11/27/2017 GEORGIA CORE AND CANCER COLLABORATION IN GEORGIA GATRA CONFERENCE MACON, GA NOVEMBER 6, 2017

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1 GEORGIA CORE AND CANCER COLLABORATION IN GEORGIA GATRA CONFERENCE ACON, GA NOVEBER 6, 2017 Nancy. Paris, SHA, FACHE President Georgia Center for Oncology Research and Education m *American Cancer Society, Cancer Facts & Figures 2017.org m *American Cancer Society, Cancer Facts & Figures

2 National Progress Against Cancer Life expectancy is increasing for cancer patients 3 years since 1980 Cancer death rates are down Rates fell an average of 2.1% per year from ; twice the decline of the previous 5 years 20% decline in cancer deaths over last two decades Five-year survival is rising Approximately 75% New medicines and practices advance treatment *Innovation.org Increase in colorectal cancer in young adults There is an increase in colorectal cancer seen in young adults (less than 50 years) Incidence rates have increased faster for rectal cancer than colon cancer. Could likely be attributed to Complex relationship between colorectal cancer and obesity, unhealthy diet, and lack of physical activity. - Dr. Otis Brawley (ACS). Due to increase in left-sided tumors, particularly in the rectum According to Rebecca L. Siegel, Ahmedin Jemal and Elizabeth. Ward (2009) In an article published in American Association for Cancer Research Others say cause of increased incidence is unknown Cancer in Georgia Cancer is the second leading cause of death in Georgia, accounting for almost a quarter of all deaths. Lung, colorectal, breast, and prostate cancer account for more than half of all cancer deaths in Georgia. inority and medically underserved Georgians experience a disproportionate cancer burden. Cancer care is excessively costly for employers and the state of Georgia. 2

3 Growth of Cancer Related Investments in Georgia Increased Philanthropic Investments Numerous cancer centers bear the names of corporations and donors demonstrating greater private contributions Growth in National Cancer Institute Funding 2000 $14 mil; up by 100% in 2005 to $28 mil; up by 30% in 2010 to $38 mil; up by 25% in 2015 to $47 mil Escalation in federal funding and academic research Georgia ranks 21 st in federal funding; academic cancer research centers at Augusta University, Clark Atlanta, Emory, Georgia Tech, ercer, orehouse and the University of Georgia Georgia CORE was created in 2003 with funding from the State of Georgia s Tobacco Settlement Georgia CORE is a public-private partnership that works collaboratively with oncologists, cancer centers, public health and academic institutions to provide higher quality, better organized, more cost-effective, patientcentered care. Supported by: Georgia Department of Public Health Georgia Department of Community Health Georgia Society of Clinical Oncology (GASCO) Georgia Research Alliance Government and Foundation Grants Private Contributions and Sponsorships Industry Contracts Board of Directors Andrew W. Pippas, D Chairman Frederick. Schnell, D, FACP Chief edical Officer Nancy. Paris, SHA, FACHE President Guilherme Cantuaria, D, PhD Teresa A. Coleman, D, FACP Walter J. Curran, Jr., D, FACR Lynn Durham, PA Sharad Ghamande, D John W. Henson, IV, D, BA, FACHE Harvey James Hamrick, D, PH Anand P. Jillella, D Roland atthews, D Steven ccune, D, PhD Charles H. Nash, III, D Petros Nikolinakos, D Patti Owen, N Jayanthi Srinivasiah, D Jose Tongol, D H. A. Zaren, D 3

