MICHIGAN CANCER CONSORTIUM 2014 ANNUAL REPORT

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1 SOURCE: FLICKR USER NASA GODDARD PHOTO AND VIDEO MICHIGAN CANCER CONSORTIUM 2014 ANNUAL REPORT

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3 MICHIGAN CANCER CONSORTIUM 2014 ANNUAL REPORT TABLE OF CONTENTS Executive Summary... page 1 Who We Are... page 2 I think MCC is a model for other states and continues to try to meet a very large range of interests and needs...for our communities, our patients, and the multiple fields of work and interests represented. ~Connie Szczepanek, Cancer Research Consortium of West Michigan Where We Are... page 2 What We Do... page 2 How We Are Doing... page Accomplishments... page 4 Prevention... page 4 Early Detection... page 5 Diagnosis and Treatment... page 7 Survivorship... page 8 MCC Highlights... page 9 Community Implementation... page 10 Spirit of Collaboration Awards... page 11 Spirit of Collaboration Honorable Mentions... page 11 Member Satisfaction and Involvement... page 12 Acknowledgements... page 14

4 June 2015 UPDATED JUNE 30, 2015 This publication was supported in part by funding from the Centers for Disease Control and Prevention (CDC) Cooperative Agreement 5U58DP Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.

5 EXECUTIVE SUMMARY The Annual Report highlights the Michigan Cancer Consortium s (MCC) accomplishments including MCC-sponsored efforts where multiple MCC members come together to work on an event, project or product. In 2014, MCC stakeholders contributed approximately 2,535 hours of in-kind work to help support the MCC s mission. The report highlights some of the individual MCC member organizations efforts to implement the cancer plan in Lastly, the report summarizes the MCC member satisfaction and involvement in the MCC. It is estimated that there will be approximately 57,420 new cancer cases in Michigan and 20,920 deaths in The estimated number of cancer survivors in Michigan as of January 1, 2014 was 543,470. The increasing number of survivors is reason to celebrate and also presents new challenges and opportunities for the MCC. According to the American Cancer Society, Cancer Facts & Figures , a substantial proportion of cancer could be prevented. All cancers caused by tobacco use and heavy alcohol consumption could be prevented completely. In 2015, almost 171,000 of the estimated 589,430 cancer deaths in the U.S. will be caused by tobacco smoking. In addition, it is estimated that up to one-third of the cancer cases that occur in economically developed countries are related to being overweight or obese, lack of physical inactivity, and/or poor nutrition and thus could be prevented. The U.S. Centers for Disease Control and Prevention s (CDC) Behavioral Risk Factor Surveillance System (BRFSS) data indicate that Michigan breast, cervical, and colorectal cancer screening rates are slightly better than national averages. However, when compared to national rates, slightly more Michigan adults describe themselves as current smokers and as obese. This year we have seen many changes in healthcare, cancer care and the Consortium. The MCC was recognized by national partners in 2014 and awarded the Comprehensive Cancer Control State Coalition Impact Award, which highlighted the work of the Tobacco Cessation Collaborative. Additionally, numerous MCC organizations participated in the Survivorship Care Plan Project, and in MCC-sponsored webinars on topics related to E-cigarettes, improving HPV vaccination rates, and pharmacologic interventions for breast cancer risk reduction. MCC members and partners have many new accomplishments, but there is much more work for all of us to do in the future. History indicates that we are up to the challenges and our consortium has the power and momentum for continued success. If you are wondering where and how you can become more engaged, please contact cochairs@michigancancer.org. Call to Action from MCC Co-Chairs We are pleased with the hard work done by MCC members. Through the efforts of individuals and member organizations, progress is being made. We are proud of this report and expect you will be too. As a member of the MCC please share the report with your colleagues, supervisors, and contacts. Thanks for another year of outstanding cancer control efforts in Michigan. Susan Hoppough and Ernesto Drelichman, MCC Co-Chairs 1

