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Three major companies share success toward 80% by 2018

​More than 260 participants tuned into our Nov. 30 80% by 2018 webinar – Employer Strategies for Success!  AmerenAT&T, and Progressive Insurance all presented compelling stories and showed how their evidence-based efforts are increasing colorectal cancer screening rates across the board at their companies. The recorded webinar and slide deck are now available in the Resource Center on the National Colorectal Cancer Roundtable website

Ameren has been working on a colorectal cancer screening initiative for several years now. They have a well-planned, comprehensive approach getting them closer and closer to 80% screened and have been recognized by the St. Louis Business Journal. AT&T is just getting started but has already seen increases in screening through their multi-faceted communication plan, including the use of internal company celebrities. Progressive Insurance wasn't seeing the results they hoped for so they created a low-cost but innovative idea to promote screening and saw impressive success.  We also heard two personal stories from our presenters and how this work has directly impacted them and their families.  

The webinar began with a brief introduction to steps employers can take to increase screening rates at their company, and also discussed how the language of the 80% by 2018 initiative is transitioning as we look into 2018 and beyond. 

Survey respondents gave positive feedback about the webinar:

  • 91% agreed the webinar delivered the information expected
  • 98% agreed the subject matter was presented effectively
  • 100% agreed the presenters were knowledgeable
  • 84% believed they gained new knowledge applicable to their work
  • 86% planned to apply what they learned from the webinar
  • 75% of age-eligible responders plan to get screened in the next six months                   

If you have any questions or would like the roster of attendees to see if any of your accounts joined, please email us at mpm@cancer.org.

  • National Lung Cancer Roundtable brings together patients, organizations, and clinicians at its first annual meeting

    The National Lung Cancer Roundtable held its inaugural meeting on December 11-12, in Bethesda, MD, the first major meeting for the new nationwide coalition of organizations committed to addressing the challenges of moving lung cancer screening into the mainstream. This year, 222,500 people in the U.S. will be diagnosed with lung cancer.

    The Roundtable launched in March 2017 and currently includes roughly 65 organizational members, among them clinical professionals, researchers, lung cancer advocates and patients, healthcare organizations and cancer centers, insurers, and government agencies.

    The first annual meeting featured keynote speaker Chris Draft (pictured here), a former NFL player who launched Team Draft in 2011 with his wife Keasha, a nonsmoker who died of lung cancer. The agenda included updates on the work so far, a workplan for 2018, and breakout sessions on lung cancer screening implementation, provider engagement and outreach, tobacco cessation in the context of lung cancer screening, shared decision-making, and optimal therapy.

    "Whatever one's connection to lung cancer, whether involved in research, clinical medicine, public health, or advocacy, no one has a greater understanding of the impact of that work than the patient," said "K" (Karen) Latzka, lung cancer survivor. "Within the patient community are passionate, intelligent, and caring individuals just waiting to take part in this important work, and I'm honored to be at the Roundtable as their representative."

    "By working together, rather than independently, we will make greater and faster progress in reducing the burden of this terrible disease," said Ella Kazerooni, MD, professor of radiology at the University of Michigan and chair of the National Lung Cancer Roundtable. 

    "It is an honor to give the keynote speech at the American Cancer Society's first National Lung Cancer Roundtable conference," said Draft. "My wife, Keasha, was diagnosed with lung cancer in December 2010, and unfortunately passed in December 2011. From that time, I have witnessed tremendous innovations in lung cancer with respect to awareness, detection, treatment, research and survivorship. We are on the cusp of drastically changing the survival rate in lung cancer, so I believe it a perfect time to convene the thought leaders in lung cancer and figure out how we can make a larger impact together moving forward."

    Deena Cook, patient advocate with the Lung Cancer Alliance, noted that "to successfully implement a lifesaving lung cancer screening program, we must cut through the stigma" surrounding the disease.