4 Research Network Archbold edical Center Atlanta Cancer Care CTCA at Southeastern Regional edical Center Central Georgia Cancer Care Curtis and Elizabeth Anderson Cancer Institute at emorial University edical Center DeKalb edical Georgia Cancer Center for Excellence at Grady emorial Hospital Georgia Cancer Center, Augusta University Gwinnett edical Center Harbin Clinic John B. Amos Cancer Center, Columbus Regional Health orehouse School of edicine Nancy N. and J.C. Lewis Cancer & Research Pavilion at St. Joseph s/candler Northeast Georgia Health System and edical Center Northside Hospital Cancer Institute Northwest Georgia Oncology Centers Peyton Anderson Cancer Center/Navicent Health Phoebe Putney emorial Hospital Piedmont Cancer Institute Southern Regional edical Center South Georgia edical Center, Pearlman Cancer Center University Cancer and Blood Center Wellstar Health System Winship Cancer Institute of Emory University Georgia CORE odel Knowledge Transfer Facilitate quality cancer care and exchange of best and promising practices Research Accelerate cancer research & expand evidence based care Higher quality, better organized, more cost effective, patient centered cancer care Navigation & Outreach Connect patients & survivors to doctors, trials, care & resources Awareness Champion Georgiabased care & resources Education Promote evidencebased guidelines for risk reduction, prevention & screening Strategic Direction & Statewide Initiatives NCI Community Oncology Research Program Research Network GeorgiaCancer Info.org Cancer Survivorship Connection Georgia s Cancer Plan Genetic Services Cancer Patient Navigators of GA Breast Cancer License Tag 4

5 Georgia Cancer Plan Cancer Risk Reduction: Tobacco and Obesity 2.Vaccination for Human Papilloma Virus 3.Breast and Cervical Cancer Screening 4.Colorectal Cancer Screening 5.Lung Cancer Screening 6.Quality Cancer Diagnosis and Treatment 7.Access to Palliative Care and Survivorship 8.Patient Case anagement and Care Coordination embers of the GC3 Consortium GeorgiaCORE.org 5

6 What Can Collaboration Accomplish? Adult Trials (97%) Pediatric Trials (27%) Total Trials (900) * Some variance between Adult and Pediatric trial totals as some count 18+ Adult, while others consider 21+ Adult. Trials, Doctors and Cancer Centers on GeorgiaCancerInfo.org Searchable Online Cancer Information Partnership with NCI Certified by Health on the Net 605 Clinical Trials 836 Oncologists 397 Cancer Treatment Sites National Treatment Standards and Guidelines Community Resources throughout Georgia Cancer Survivorship Connection Statewide Initiatives 39,464 Unique Users in

7 Cancer Trials in Georgia (GeorgiaCancerInfo.org) 53 Cancer types by which to search for trials 72 Breast cancer trials, 36 Brain cancer trials, 14 Colorectal cancer trials 584 Adult trials in Georgia 201 Pediatric Trials 250 Number of Trials by Phases in Georgia 269, 44% Number of Trials , 28% 160, 26% 50 0 I II III IV Phase 6, 1% Proliferation of Clinical Trials and Accredited Centers Eleven-fold increase in cancer clinical trials (from 82 to 900) Research hubs in greater Atlanta counties Fulton, DeKalb, Gwinnett and Cobb; and in Albany, Athens, Columbus, Dublin, Gainesville, acon, Thomasville, Valdosta, Rome and Savannah Atlanta Decatur Lawrenceville arietta Trials within 25 miles Oncologists within 25 miles * NCI Community Oncology Research Program (NCORP) NCI funded 2 Georgia-based consortiums for 5 years; 34 funded nationally. inority NCORP Augusta University DeKalb edical Center Georgia Southern University orehouse School of edicine Phoebe Putney emorial Hospital Georgia NCORP Northside Hospital St. Joseph's/Candler Georgia CORE with Harbin Clinic, John B. Amos Cancer Center, Peyton Anderson Cancer Center at Navicent Health and Northeast Georgia edical Center 7

8 Georgia NCORP The primary goal is to increase access and accrual to cancer research for Georgians at risk for or with a diagnosis of cancer in their own communities, with a targeted focus on the underserved. Cancer Incidence Rate Partners Northside Hospital Cancer Institute St. Joseph s/candler Lewis Cancer & Research Pavilion Georgia Center for Oncology Research and Education Network embers Harbin Clinic John B. Amos Cancer Center at Columbus Regional Health Peyton Anderson Cancer Center, Navicent Health Cancer Services at Northeast Georgia edical Center Georgia NCORP Highlights 103 rostered physicians, 52 accruing 76 NCI clinical trials open 41% of accruals to high priority/precision medicine trials 23.4% racial/ethnic minority accruals Investigators and research managers active in leadership Recognition as a High Performing NCORP by NCI In top quartile of NCORPs for achieving stated goals Among top 4 accruers nationally to NRG Oncology Survivorship Resources on GeorgiaCancerInfo.org/Survivorship 8

