancer were diagnosed world wide in 2012. Refining strategies to implement and sustain cancer prevention interventions that are established as effective to reduce cancer incidence offers the best and fastest return on our past investment in cancer research 1. Accelerating the implementation of what we know can maximize our return on our past research investment and maximize global health benefits.
What we currently know:
- There are effective cancer prevention strategies, including1:
- Across prevention targets, there are many persistent disparities among and within countries across race/ethnic and income groups 2,3
- Colorectal cancer screening – 50% reduction colorectal cancer
- HPV and HepB vaccines – 70 to 100% reduction (cervix and liver cancer)
- SERMs – 40 to 50% reduction in breast cancer
- Aspirin – 40% reduction in colon cancer
- Smoking cessation – 75 % in lung cancer
- Health care system’s general approach to cancer screening can be improved. In the USA, only about 43% of adults are current on all cancer screenings needed4. For colorectal cancer alone it is estimated that over 24 million adults need to be screened in the next 3 years to reach the target; 80% population coverage by 2018 5.
A key opportunity is to determine how to increase uptake of known cancer prevention strategies across all populations and design new interventions with implementation and dissemination in mind.
Some key implementation science questions include:
1. How to speed the uptake of effective cancer prevention strategies in community settings so they can reach populations that will benefit the most?
2. Does implementation of known effective prevention and screening strategies as a cohesive integrated set of cancer prevention services increase their uptake, and what would the impact be on cancer outcomes?
3. What components or organizational features of the provider setting support integrated cancer prevention service delivery?
4. How do different population groups perceive cancer precision medicine (and screening?) approaches, and what are the barriers to their uptake?
5. How do we communicate complex prevention concepts to different groups?
Answering these questions through rigorous implementation science across community, provider, and organizational strategies offers opportunities for widespread impact. It should also reduce or eliminate cancer disparities.
1. Colditz GA, Wolin KY, Gehlert S. Applying what we know to accelerate cancer prevention. Sci Transl Med. 2012;4(127):127rv124.
2. Steele CB, Rim SH, Joseph DA, et al. Colorectal cancer incidence and screening - United States, 2008 and 2010. MMWR Surveill Summ. 2013;62 Suppl 3:53-60.
3. Meyer PA, Yoon PW, Kaufmann RB, Centers for Disease C, Prevention. Introduction: CDC Health Disparities and Inequalities Report - United States, 2013. MMWR Surveill Summ. 2013;62 Suppl 3:3-5.
4. Emmons KM, Cleghorn D, Tellez T, et al. Prevalence and implications of multiple cancer screening needs among Hispanic community health center patients. Cancer Causes Control. 2011;22(9):1343-1349.
5. Fedewa SA, Ma J, Sauer AG, et al. How many individuals will need to be screened to increase colorectal cancer screening prevalence to 80% by 2018? Cancer. 2015;121(23):4258-4265.