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ACS National Consortium hosts first Issue Hub

​300 attendees learn how to boost cancer screening rates.

As part of our comprehensive effort to increase cancer screening rates, we launched a national consortium this spring to engage a diverse and influential group of leaders. 

On June 1, the consortium welcomed over 300 attendees to participate on our inaugural Issue Hub titled “Accelerating What We Know Works in Cancer Screening and Care.” National Consortium Issue Hubs are facilitated panel discussions with renowned subject matter experts who are challenged to identify, deliberate, and build consensus around the most pressing issues in the recovery and improvement of cancer screening and care nationwide. 

This was the first of three planned Issue Hubs this year.

This session explored key areas of national alignment in the implementation of evidence-based and emerging cancer screening activities. Moreover, the information gathered during this Issue Hub is critical to the future conversations and decision-making of the National Consortium. 

The panel for this Issue Hub reflected the level of thought-leaders and influential voices we hope to continue gathering around our virtual table. Panelists included:        

  • Keysha Brooks-Coley, MA – vice president, Federal Advocacy and Strategic Alliances, ACS CAN
  • Timothy Mullet, MD, FACS – chair, Commission on Cancer of the American College of Surgeons
  • Lisa Richardson, MD, MPH – director, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
  • Robert Smith, PhD – senior vice president, Cancer Screening, ACS
  • John Williams, MD, FACS – chair, President’s Cancer Panel
  • Discussion Lead: Rich Wender, MD –  chair, Family Medicine and Community Health University of Pennsylvania; chair, National Colorectal Cancer Roundtable

Throughout the 90-minute session, panelists shared their best thinking on:

  • The factors, big and small, that prevent us from seeing the outcomes we want to see in cancer screening and care.
  • How to accelerate adoption of proven cancer screening and care activities to reach our desired outcomes.
  • The innovations or opportunities necessitated by the pandemic that we could leverage to expand our capacity in cancer screening and care.

Attendees were invited to engage via virtual meeting tools, including live polling and idea boards. 

The National Consortium’s next Issue Hubs are tentatively scheduled for August and November. Panelists will rotate so that stakeholders around the country can listen to, learn from, and ideate with a variety of public health leaders, researchers, clinicians, and other thought leaders.  

Early survey results indicate an appetite for participation on these events: 

  • 97% thought the overall session was excellent or good
  • 99% would like to attend another Issue Hub
  • 97% would like to stay connected with the National Consortium efforts
  • 94% would recommend attending an Issue Hub to a colleague 
  • 92% learned something new and 91% learned something they would consider valuable

National Consortium members will reconvene on June 17 in a virtual summit to further consider the discussion of our first Issue Hub and look to provide actionable recommendations which are necessary to not just accelerate our recovery from the pandemic, but also accelerate our resilience and overall improvement in providing quality cancer screening and care for all. 

A recording of the June Issue Hub is available here. A summary report of the Issue Hub will be made available by June 18. For questions about the consortium, contact Sarah Shafir or Caleb Level. View a list of the consortium members.

About ACS’s National Consortium

ACS and ACS CAN have organized mission priorities and program work to effectively respond to consequences from the COVID-19 pandemic on cancer screening and care. The National Consortium, which focuses on accelerating, strengthening, and mobilizing, is one component of this initiative. It is an issue-focused, time-bound partnership that is dedicated to the acceleration of a national response to the COVID-19 pandemic in relation to its detrimental impact on our collective progress in cancer screening and care across the U.S. Our overall return to screening effort is supported by Genentech, Pfizer, Merck, and the National Football League. 


  • NCI showcases ACS Senior Scientific Director Rebecca Siegel’s CRC research

    This year marks the 50th anniversary of the National Cancer Act of 1971, which created a national commitment to making progress against cancer. The law established the National Cancer Institute (NCI) in its current form and represented the US’s commitment to the “war on cancer,” as then-President Nixon described it.

    To highlight progress against cancer since the law’s inception, the National Cancer Institute this year is sharing groundbreaking developments in cancer research. One of the brilliant scientists featured on their website right now is our own Rebecca Siegel, MPH, senior scientific director, Surveillance Research.

    The article shares how Becky examined data from the NCI’s SEER program and other cancer databases to uncover an increase in the number of people under 50 being diagnosed with colorectal cancer, which led ACS to lower our CRC screening age from 50 to 45 in 2018, no doubt saving countless lives. The USPSTF just followed suit last month, joining ACS in recommending people at average risk begin screening for CRC at age 45.