6 WHO WE ARE The MCC is a statewide, broad-based partnership that strives to include all interested public and private organizations in the fight against cancer. The MCC provides a forum for collaboration to reduce the burden of cancer among the residents of Michigan by achieving the MCC's research-based and results-oriented cancer prevention and control priorities. Over one hundred public and private organizations are members of the MCC. Each organization commits to working on implementing of the Michigan Cancer Plan and the MCC s priorities. A full list of MCC members can be accessed on the MCC website ( WHERE WE ARE The MCC is comprised of 109 member organizations located around the state. WHAT WE DO The Comprehensive Cancer Control Plan for Michigan is a blueprint for action to address the cancer burden in the state. The plan represents the collective wisdom of a wide range of individuals and organizations in our state, from nationally recognized cancer experts to state health care leaders to health care providers to insurers to representatives of community-based organizations, all working together to achieve our common goals. 2

7 H HOW WE ARE DOING Here is a snapshot of how we re doing in Michigan compared to national data. 100% 80% 60% 40% 20% 0% Adult Cancer Risk Factors 1 Michigan vs. National Median Adults Who Are Current Smokers Considered Overweight Considered Obese Participated in Physical Activities in Past Month Cancer Screening Rates 2 Michigan vs. National Median 100% 80% 60% 40% 20% 0% Breast Cervical Colorectal Cancer Cancer Cancer Michigan National Michigan National , , Sources: Centers for Diseasee Control and Prevention and Behavioral Risk Factor Surveillancee System. This reflectss latest data available. New BRFSS data is expected in the fall of Michigan s National Ranking 543,470 cancer survivors highest rate of new cancer cases 16 th 17 th highest rate of cancer deaths Source: NCI/CDC State Cancer Profile ( ) and American Cancer Society Cancer Facts and Figures 2014 MCC Policy and Health Disparities Accomplishments, Priorities Developed 15 Activities Influenced 1,800 Michiganders Reached 40 Organizations Participated Thousands of Additional Residentss Reached 450 Activities Reported by MCC Member Organizations 3

8 ACCOMPLISHMENTS PREVENTION Cancer prevention includes those steps taken by individuals, organizations, or communities to prevent the development of the disease. The MCC s current priorities related to prevention include efforts to decrease tobacco use, increase HPV vaccination, and increasing the number of Michigan residents who lead a healthy lifestyle. 100% 80% HPV Vaccination (N=97) We have a kiosk at the Farmers Market in Flint where we promoted our Stop Smoking programs. We also have classes available for employees on lunch periods to access quit smoking programs. Marsha Schmit, Hurley Medical Center 60% 40% 20% 0% Source: IPR % 51% Promoted HPV Series Completion Promoted HPV Vaccine We assisted our local university, Northern Michigan University, to become a smoke-free campus Julie Scott, Marquette County Supporting healthy lifestyles is a step towards cancer prevention. Health Department MCC members are working to create opportunities for Michiganders to live a healthy lifestyle through increased physical activity, improved diet and nutrition, decreased obesity, limited sun exposure, and increased breastfeeding. 100% 80% 60% MCC Members Implementing Healthy Lifestyle Activities (N=76) 93% 86% 74% 40% 20% 50% 41% 0% Diet and Nutrition Physical Activity Obesity Breastfeeding Sun Exposure Source: IPR 2014 Webinars The MCC held two webinars in the fall of 2014 to address cancer prevention. Improving HPV Vaccination Rates in Michigan drew attendees from all over the country, with nearly 400 people participating. Pharmacologic Interventions for Breast Cancer Risk Reduction featured tools and resources from the MCC and drew 125 attendees. With requests for more information on e-cigarettes, an on-demand webinar was created. These webinars are available on the MCC website and have been viewed more than 400 times. 4