    The members of the Steering Committee are:

    • Ella A. Kazerooni, MD, MS (chair), University of Michigan

    • Douglas E. Wood, MD (vice chair), University of Washington

    • Robert A. Smith, PHD (PI), American Cancer Society

    • Joseph Chin, MD, MS, Centers for Medicare and Medicaid Services

    • V. Paul Doria-Rose, DVM, PhD, National Cancer Institute

    • Laurie Fenton Ambrose, Lung Cancer Alliance

    • Thomas P. Houston, MD, American Academy of Family Physicians

    • Jane Kim, MD, MPH, Department of Veterans Affairs

    • Bryan Loy, MD, MBA, Humana

    • Peter Mazzone, MD, MPH, Cleveland Clinic

    • Jamie S. Ostroff, PHD, Memorial Sloan Kettering Cancer Center

    • Gerard A. Silvestri, MD, MS, Medical University of South Carolina

    • Joelle Thirsk Fathi, DNP, RN, ARNP, Washington State Nurses Association

    Check out participants' Twitter posts by searching #NLCRT2017.

    The Roundtable is funded by an unrestricted educational grant from AstraZeneca and in-kind support from the American Cancer Society. For more information, contact Lauren Rosenthal, MPH, director of the NLCRT at lauren.rosenthal@cancer.org and Robert A. Smith, PhD., vce president of cancer screening at the American Cancer Society, at robert.smith@cancer.org.

  • Study finds even newer, low-dose hormonal birth control raises breast cancer risk slightly

    A study of Danish women finds that newer forms of contraceptives, including birth control pills and hormone-releasing IUDs, increase the risk of breast cancer about as much as older forms of hormonal contraceptives – about 20%. 

    "A 20 percent increase of a very small number is still a very small number,"  Mia Gaudet, PhD, our strategic director, Breast and Gynecologic Cancer Research, told NPR. The risk contributed by hormonal contraception, she says, is similar to the extra breast cancer risk contributed by physical inactivity, excessive weight gain in adulthood, or drinking an average of one or more alcoholic drinks per day.

    "The absolute increase in risk [found in the study] is 13 per 100,000 women overall, but only 2 per 100,000 women younger than 35 years of age," writes epidemiologist David Hunter, of the University of Oxford, in an editorial accompanying the study published Dec. 6 in the New England Journal of Medicine.

    Studies have long shown that hormonal birth control slightly raises breast cancer risk. But newer contraceptives contain less of the hormone drugs estradiol and progestin, and it was hoped that they would not increase breast cancer risk as much.

    Mia said the findings don’t necessarily mean that women should stop using hormonal contraceptives. She says women need to balance their immediate needs with long-term risk. They should also take into consideration that older studies have linked hormonal contraceptives to a lower risk of getting ovarian, endometrial, and colorectal cancers later in life.Women may want to have a discussion about the benefits and risks of hormonal contraceptives with their doctor.

    Read more on cancer.org.

  • Cancer survival data reveal large, consistent, and persistent racial disparities

    Cancer, a peer-reviewed journal of the American Cancer Society, has published a supplement entitled "Population-Based Cancer Survival in the United States (2001-2009): Findings from the CONCORD-2 Study" sponsored by the U.S. Centers for Disease Control and Prevention (CDC).

    In this supplement, the authors provide survival estimates by race (black, white), state of residence at diagnosis, and stage at diagnosis for nine solid tumors in adults, and for acute lymphoblastic leukemia in children. Data are from 37 statewide cancer registries that participated in the CONCORD-2 study, covering 80% of the U.S. population. 

    Each of the 10 cancer-specific papers includes clinical and cancer control perspectives. These perspectives highlight how clinical practice may have had an impact on population-based cancer survival trends, and how states funded by the CDC's National Comprehensive Cancer Control Program can use population-based survival data, along with incidence and mortality data, to inform cancer control activities.

    For the analyses, a team led by investigators at the CDC used information from the second CONCORD study, which reported survival for patients who had cancer diagnosed between 1995 and 2009 in 67 countries, and enabled the comparison of survival of patients in the U.S. with other countries.