    Congrats to Becky on this well-deserved recognition! This is a terrific example of the kind of research and innovation ACS is known for. Be sure to check out the story – it’s a great read!


  • Study underscores dangers of insurance disruption

    ​Lack of coverage consistently associated with worse healthcare access.

    A new study underscores the importance of health insurance coverage continuity in access to and receipt of care and care affordability in the U.S. Researchers found that health insurance coverage disruptions were consistently associated with worse healthcare access and problems with care affordability. The study appears in the American Journal of Preventive Medicine. 

    Decades of research has demonstrated that health insurance coverage is associated with better access to care and health outcomes in the U.S. However, less research has addressed coverage disruptions (i.e., periods without insurance) among adults with current coverage and the relationship of disruptions to care access, receipt of recommended preventive services, and affordability. To learn more, investigators led by Robin Yabroff (pictured here), PhD, MBA, our scientific VP, Health Services Research, conducted a comprehensive examination of insurance coverage disruptions among adults aged 18 to 64 years from the 2011-2018 National Health Interview Survey using multiple measures of access and affordability, and evaluated the effects of the duration of coverage disruption among currently insured and uninsured.  

    The study found that prior disruptions in insurance coverage were relatively common among adults aged 18-64 years. Among currently insured adults, 5.0% with private insurance and 10.7% with public insurance reported a coverage disruption in the prior year, representing nearly 9.1 million adults in 2018. Among currently uninsured adults, 24.9% reported coverage loss within the prior year, representing nearly 8.1 million adults in 2018. Compared to adults with continuous health insurance coverage, adults with coverage disruptions were less likely to receive recommended preventive services and more likely to forgo any needed care because of cost and report medication non-adherence because of cost.  

    Longer coverage disruptions were associated with worse care access and affordability. The magnitude of associations between coverage disruptions and care access and affordability was similar among adults with either current private or current public coverage. Currently uninsured adults, especially with longer uninsured periods, reported significantly worse care access, receipt, and affordability than currently insured adults with coverage disruptions or continuous coverage.  

    “Our findings highlight the importance of health insurance coverage continuity related to access to care and affordability. This is especially relevant with recent increases in unemployment due to the COVID-19 pandemic and widespread loss of employer-based private coverage, the primary source of private coverage in the working-age population,” said the authors. 

    Article: Yabroff R, Zhao, J, Halpern M, Fedewa S, Han X, Nogueira L, Zheng Z, Jemal A. Health insurance disruptions and care access and affordability in the US. AJPM: American Journal of Preventive Medicine, 2021. doi: 0.1016/j.amepre.2021.02.014. 


  • Breast cancer survivors at higher risk for future cancers

    Study evaluates risk by tumor subtypes and diagnosis age of breast cancer.

    A new study finds breast cancer survivors in general have higher risk of new cancer diagnosis compared to healthy individuals. The article, published May 18 in CANCER, states that compared to the general population in the U.S., the risk of new cancer diagnoses among survivors was 20% higher for those with hormone receptor (HR) positive cancers and 44% higher for those with HR-negative cancers.  

    Breast cancer is the most commonly diagnosed and prevalent cancer among women in the U.S., with more than 3.9 million breast cancer survivors as of 2019. That number is expected to increase with the aging population and advances in breast cancer treatment. 

    Subsequent primary cancer (SPC) after breast cancer is a well-known late effect, but the risk by breast cancer subtype and age at diagnosis was largely unknown except for contralateral breast, lung, and ovarian cancers. 

    This study, led by Hyuna Sung, PhD, ACS Principal Scientist, Cancer Surveillance Research (pictured here), is the first to examine the risk of a range of SPCs including 26 types, and evaluate the risk by tumor subtypes and diagnosis age of breast cancer. This study included women (aged 20 to 84 years) diagnosed with invasive breast cancer from 1992-2015 and who survived for a year or more. 

    “With most women living decades after a breast cancer diagnosis, it is important to identify survivors at higher risk for future cancers and provide tailored recommendations for risk reduction and early detection,” said Dr. Sung.  

    Data show that the risk differs by survivor characteristics, such as breast cancer subtypes and their diagnosis age. For example, several cancers including subsequent breast cancer, acute nonlymphocytic leukemia, ovarian cancer, and lung cancer are more likely to develop after HR-negative cancer than after HR-positive cancer. Women who were first diagnosed with breast cancer before age 50 also have greater risk for subsequent cancer than women with later onset breast cancer. 