9 ACCOMPLISHMENTS EARLY DETECTION Early detection is discovering cancer or a premalignancy before an individual shows disease signs or symptoms. For certain cancers, screening tests can detect cancerous or precancerous changes at an early stage, allowing prompt treatment and the increased likelihood of a positive outcome. Early detection through regular screening examinations saves lives by identifying cancers when they are most curable and treatment is most likely successful. The MCC s current priorities related to cancer screening include increasing screening for breast, cervical, colorectal, and lung cancer. In 2014, MCC members participated in public education programs and promoted provider education to promote timely cancer screening. 80% MCC Members Implementing Early Detection Activities (N=95) 70% 60% 50% 72% 60% 53% 40% 30% 38% 20% 10% 0% Breast Colorectal Cervical Lung Source: IPR 2014 Policy and system change interventions have the potential to impact many people. These actions include focused legislative, community, or organizational change to result in long-lasting sustainable improvement. These efforts don t just rely on individual behavior change, but help to reduce cancer risk behaviors by creating an environment to make it easier to do something (eat healthier, get cancer screening, exercise more) or harder to do something (restrict smoking, remove soda machines in schools). MCC member organizations that are working on early detection activities are promoting and implementing several policy and system change interventions. LEGISLATIVE UPDATE In 2014, the Breast Cancer Awareness License plate was released. Now Michigan residents can visibly support and increase awareness of the importance of breast cancer early detection. 5

10 80% 70% 60% 73% Policy and System Change Interventions For Early Detection of Cancer (N=49) 67% 50% 40% 30% 49% 47% 41% 20% 10% 0% Patient Navigation Patient Reminder System Reduction of Structural Barriers Office Policy on Screening/ Referrals Provider Reminder System Source: IPR 2014 We moved our screening off site and are now doing screening at a local hospital and Federally Qualified Health Center. We made great changes to how we are doing referrals to these off site locations and have helped decrease the time between asking about screening and when they get an appointment. We are helping navigate these patients through the screening process and ensuring they get their follow up testing done as well. If they have missed a test we follow up with our off site provider as well as the patient. Barry Eaton District Health Department MCC Lung Cancer Early Detection Workgroup Develops Resources for Both Providers and Patients The MCC s Lung Cancer Early Detection Workgroup developed new resources in 2014 to assist MCC members and their patients with information related to lung cancer screening and tobacco dependence. 3 rd Year of MCC Challenge Completed The MCC Challenge assists MCC member organizations in implementing evidence-based Community Guide strategies to improve cancer screening rates among their employees. The three organizations participating in the 3 rd year of the project provided nearly 850 colorectal cancer (CRC) screening reminder postcards to employees. Each organization improved their CRC screening rates over the course of the year. 6

11 ACCOMPLISHMENTS DIAGNOSIS AND TREATMENT Patient navigators in breast and lung cancer programs work to follow and guide patients through their care beginning at the time of identifying the initial abnormality. A specialized social worker is also on staff and meets with all patients to ensure adequate care coordination, coverage and any other needs. Anas Al-Janadi, MD, Michigan State University- Breslin Cancer Center Timely and appropriate care following screening services ensures that individuals are adequately counseled about the results of their screening tests and, if needed, ensures patients are referred for further diagnostic testing and appropriate treatment. Quality cancer diagnostic results help inform all areas of patient care planning, including staging, treatment, palliation, rehabilitation, and surveillance. For patients diagnosed with cancer, access to evidence-based treatment is critical. Cancer treatment varies by type of cancer, stage at diagnosis, age of the person undergoing treatment and general health status. Genetics is playing an increased role in health care. Of the 37% of MCC organizations that work on activities related to genetic counseling, 78% reported that they implement activities to increase public knowledge on the impact of genetics on cancer risk and educate providers on evidence based guidelines regarding family history, genetic counseling, and testing. MCC members are also involved in activities related to cancer research. 35% 30% MCC Members Involved in Cancer Research Activities (N=88) 32% 25% 20% 15% 10% 16% 5% 0% Collection of bio-specimens Provision of clinical trials Source: IPR 2014 Prostate Cancer Decision Aid Updated The MCC s Making the Choice: Deciding What To Do About Early Stage Prostate Cancer booklet was updated in This is the fifth update for a long-standing MCC product, also available in Spanish and Arabic. 7