    Here is a very biref summary of the findings: 

    • Ovarian cancer: Researchers found that among the 172,849 ovarian cancers diagnosed from 2001–2009, more than one-half were diagnosed at a distant stage. Five-year net survival was 39.6 percent in 2001–2003 and 41 percent in 2004–2009. Black women had consistently worse survival compared with white women (29.6 percent from 2001–2003 and 31.1 percent from 2004–2009), despite similar stage distributions. Stage-specific survival for all races combined between 2004 and 2009 was 86.4 percent for localized stage, 60.9 percent for regional stage, and 27.4 percent for distant stage.
    • Cervical cancer: The 5-year survival for women with cervical cancer in the United States was 63.5% between 2001-2003 and remained constant between 2004-2009. However, the survival for black women was lower than survival for white women, in both time periods.
    • Colon cancer: the five-year net survival increased 0.9 percent from 63.7 percent during 2001–2003 to 64.6 percent for 2004–2009. Survival improved for both blacks and whites, but the five-year net survival among blacks diagnosed during 2004–2009 had still not reached the level of survival of whites diagnosed during 1990–1994, some 15–20 years earlier. Also, more black than white patients were diagnosed at distant stage in 2001–2003 (21.5 percent versus 17.2 percent, respectively), and in 2004–2009 (23.3 percent versus 18.8 percent).
    • Breast cancer: Five-year net survival was very high (88.2 percent), but survival was more than 10 percentage points lower for black women than for white women—a difference that persisted over time. From 2001–2003, survival was 89.1 percent for white women and 76.9 percent for black women. From 2004–2009, survival was 89.6 percent for white women and 78.4 percent for black women.
    • Rectal cancer:  From 2001-2009, there was little improvement in net survival for rectal cancer, with persistent disparities in survival between blacks and whites.
    • Liver cancer: Some progress has occurred in survival for patients with liver cancer, but 5-year survival remains low, even for those diagnosed at the localized stage. Because of the low survival observed in all states, efforts directed at controlling well-established risk factors such as hepatitis B may have the greatest impact on reducing the burden of liver cancer in the U.S.
    • Lung cancer: Survival improved slightly between 2001 and 2009, but remained lower among blacks than whites. Efforts to control well established risk factors would be expected to have the greatest impact on reducing the burden of lung cancer, and efforts to ensure that all patients receive timely and appropriate treatment would be expected to reduce the variation between states, and the persistently lower survival among blacks than whites.
    • Prostate cancer: Population-based prostate cancer survival in the U.S. is high (97%) for men diagnosed between 2001 and 2009, but racial disparities persist. The percentages of both black and white males diagnosed with localized stage cancer increased during this period, however, and 5-year survival for males diagnosed at this stage exceeds 99%.
    • Stomach cancer: Age-standardized 5-year net survival remains low, but it improved slightly between 2001-2003 and 2004-2009. The differences between blacks and whites in pooled 5-year survival for 37 states combined are not large. Primary prevention through control of well-established risk factors will be an important public health action for the longer term.
    • Survival among children diagnosed with acute lymphoblastic leukemia: Survival up to 5 years after diagnosis is high among children diagnosed with acute lymphoblastic leukemia in the U.S., but disparities by race exist.

    The supplement is available for free on CancerOnline, and appears with the December 15 print issue of Cancer.

  • ACS study suggests that our CHANGE grants are helping improve colorectal cancer screening rates

    A new American Cancer Society study led by Kara S. Riehman, PhD, suggests that our CHANGE grants have been effective in promoting improvements in colorectal cancer screening rates in federally qualified health centers (FQHCs). The study appears early online in the American Journal of Preventive Medicine, and the authors say it has implications for broader public health efforts to increase cancer prevention and screening.

    The study concludes that these improvements exceed those of nonfunded federally qualified health centers. "Funding that results in targeted, intensive efforts supported by technical assistance and accountability for data and reporting, can result in improved system policies and practices that, in turn, can increase screening rates among uninsured and underserved populations," the authors write.

    In 2013, ACS initiated the Community Health Advocates Implementing Nationwide Grants for Empowerment and Equity (CHANGE) grant program, designed to reduce breast and colorectal cancer screening disparities by building community capacity to implement evidence-based interventions proven to increase cancer screening rates. Funding is awarded to FQHC partners, with technical assistance provided by ACS field staff.