    “Differential risk of subsequent cancer according to survivor characteristics highlights that more targeted approaches for cancer prevention and early-detection strategies are needed in survivorship care planning to mitigate the burden of subsequent cancers in the growing population of survivors,” said the authors. 


  • Cancer prevention & early detection still suboptimal in the U.S.

    ​Historical gains in smoking cessation undercut by social and geographic disparities.

    Cancer prevention and early detection measures show mixed progress, and substantial racial/ethnic, socioeconomic, and geographic disparities continue to exist, according to American Cancer Society data on cancer prevention and early detection efforts in the U.S. in 2018 and 2019, pre-COVID-19. 

    This study is published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research, and accompanies our biennial report, Cancer Prevention & Early Detection Facts & Figures (pictured above). It is one of the only sources that looks at major modifiable cancer risk factors, including tobacco use, obesity, diet and physical activity, HPV vaccination, ultraviolet radiation exposure, environmental exposure, and screening test use.

    In 2021, an estimated 608,570 cancer deaths are expected to occur in the U.S. with about 45% attributable to behaviors that could be changed, such as cigarette smoking, excess body weight, alcohol intake, physical inactivity, and unhealthy diet. Cigarette smoking alone accounts for nearly 30% of cancer deaths.

    The article, led by Priti Bandi, PhD (pictured here), reported a mixed picture, with historic lows in smoking rates but suboptimal obesity, cancer screening, and HPV vaccination levels. Additionally, racial/ethnic, and socioeconomic status disparities persisted across most major modifiable cancer risk factors and preventive outcomes. We know that screening rates, not where we wanted them to be pre-COVID, dropped precipitously during the pandemic.

    Tobacco

    Cigarette smoking in 2019 reached a historic low (14.2%) mainly because 61.7% (54.9 million) of all persons who ever smoked quit (a measure also known as the quit ratio). While the quit ratio has improved across most subpopulations since 1965, it continues to be lower among persons who are Black, American Indian/Alaska Native, poor, lower educated, lesbian, gay, or bisexual, and residents of Southern states.

    Persons who smoke in many of these same subgroups also have lower levels of recent successful cessation, despite having similar or higher quit attempt levels. This disparity was most striking among lower-income and Medicaid insured or uninsured persons in whom the successful cessation rate is about 40% lower than higher income and privately insured persons, respectively, even though their quit attempt prevalence was similar.

    Despite being recommended as effective clinical cessation interventions since the late-1990s, only 71.7% reported getting medical doctor advice to quit, and just about 1 in 3 used evidence-based cessation treatments for tobacco dependence in 2018-2019, with significantly lower levels among those who were Hispanic, younger, and Southern residents.

    “While historical gains in smoking cessation have led to steep declines in lung cancer mortality in the past decade, substantial progress can still be made by improving cessation outcomes among socially vulnerable groups. Much can be achieved by expanding tobacco cessation coverage in state Medicaid programs and equitably implementing effective tobacco control policies within and across U.S. states,” Dr. Bandi said.

    Cancer Screening

    Early detection of cancer through screening reduces mortality from cancers of the breast, cervix, colon, rectum, and lung. Colorectal and cervical cancers screening can also prevent these cancers by identifying precancerous lesions that can be removed. Cancer screening prevalence was suboptimal in 2018 (colorectal cancer ≥50 years: 65.6%; breast ≥45 years: 63.2%; cervical 21-65 years: 83.7%), especially among uninsured adults (colorectal: 29.8%; breast: 31.1%).

    Approximately 18% of cancer cases in the U.S. can be attributed to a combination of excess body weight, insufficient physical activity, unhealthy diet, and consumption of alcoholic beverages.

    Excess Body Weight

    Obesity levels remain high in 2017-2018. Among adults >20 years, the prevalence of obesity was 42.4% (an estimated 99.14 million adults), and the prevalence of overweight was 30.7%. Overall, obesity prevalence was disproportionately higher among Black (56.9%) and Hispanic (43.7%) women and lowest among Asian men (17.5%) and women (17.2%).

    Physical Activity

    In 2018, over a quarter (25.6%) of adults reported no leisure time physical activity. The disparity by education was vast, ranging from nearly half (48.2%) of people with <high school education compared to 14.5% of college graduates.