12 ACCOMPLISHMENTS SURVIVORSHIP Advances in early detection and treatment are improving cancer outcomes, and today more individuals are living many years after cancer diagnoses. Someone is considered a cancer survivor from the time of diagnosis through treatment and beyond. Survivorship encompasses more than just the need for services to address the psychosocial and spiritual impact of a cancer diagnosis. Health promotion after cancer treatment can improve survival and quality of life Number of MCC Member Organizations Implementing Survivorship Activities (N=97) 35 Survivor care plans 43 Advance care planning, hospice care or palliative care Awareness of and access to survivorship resources Comprehensive survivorship services 60 Navigation services Source: IPR 2014 Over 230 activities are held each month for the psychosocial well-being of cancer survivors and their families and friends. This includes lectures, workshops and support groups for people of all ages and types of cancer. Jan Miller, Gilda s Club-Grand Rapids Why Cancer Patients Should Quit Tobacco Video The MCC and the Michigan Oncology Quality Consortium (MOQC) partnership produced a new video to educate patients on the importance of quitting tobacco during and after cancer treatment. Survivorship Care Plan Update Webinar On July 1, 2014, the MDHHS hosted a webinar, in cooperation with the State of Colorado Central Cancer Registry, demonstrating a software system that would allow health providers to use state-held registry data to populate survivorship care plans. Survivorship Care Plan Learning Collaborative Many Michigan cancer centers and health systems participated in the Survivorship Care Plans Learning Collaborative, a partnership between the MCC and the Michigan Department of Health and Human Services (MDHHS) Cancer Prevention and Control Section. The learning collaborative will help these organizations meet the Commission on Cancer s standard for survivorship care plans. 8

13 M MCC HIGHLIGHTS MCC Board of Directors Meetings Four in 2014 The MCC board intentionally devotes meeting time to education and awareness activities that focus on current and timely cancer prevention and control issues. Board meetings weree held March 26, June 25, September 17, and November 5. MCC Receives C-Change s 2014 Comprehensive Cancer Control State Coalition Impact Award The MCC was selected to receivee C-Change s 2014 Comprehensive Cancer Control (CCC) State Coalition Impact Award. Susan Hoppough, MCC Co-Chair, accepted thee C-Change National Award from Duke Basketball coach, Mike Krzyzewski, on behalf of the Michigan Cancer Consortium. Michigan Cancer Consortium ss Newly Redesigned Website The MCC introduced its new website in 2014 after making significant revisions in appearance and content. Website work was guided by the MCC Communication Subcommittee. MCCC Annual Meeting Enhancing Clinical Care Through Collaboration With over 200 attendees, the November 5, 2014 MCC Annual Meetingg featured keynote speakers, educational breakout sessions, Spirit of Collaboration Awards, and poster presentations. Topics addressed in highly-rated breakout sessions include survivorship, cancer genetics, lung cancer screening and clinical trials. 9

14 C COMMUNITY IMPLEMENTATION Six organizations weree awarded Community Implementation Grants to support local implementation of Michigan s Cancer Plan. The Partners for Cessation project is raising awareness among the community, healthh care professionals and health care providers about tobacco related healthh disparitiess and the need to connect tobacco users to evidence-based cessation services. This projectt has made a systems change among six health care facilities in the districtt to make sure that all tobacco users are not only being asked and advised about tobacco use, but are also getting connected, if they chose, to cessation services. One goal of this project is to increase HPV vaccine compliance among youth and young adults by 20% %. A multi-component outreach campaign to reduce missed opportunities for HPV vaccination, increase access to HPV vaccination, and build youth and parent support for HPV vaccination is planned. A second goal is to work with 40 businesses to implement policy, system, and environmental level changes thatt support healthy lifestyles for employees. Individuals with a mental health diagnosis make up 20% of the population, but consume 31% of all cigarettes. To reduce the burden of smoking within this community this project is trainingg Ingham Community Health Center clinics to provide an effective tobaccoo cessation intervention to every tobacco user. This project supports Tobacco and You quit-tobacco classes which are led by Peer Support Specialists and held at locations that are familiar to individuals with a mental health diagnosis to make it easier for them to attend. While Michigan tribal clinics have policies in place to screen and refer adults for tobacco use they don t address this with younger patients. The purpose of this project is to utilize the data gathered in the American Indian Adult Tobacco Survey in expanding smoking cessation screening for youth. The Inter-Tribal Council is working with The Keweenaw Bay Indian Community and the Saginaw Chippewa Indian Community to implement this project with youth when receiving dental services. PATH (Personal Action Towardd Health), also knownn as The Stanford Chronic Disease Self-Management Program, is designed to help people learn techniques and strategies for the day-to-day management of chronic or long-term health conditions.. McLaren Oakland continues to use PATH specifically for cancer survivors. The primary goal of the Cancer Resource Navigator Link Project is to increase awareness and utilization of psychosocia al resources available to patients through Saint Joseph Mercy Hospital, the American Cancer Society, and Cancer Support Community. A resourcee navigationn coordinator links patients to the tremendous psychosocial support services available, which patients and family members would like to know about sooner after diagnosis. 10

