CDC s National Comprehensive Cancer Control Program (NCCCP): 2010 Priorities and New Program Opportunities Laura Seeff MD Chief, Comprehensive Cancer Control Branch Division of Cancer Prevention and Control National Comprehensive Cancer Control Program Director's Meeting June 7, 2010 Los Angeles, CA National Center for Chronic Disease Prevention and Health Promotion
CDC s National Comprehensive Cancer Control (CCC) Program 65 programs in each US state, DC, 7 tribal organizations, 7 territories 69 cancer plans nationwide; 95% in implementation Robust state-, tribal-, territorial-wide coalitions work with diverse partners All work across cancer continuum, policy interventions
2010 National Comprehensive Cancer Control Status of Cancer Plans South Puget Intertribal Planning Agency Northwest Portland Area Indian Health Board CA OR WA OR NV ID UT MT WY CO ND Aberdeen Area Tribal Chairmen s Health Board SD NE KS MN IA Fond Du Lac Reservation MO WI IL IN MI KY OH WV PA VA NY NJ VT NH MA CT DC DE MD ME RI AK AZ Tohono Northwest O Odham Portland Area Indian Nation Health Board NM Cherokee Nation OK AR MS TN AL GA SC NC TX LA Alaska Native Tribal Health Consortium HI FL AMERICAN SAMOA FEDERATED STATES OF MICRONESIA GUAM COMMONWEALTH OF THE NORTHERN MARIANA ISLANDS PUERTO RICO REPUBLIC OF THE MARSHALL ISLANDS REPUBLIC OF PALAU Creating New Plan Current Plan or Updating Plan National Comprehensive Cancer Control Program Division of Cancer Prevention and Control National Center for Chronic Disease Prevention and Health Promotion Office of Noncommunicable Diseases, Injury and Environmental Health February 2010
Comprehensive Cancer Control (CCC) Priority Setting Process, 2010: Why? Developed priorities for CDC-funded CCC activities Build on success of NCCCP Emphasis on measurable outcomes, value of efforts, and highest impact Long standing focus areas Resonate with cancer continuum framework
Comprehensive Cancer Control (CCC) Priority Implementation: How? CCC work may be broader in scope Continue interventions under current plans Continue to emphasize these priority areas As plans updated, enhance priority areas Implement through new funding opportunities
CDC-funded CCC Program Priorities 2010 Emphasize Primary Prevention Coordinate Early Detection and Treatment Interventions Address Public Health Needs of Cancer Survivors Implement Policies to Sustain Cancer Control Eliminate Health Disparities to Achieve Health Equity Use Evidence and Measure Impact through Evaluation
EMPHASIZE PRIMARY PREVENTION
Emphasize Primary Prevention: Strategies Collaborate with tobacco, physical activity, nutrition, obesity, vaccine, diabetes and other relevant partners to implement evidence-based primary prevention interventions Consider effective policy changes to guide primary prevention efforts Develop and provide consistent primary prevention messages Support collaborative primary prevention research activities
Emphasize Primary Prevention: Example Activities Develop collaborative messaging and activities that address cancer risk behaviors and link them to chronic disease outcomes Provide evidentiary basis for effective primary prevention health policies Use coalition to: Implement smoke-free policies and/or tobacco-free policies Restrict tobacco sales (internet, to minors, at stores/events) Implement of Human Papilloma Virus (HPV) and Hepatitis B Virus (HBV) vaccine policy Establish legislation to require daily quality PE in schools Regulate use of indoor tanning devices by children and adolescents
COORDINATE EARLY DETECTION AND TREATMENT INTERVENTIONS
Coordinate Early Detection and Treatment Activities Using Coalition: Strategies Populate coalition with key cancer control representatives who can be successful in implementing cancer control activities Use CCC program and coalition to link cancer control programs and clinical and public health systems Support cancer patient navigator and community health worker programs
Coordinate Early Detection and Treatment Activities Using Coalition: Example Activities Define the expectations and outcomes of the partnership/coalition, and routinely evaluate success Bridge clinical health and public health systems and include members of these systems in coalition Link cancer control with other chronic disease activities by integrating patient navigator programs
Number ADDRESS PUBLIC HEALTH NEEDS OF CANCER SURVIVORS 12,000,000 10,000,000 8,000,000 6,000,000 4,000,000 2,000,000 0 1971 1976 1981 1986 1991 1996 2001 2006 Year 11.4 Million Estimated Cancer Survivors in the U.S. in 2006
Address Public Health needs of Cancer Survivors: Strategies Define the scope, needs, and health behaviors of the cancer survivor population Enhance survivorship surveillance Define health risks from cancer treatment and disseminate clinical management guidelines for cancer survivors Ensure that cancer survivors have access to a medical home Assess capacity to support survivorship interventions