    Diet

    Overall, most adults do not meet the guidelines for healthy eating. In 2019, about 12.3% of adults reported consuming three or more servings of vegetables per day and about 26.2% of adults reported eating two or more servings of fruit daily. Vegetable consumption was higher among Asian and White women than Hispanic or Black women.

    Alcohol

    In 2018, an estimated 5.1% of adults were classified as heavier drinkers (12+ drinks in lifetime, and >14 drinks per week for men; >7 drinks per week for women). Heavier alcohol consumption increased with higher levels of education among women (2.4% with less than a high school diploma vs. 6.4% of college graduates); whereas among men prevalence was highest (7.1%) in men with less than a high school diploma and lowest (4.2%) among college educated.

    HPV Vaccination

    In 2019, data show the HPV vaccination in adolescents (aged 13-17 years) remains underutilized and over 40% were not up to date. In adults (ages 19-26 years), 52% of women and 31.7% of men reported ever having received one or more dose of the HPV vaccine.

    “More work is needed in order to further reduce cancer risk factors and improve cancer screening,” said the authors. “Immediate actions are needed to increase smoking cessation in health disparate populations, stem the tide of obesity epidemic, and improve screening and HPV vaccination coverage.” 

    Article: Bandi P, Minihan A, Siegel RL, Islami F, Nargis N, Jemal A, Fedewa SA. Updated Review of Major Cancer Risk Factors and Screening Test Use in the United States in 2018 and 2019, with a Focus on Smoking Cessation. Cancer Epidemiology Biomarkers & Prevention 2021. doi: 10.1158/1055-9965.EPI-20-1754.


  • USPSTF updates colorectal cancer screening guideline

    ​Taskforce now aligns with ACS recommendation to start at 45.

    Update USPSTF updates colorectal cancer screening guideline Taskforce now aligns with ACS recommendation to start at 45.

    The United States Preventive Services Taskforce (USPSTF), an independent, volunteer panel of national experts in prevention and evidence-based medicine, today announced their final recommendation statement, evidence summary, and modeling study on screening for colorectal cancer.  

    Since 2018, the American Cancer Society has recommended adults begin screening at age 45. Now, the USPSTF will also recommend screening beginning at age 45, rather than at age 50 as previously recommended. The taskforce’s lowered screening age aims to address the rising incidence of colorectal cancer in younger adults and now aligns with ACS’s research findings and guidelines. 

    The USPSTF’s updated guidelines have positive implications for insurance coverage for colorectal cancer screening for many people. The final guideline now classifies screenings for adults ages 50 to 75 as an “A” recommendation and ages 45 to 49 as a “B” recommendation. The Affordable Care Act (ACA) requires non-grandfathered private health insurance plans and Medicaid expansion plans to cover all preventive services that receive an “A” or “B” grade from USPSTF, which means individuals with ACA-compliant plans ages 45-49 who previously were not eligible to get coverage for colorectal screenings will gain coverage at no cost. 

    ACS and ACS CAN shared this joint statement about the taskforce’s recommendation. It may be shared with local media as appropriate.


  • ACS seeks applications for health equity grants; letters of intent due before June 16

    ​This new program will fund Cancer Health Equity Research Centers at minority serving institutions.

    The American Cancer Society is deeply committed to addressing the complex societal factors – such as racism, discrimination, and poverty – that prevent all people from having a fair and just opportunity to prevent, find, treat, and survive cancer. Now, we’re launching a new competitive grant program to help minority serving institutions target cancer health disparities unique to a local community. 

    This funding is intended to support the formation of new Cancer Health Equity Research Centers (CHERCs) at minority serving institutions. To be considered a minority serving institution, at least 25-50% of a college or university’s enrollment should be comprised of a single or combination of racial or ethnic minorities, such as Historically Black Colleges and Universities, Hispanic-Serving Institutions, Tribal Universities, Alaska Native and Native Hawaiian Serving Institutions, and Asian American and Pacific Islander Serving Institutions. The grants will help stimulate novel collaborations and approaches to mitigate societal risk factors, contributing to our goals for achieving health equity and reducing cancer mortality. 

    Visit cancer.org to learn more about the program and share with your fellow volunteers and supporters yet another way ACS is innovating to reduce disparities and move closer to health equity. 

    Important dates 

    Letters of intent are due by 11:59 p.m. ET on June 15, 2021. Those letters will be used for selecting investigators to submit a full application. An independent and competitive peer review of grant applications will be conducted in October 2021, and awardees will be notified on Oct. 27, 2021.