    Funded FQHCs were required to implement at least one provider-oriented strategy (provider assessment and feedback or provider reminder/recall systems), and at least one client-oriented strategy (education, client reminders, or navigation). Most grantees (88.4%) implemented three to five intervention strategies throughout their funding period.

    Investigators compared screening rates of FQHCs funded by CHANGE grants to those of matched controls. At the start of the study period, colorectal cancer screening rates were low across the board, with funded FQHCs lagging nonfunded FQHCs (26.4% vs 30.4%).

    In the first year (2013-2014), funded FQHCs increased their CRC screening rates significantly more than nonfunded FQHCs. Funded FQHCs increased by 8.7% (from 26.4% to 35.1%) while nonfunded FQHCs increased by 2.7% (from 28.5% to 31.2%). Across the three years, increases were 12.7% (from 26.4% to 39.1%) and 9.0% (from 28.5% to 37.5%), respectively. The difference in change rates between groups across the three years was not significant.

    "Even in the absence of the ACS grant funds, many FQHCs increased their CRC screening rates substantially during the 3-year period," write the authors. "The 80% by 2018 CRC campaign is a national initiative that serves as a catalyst for concentrated focus on CRC screening and may have contributed to an overall increase in CRC screening rates." 

    Colorectal cancer (CRC) ranks as the third leading cause of cancer death in the U.S. Screening for colorectal cancer in average-risk adults is recommended beginning at age 50 years and continuing until age 75 years. 

    The study's authors also include Robert L. Stephens, PhD, Joenell Henry-Tanner, MPH, and Durado Brooks, MD, MPH.

  • ACS study: more than 4 in 10 cancers and cancer deaths associated with modifiable risk factors

    A new American Cancer Society study led by Farhad Islami, MD, PhD, finds more than 4 in 10 cancer cases and deaths in the U.S. are associated with major modifiable risk factors, many of which can be mitigated with prevention strategies. The study appears early online in CA: A Cancer Journal for Clinicians.

    For a new analysis, ACS investigators used the prevalence of known risk factors and their relative risk (the extent to which they increase cancer risk) to estimate the proportion of cancers that are associated with those risk factors. They then applied those proportions to actual cancer data to estimate the number of associated cases and deaths overall and for 26 cancer types. The risk factors included in the analysis were: cigarette smoking, secondhand smoke, excess body weight, alcohol intake, consumption of red and processed meat, low consumption of fruits/vegetables, dietary fiber, and dietary calcium; physical inactivity, ultraviolet light, and six cancer-associated infections.

    They found in the U.S., an estimated 42.0% of all cancer cases (659,640 of 1,570,975 cancers) and 45.1% of cancer deaths (265,150 of 587,521 deaths) in 2014 were attributable to the risk factors evaluated.

    Cigarette smoking accounted for the highest proportion of cancer cases (19.0%; 298,970 cases) and deaths (28.8%; 169,180 deaths), followed by excess body weight (7.8% of cases; 6.5% of deaths), alcohol intake (5.6% of cases; 4.0% of deaths), UV radiation (4.7% of cancers; 1.5% of deaths) and physical inactivity (2.9% of cases and 2.2% of deaths). Low fruit and vegetable intake accounted for 1.9% of cases and 2.7% of deaths, while HPV infection accounted for 1.8% of cases and 1.1% of deaths.

    Lung cancer had the highest number of cancer cases (184,970) and deaths (132,960) attributable to evaluated risk factors, followed by colorectal cancer (76,910 cases and 28,290 deaths). Several major cancers had a high proportion of cases attributable to evaluated risk factors, including 85.8% of lung cancers, 71% of liver cancers, 54.6% of colorectal cancers, and 28.7% of breast cancers.