Address Public Health needs of Cancer Survivors: Example Activities Utilize and maintain the BRFSS survivorship module Use cancer registry data to define interventions for follow-up treatment and care among cancer survivors Develop evaluation measures for survivorship interventions Conduct research to assess health risks associated with cancer treatment Continue primary and secondary prevention efforts for survivors Monitor and track progress of cancer survivors health, economic, psychosocial issues
CROSS-CUTTING PRIORITIES POLICY DISPARITIES IMPACT
Develop and Implement a Cancer Control Policy Agenda: Strategies Provide evidentiary basis for effectiveness of health policies Include coalition members who can effectively implement evidence based cancer control policies to increase primary, secondary and tertiary prevention of cancer Use coalition to implement evidence based policy interventions with well defined goals and outcomes
Develop and Implement a Cancer Control Policy Agenda: Example Activities Maintain staff with competency in issue framing and policy analysis & formulation Develop and implement strategy to support policy interventions Engage community in supporting policy interventions Use coalition to engage policy makers
Eliminate Health Disparities to Achieve Health Equity: Strategies Enhance data collection and reporting of incidence, prevalence, and mortality, and related adverse conditions among subpopulations. by age, gender, race/ethnicity, income, education level, health literacy level, health insurance status, geographic location, language, or other sociodemographic factors Maintain diversity within coalition Collaborate with partners on activities to eliminate health disparities
Eliminate Health Disparities to Achieve Health Equity: Example Activities Assess/monitor coalition structure Support workforce development and training opportunities to diversify the public health workforce Identify existing data resources to measure disparate disease burden of cancer and related adverse conditions Expand existing or develop new data resources Track progress in eliminating health disparities using periodic status reports Conduct health disparities research
Use Evidence and Measure Impact Through Evaluation: Strategies Ensure that all comprehensive cancer control interventions are evidence-based or contribute to the evidence base Ensure that all CCC interventions and activities reflect cancer surveillance data Develop capacity to implement quality evaluations
Use Evidence and Measure Impact Through Evaluation: Example Activities Utilize NPCR and other cancer surveillance data to develop cancer interventions Maintain current knowledge of cancer control evidence base Conduct routine evaluation of all CCC activities and disseminate and translate evaluation findings to improve programmatic efforts Focus on reducing the burden of the top 3-4 cancers in each state/tribe/territory/jurisdiction
New Program Opportunities 2010 New Policy Implementation Funding Announcement Comparative Effectiveness Research project with Tobacco Quitline Programs
New 2010 Funding Opportunity: Demonstrating the Capacity of Comprehensive Cancer Control Programs to Implement Policy and Environmental Cancer Control Interventions CDC-RFA DP10-1017 New 5-year program designed for NCCCP grantees To demonstrate the enhancement and expansion of existing recipient activity under DP07-703 entitled Effect Policy Change Eligible applicants are CCC programs funded under DP07-703 Technical assistance calls with dial-in information in amended FOA Monday, June 21, 2010 from 9:30 a.m. to 11:30 a.m. (east coast) Tuesday, June 22, 2010 from 3:30 p.m. to 5:30 p.m. (east coast) Application submission date July 26, 2010
Background Demonstrate ability of CCC programs to fully develop and implement cancer-specific policy agenda to advance policy, environmental, and systems changes to improve cancer control Enhance primary, secondary, and tertiary prevention of cancer and have broad population reach Should address decreased tobacco use, increased physical activity, healthier diets, increased access to screening tests, improved screening among survivors to reduce the risk of recurrent or new cancers, and improved delivery of high quality cancer care
Select Recipient Activities Retain appropriate staff Obtain state and local support for policy and environmental change using CCC coalition as foundation Develop a policy agenda Implement activities to advance 3-5 policy or environmental changes to improve cancer control within the 5-year program period Collaborate and coordinate with appropriate ARRA-funded partners Evaluate and monitor progress
New Program Opportunities 2010 New Policy Implementation Funding Announcement Comparative Effectiveness Research with Tobacco Quitline Programs
Thank you! The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.