    Potential applicants can learn more by attending a 2 p.m. ET Microsoft Teams meeting on May 20. It will be recorded.

    Again, all these details and more can be found on cancer.org.


  • ResearcHERS campaigns kick off this month

    ​The goal is to raise at least $1.6 million.

    ResearcHERS is a movement that shines a light on the incredible discoveries made by women, and empowers women leaders to support the American Cancer Society’s national research program that funds some of the brightest female minds in cancer research. 

    This  fundraising campaign began in the North Central Region in 2019 and now has a nationwide focus with 32 campaigns in the month of May – goaled at over $1.6 million. As of May 3, more than $640,000 had already been raised. 

    ResearcHERS is fundraising by women, to support and sustain women-led research and careers. Here’s how:

    The staff supporting ResearcHERS: Women Fighting Cancer of Indiana in the North Central Region are celebrating a big win.. Through engaging leaders, stewarding past ambassadors, and leveraging volunteers to exceed goal, the campaign recently secured an individual personal gift of $150,000 for one of their ambassadors. 

    The recipient, Cathy Langham, is the co-chair for the Indiana campaign. She secured the gift through sharing the ACS story and demonstrating how the donation will impact our mission. Cathy is now the top candidate on the leaderboard for ResearcHERS by over $100,000. 


    More about ResearcHERS

    The American Cancer Society is proud to be a top supporter of women in cancer research. Currently, nearly half of ACS’ grantees are women, most of them early in their careers. As of January 1, 2021, there are 664 grants in effect totaling $382.3 million and of that total 299 are women-led research projects totaling $156.1 million. Your are invited to view replays of the inspiring virtual kick-offs that took place in April in the North Central and Northeast Regions.

    If you  would like to learn more about the ResearcHERS campaigns, visit www.acsresearchers.org.


  • CANCER announces new editor-in-chief

    ​Suresh S. Ramalingam, MD, succeeds Fadlo R. Khuri, MD.

    CANCER, a peer-reviewed journal of the American Cancer Society, today announced that Suresh S. Ramalingam, MD, will join the journal as the new editor-in-chief, with a five-year editorship beginning on July 1, 2021. Dr. Ramalingam is internationally recognized for his research, specifically for the development of individualized therapies for patients with small cell and non-small cell lung cancer. 

    Currently, Dr. Ramalingam is deputy director of Winship Cancer Institute of Emory University, where he leads the integration of the research, clinical, and educational components, and is assistant dean for cancer research at Emory University School of Medicine. He has worked with CANCER as the editor for the journal’s Chest and Lung Disease, Clinical Trials, and Medical Oncology sections since 2011. 

    “I am incredibly honored to serve as the new editor-in-chief of CANCER, one of the oldest and most prestigious oncology journals, which has been positioned as an important global forum for exchange of scientific knowledge under the leadership of my predecessor Dr. Fadlo R. Khuri,” said Dr. Ramalingam. “I look forward to continuing to position CANCER as a destination journal of major research discoveries and to help the journal grow in reputation and impact.”

    Dr. Ramalingam succeeds Dr. Khuri, who leaves the editor-in-chief position after 10 years of providing vision, leadership, and dedicated service to help increase the journal’s visibility among some of the top research journals in the field. During his tenure, submissions to CANCER increased by more than 40% and full-text accesses to the journal’s online content more than doubled, making it the most downloaded medical journal on Wiley Online Library.

    “We are incredibly grateful for all that Dr. Khuri has done to elevate CANCER’s esteemed format and reputation within the oncology community as he is praised by his colleagues for his dedication to the journal,” said Bill Cance, MD, our chief medical and scientific officer. “We are excited to continue that legacy and scientific impact of the journal among leading researchers under the new editorship of Dr. Ramalingam.” 

    Dr. Ramalingam holds additional titles at Emory University School of Medicine including professor of hematology and medical oncology, director of the Division of Medical Oncology, and the Roberto C. Goizueta Distinguished Chair for Cancer Research.

    About CANCER
    CANCER is a peer-reviewed publication of the American Cancer Society integrating scientific information from worldwide sources for all oncologic specialties. The objective of CANCER is to provide an interdisciplinary forum for the exchange of information among oncologic disciplines concerned with the etiology, course, and treatment of human cancer. CANCER is published on behalf of the American Cancer Society by Wiley and can be accessed online.
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