    Other selected findings from the report:

    • Smoking accounted for 81.7% of lung cancers, 73.8% of larynx cancers, 50% of esophageal cancers, and 46.9% of bladder cancers.   
    • Excess body weight was associated with 60.3% of uterine cancers, about one-third of liver cancers (33.9%); 11.3% of breast cancers in women; and 5.2% of colorectal cancers.
    • Alcohol intake was associated with almost one-half of oral cavity and pharyngeal cancers in men (46.3%) and about one-fourth (27.4%) in women; 24.8% of liver cancers in men and 11.9% in women; 17.1% of colorectal cancers in men and 8.1% in women; and 16.4% of breast cancers in women.
    • UV radiation was associated with 96.0% of melanomas of the skin in men and 93.7% in women.
    • Physical inactivity accounted for 26.7% of uterine cancers, 16.3% of colorectal cancers, and 3.9% of female breast cancers.
    • Low fruit and vegetable consumption was associated with 17.6% of oral cavity/pharyngeal cancers, 17.4% of laryngeal cancers, and 8.9% of lung cancers.
    • Red and processed meat consumption accounted for 5.4% and 8.2% of colorectal cancers, respectively. Low dietary fiber accounted for 10.3% of colorectal cancer cases, while low dietary calcium accounted for 4.9%.

    The authors also measured the combined contribution of excess body weight, alcohol intake, poor diet, and physical inactivity to the cancer burden. These four factors accounted for 13.9% and 22.4% of all cancer cases in men and women, respectively. The corresponding proportions for cancer deaths were 14.9% and 16.9%, respectively. Studies have shown that following the American Cancer Society's cancer prevention guidelines for maintaining a healthy body weight, limiting alcohol intake (for those who drink), consuming a healthy diet, and being physically active is associated with a reduced risk of developing and dying from cancer.

    The authors say their results may underestimate the overall proportion of cancers attributable to modifiable factors because several other potentially modifiable risk factors could not be evaluated due to lack of exposure data. Also, a number of cancer types with likely, but as-yet unestablished associations with modifiable risk factors were not considered.

    "Our findings emphasize the continued need for widespread implementation of known preventive measures in the country to reduce the morbidity and premature mortality from cancers associated with potentially modifiable risk factors," write the authors. "Increasing access to preventive health care and awareness about preventive measures should be part of any comprehensive strategy for broad and equitable implementation of known interventions to accelerate progress against cancer."

    "In 1981, Doll and Peto published what has become a classic paper on the causes of cancer," said Otis W. Brawley, MD., our chief medical officer and study co-author. "Since then, volumes of data have been published that have clarified the association between several important risk factors and cancer. In this new report, ACS scientists provide a 21st century calculation that will guide us in the years ahead."

  • Alpa Patel named an American College of Sports Medicine Fellow

    ​Congratulations to Alpa Patel, PhD, our strategic director, Cancer Prevention Study-3 (CPS-3), who has been named an American College of Sports Medicine Fellow.

    Fellowship is an elite membership status that recognizes distinguished achievement in sports medicine or exercise science.

    The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. Its focus is to advance scientific research and provide application of exercise science through a broad range of initiatives and programs on topics such as obesity prevention, walking for better health, and promoting active transportation. The College also engages in a broad range of advocacy efforts and conducts roundtables by bringing together experts to develop clear consensus statements on critical health and science issues. 

    "I decided to apply to become a fellow because ACSM fellowship would allow me to become more actively involved in the College, including in serving in a leadership capacity," explained Alpa. "This opportunity provides me, on behalf of the American Cancer Society, to have a greater impact in a broad range of ACSM activities that directly connect with our mission priorities in physical activity. For example, a roundtable of exercise and cancer will be taking place in Spring 2018, on which I have been invited to serve as part of the executive committee."

    Alpa, a cancer epidemiologist, serves as the principal investigator of CPS-3 and is responsible for directing study operations. Her research focuses on lifestyle determinants of cancer risk and prevention, with an emphasis on the role of physical activity, sedentary behavior, and obesity in relation to cancer and overall longevity. 

  • Differences in insurance coverage associated with nearly half of black-white survival disparity in colorectal cancer

    Health insurance coverage differences account for nearly one-half of the black-white survival disparity in colorectal cancer patients, according to a new study led by Helmneh Sineshaw, MD, MPH, at the American Cancer Society, with collaborators from Dana-Farber Cancer Institute at Harvard Medical School.