15 SPIRIT OF COLLABORATION AWARDS Every year since 2001, the MCC has presented its highest honor the MCC Spirit of Collaboration Award to member organizations that have done outstanding collaborative work to significantly move comprehensive cancer control activities forward in our state. Enhancing Breast Cancer Genomics Best Practices and Policies in the State of Michigan ( ) This research-based collaboration involved numerous national, state, and local partners and utilized multi-faceted comprehensive cancer genomics programs to assure appropriate translation of health plan policy change, provider education, and surveillance to promote best BRCA practices. The ultimate impact of the project is a reduction in early breast and ovarian cancer deaths to Michigan residents resulting from appropriate use of cancer genetic and related clinical services in persons at risk. Jewish Women s Health Project The purpose of the project is to use a community based participatory research approach to address the specific cancer needs and issues among Orthodox Jewish women and to develop and pilot a cancer education program. A community cancer-related health survey was developed, 450 women received the survey in the mail, and 260 surveys were returned. The education program is a religious based cancer-related health education program. Collaborating partners were involved in the development of this program and the program is being delivered by community members. Michigan Oncology Quality Consortium MOQC identified a significant quality gap in terms of the lack of cessation counseling/referrals for cancer patients identified as tobacco users. The MCC and the MDHHS Tobacco Control Program worked to reduce barriers to referrals by funding free counseling and Nicotine Replacement Therapy (NRT) for cancer patients using the Quitline service. These organizations also partnered on a learning collaborative to improve cancer patient access to tobacco cessation services. Eighteen oncology practices/clinics (63 physicians) participated in 3 learning sessions to redesign care and identify best practices (this work has now spread to over 25 locations in Michigan and is one of the largest multi-site tobacco cessation programs for cancer patients in the country). As of April 2014, over 1,000 patients had been referred to Quitline. Personal Action Towards Health (PATH) PATH is Michigan s brand for the Stanford Chronic Disease Self-Management Program, an evidence-based 6-week workshop that meets once a week for 2.5 hours. The Redefining You: The New Normal After Cancer PATH program sought to empower cancer survivors to adopt healthier lifestyles. In its second year, a total of 48 participants attended at least 4 of the 6 sessions and all 48 participants stated they would use at least one of the self-management tools learned during PATH after the workshop ended. SPIRIT OF COLLABORATION HONORABLE MENTIONS Harley Men s Health Event Michigan Urological Surgery Improvement Collaborative (MUSIC) 11