9 What is Needed to Improve Quality of Life for Survivors? Employment Support Insurance Support Financial Support INFORATION/ Plan EDUCATION Support Groups FAITH Attitude Survivorship LISTEN Encourage FOLLOW UP CARE Patience Transportation Healthy Lifestyle Counseling entorship TIE Honesty TEA CARE RESEARCH Resources Communication COPASSION Survivor Programs Cancer Survivor Needs Physical Sleep & Fatigue Pain Spiritual Neuropathy Weight Gain Sexuality Practical Financial & oney Work related Health Insurance anaging Household Return to responsibilities Quality of Life Emotional Depression Anxiety Spiritual anaging Stress Fear of Recurrence New Normal Spiritual Loss of Faith Religious Support Hope End of Life Thoughts Georgia s Cancer Survivor Voices From the time of diagnosis, through the balance of his or her life; includes family members, friends, and caregivers (NCI) 9

10 Statewide Survivor Needs Assessment GC3 Survivorship Working Group Partnership with Rollins School of Public Health & Georgia Cancer Control Consortium Survivorship Working Group Develop and implement a survey to assess physical, emotional, practical and spiritual needs & level of distress Dissemination 40 CoC accredited hospitals with identified survivorship champions, 16 survivorship focused organizations, 5 regional cancer coalitions via , social media and mail Survey Results Executive Summary Publication: Escoffery, C Patterson, A Paris, N Kirsch, L Frank, C O Connor. Assessment of distress, unmet needs, and receipt of care plans among cancer survivors in Georgia. J Ga Public Health Assoc. 2016; 6: Phase 2 Targeted focus on disparate populations 29 Demographics of Survivors (N~729) Primarily female (78%), married (65%), white (83%), and educated (88% some college+) ost (80%) were within 5 years of treatment ean age: 58.2 (SD=11.6) ost reported other comorbid conditions: hypertension, high cholesterol, joint problems, and gastrointestinal problems Survey Results Practical Needs 10

11 Survey Results Emotional Needs Survey Results Physical Needs 33 Survey Conclusions Education and support are needed by survivors: Late and long term effects and wellness behaviors Provider and community resources to support survivors and their families Distress screening is necessary due to high reports of emotional needs not being met: Commission on Cancer (COC) requiring cancer centers to implement distressscreening Care plans are necessary Education about survivorship and late effects ulti disciplinary survivorship care Would better meet the emotional and mental health needs of survivors, and improve the coordination of care among oncologists, primary care providers, and other specialists 11

12 Survivorship Care Plans Coordinated plan for cancer survivor and healthcare team Treatment Summary Detailed plan for ongoing care (follow up visits and testing, recommendations for early detection and management of treatmentrelated effects Tool for coordinated care with oncology provider, primary care provider and other specialists American Society of Clinical Oncology Journey Forward OncoLink Care Plan Screening Tool for BRCA 1/2 utations Website developed using B-RST Algorithm with CDC funding* Risk Assessment for HBOC and Genetic Counseling Referral 6 Questions, 3 Results (Negative, oderate, Positive), 5 inutes USPSTF s recommendation cites Breast Cancer Genetics Referral Screening Tool (B-RST *) and Una herramienta de detección New Spanish translation *Developed and validated by Cecelia Bellcross, PhD, S, CGC, Emory University School of edicine, Department of Human Genetics BreastCancerGeneScreen.org 12

13 Breast Cancer License Tag Proceeds Support Breast Cancer Screening Breast Cancer License Tag Awardees ($2.9 million to 26 organizations): $22 per tag helps underserved women in 109 counties Breast Cancer License Tag Program Grantees Counties Served by Genetic Testing Fund Counties Served by Breast Cancer License Tag Program Breast Cancer Incidence Rate Not enough cases to calculate rate Discussion and Questions? 13