    The study, published in Gastroenterology, reinforces the importance of equitable health insurance coverage to mitigate the black-white survival disparity in colorectal cancer.

    Colorectal cancer (CRC) is the third most commonly diagnosed cancer in both men and women in the U.S.. Overall, CRC incidence and mortality rates are decreasing in the U.S. as a result of earlier detection and improved treatments. Nonetheless, CRC incidence and mortality rates continue to be higher in blacks than in whites.

    For the new study, investigators led by Dr. Sineshaw, focused on the impact of access to care on black-white survival disparity. They looked at 199,098 CRC patients ages 18 to 64 in the National Cancer Database.

    They found the absolute 5-year survival difference between black and white CRC patients in the entire cohort was 9.2% (57.3% vs 66.5%). That difference was cut almost in half, to 4.9%, after matching for insurance status. Tumor characteristics also played a large role. The survival difference dropped to 2.3% after tumor characteristics matching.

    "These findings reinforce the importance of equitable health insurance coverage to mitigate the survival disparity between black versus white CRC patients in this age range, and underscore the need for further studies to elucidate reasons for racial differences in tumor characteristics," write the authors.

    Colorectal cancer is not the only cancer impacted by insurance status. In October, an American Cancer Society study found that differences in insurance explained one-third of the black-white difference in women with early-stage breast cancer.

  • A warning for alcohol drinkers

    ​An article in the Nov. 7 issue of The New York Times includes a lengthy article about the dangers of drinking alcohol, and it quotes Susan Gapstur, PhD, MPH, our vice president for epidemiology. She suggests that one way alcohol may lead to cancer is because the body metabolizes it into acetaldehyde, which causes changes and mutations in DNA. The formation of acetaldehyde starts when alcohol comes in contact with bacteria in the mouth, which may explain the link between alcohol and cancers of the throat, voice box and esophagus.

    The article was prompted by a statement published Tuesday in the Journal of Clinical Oncology by the American Society of Clinical Oncology, which represents many of the nation’s top cancer doctors. The warning cites evidence that even light drinking can slightly raise a woman’s risk of breast cancer and increase a common type of esophageal cancer.

    Heavy drinkers face much higher risks of mouth and throat cancer, cancer of the voice box, liver cancer and, to a lesser extent, colorectal cancers, the group cautions.

    “The message is not, ‘Don’t drink.’ It’s, ‘If you want to reduce your cancer risk, drink less. And if you don’t drink, don’t start,’” said Dr. Noelle LoConte, an associate professor at the University of Wisconsin-Madison and the lead author of the ASCO statement. “It’s different than tobacco where we say, ‘Never smoke. Don’t start.’ This is a little more subtle.”

    The doctors’ group is also calling for new public health initiatives to curb alcohol use, from taxes to restrictions on ads targeting minors, like the new ban on alcohol advertising on New York City’s subways and buses slated to go into effect in January. 

    For women, just one alcoholic drink a day can increase breast cancer risk, according to a report released in May from the American Institute for Cancer Research and the World Cancer Research Fund that was cited by ASCO.

    Susan notes in the article that the International Agency for Research on Cancer, part of the World Health Organization, first classified the consumption of alcoholic beverages as carcinogenic to humans in 1987, tying consumption to cancers of the mouth, throat, voice box, esophagus and liver. Since then, she said, more and more evidence has accumulated tying alcohol to a broader group of cancers, including colorectal cancer and, in women, breast cancer. A more recent I.A.R.C. report concluded that alcohol “is a cause of cancers of the oral cavity, pharynx, larynx, esophagus, colorectum, liver, and female breast.” 

    “The story of alcohol has been quite consistent and has been peeled away like an onion over time, and we’re continuing to learn more about the mechanisms involved,” Susan said. “We don’t have randomized trials, but sometimes when you start looking at the coherence of all the evidence, including the observational epidemiology, the lab studies, the mechanistic studies, you begin to see a picture and get more clarity.”

    Read the full article here.

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