16 MEMBER SATISFACTION AND INVOLVEMENT Implementation Progress Report Survey The Comprehensive Cancer Control Plan for Michigan serves as a guide to reducing the human and economic burden of cancer in the state. MCC member organizations and their partners work together to promote the plan and implement its strategies. The annual implementation progress report (IPR) survey evaluates the work of the Consortium towards the implementing the Cancer Plan. Additionally, the IPR survey assesses MCC members satisfaction with the operations of the Consortium. The completion rate for the 2014 IPR survey was 89%. The following graphic shows the types of agencies that make up the MCC membership. Health care insurance plans Trade/ professional/ advocacy organizations University based health care delivery systems with cancer programs Community based health care delivery systems and practices with cancer programs MCC Member Organizations Health education/ health research and evaluation including medical schools Public health organizations Organizations representing or serving hard to reach and/or special populations The MCC is the best run Board that I interact with in Michigan. The staff and leadership are outstanding. The content of the materials and meetings have a nice balance among research, community and medical issues and topics. Excellent job! Amy Ann Moore, Ingham County Health Department 12

17 MCC Leadership A majority of members feel that the MCC Board of Directors communicates effectively and provides strong leadership for the MCC. Members indicated that the following statements somewhat or completely describe the Board of Directors: Member Satisfaction with MCC Board of Directors (N=90) Represents the interests of the MCC membership as a whole Provides strong leadership Ensures relevant and timely communication Provides members with opportunities to be involved 84% 86% 88% 89% 0% 20% 40% 60% 80% 100% Source: IPR 2014 Involvement in the Work of the MCC MCC member organizations participate in the work of the MCC in a variety of ways, from communicating about the MCC s work within their organization to participating on a committee or workgroup. MCC members share information within and outside of their own organization about what the MCC does, including resources like the MCC Website, Tobacco Quitline Fax Back Form, the MCC Update newsletter and MCC cancer fact sheets and other resources for providers. Benefits of Being a MCC Member MCC member organizations value their association with MCC and gain several benefits as a result. The chart below depicts the top six benefits as identified by members. We are very glad that we partner with the MCC. Hiam Hamade, ACCESS Community Health Center Benefits of Being a MCC Member Organization (N=87) Opportunities to network with other professionals and leaders in cancer care Opportunities to network with representatives of similar organizations Opportunities to attend the annual meeting and hear educational presentations Knowing where to access patient education materials Knowing where to access guidelines, recommendations and other materials for providers Being informed on cancer-related resources, initiatives and programs 71% 71% 75% 84% 85% 92% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90%100% Source: IPR

18 ACKNOWLEDGEMENTS Many thanks to the MCC members who completed the 2014 implementation progress report survey this report is a reflection of your outstanding work! MCC Board of Directors The MCC Board of Directors represents the members and provides leadership and guidance to the MCC in their work. The 2014 MCC Board of Directors were: Co-Chair: Ernesto Drelichman, MD, FACS, St. John Providence Health System Co-Chair: Susan Hoppough, PhD, RN, The Lacks Cancer Center at Mercy Health Saint Mary's Immediate Past Co-Chair: Aaron P. Scholnik, MD, FACP, Marquette General Cancer Center Secretary: Noel Pingatore, BS, CPH, Inter-Tribal Council of Michigan, Inc. Anas Al-Janadi, MD, Michigan State University Breslin Cancer Center Alicia Gardner, RN, BSN, American Cancer Society, Inc. Lakeshore Division Kim Harrison, MHSA, Physician Resource Management, Inc. Elisabeth Heath, MD, Barbara Ann Karmanos Cancer Institute Karen Jennings, BA, Ingham County Health Department Carolyn Johnston, MD, University of Michigan Comprehensive Cancer Center Brian Lane, MD, PhD, Spectrum Health Cancer Program Tom Rich, MPH, American Cancer Society, Inc., Lakeshore Division Ann G. Schwartz, PhD, MPH, Barbara Ann Karmanos Cancer Institute Jane Severson, MSN, RN, MHSA, University of Michigan Comprehensive Cancer Center Mary Jo Voelpel, DO, FACOI, FACNM, Michigan Osteopathic Association Dana Zakalik, MD, Beaumont Health System Cancer Institute Joan Westendorp, OCN, MSN, RN, West Michigan Cancer Center MCC Committees Much of the work of the MCC happens in its committees, subcommittees and workgroups. Not involved yet? Consider joining a MCC committee! 14

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