CRN Monthly Update for August 2015

In this issue:


CRN-facilitated Pilot Projects in Lung Cancer Screening

Since last fall, three pilot projects, funded by the NCI through Administrative Supplements, have been examining the implementation and data challenges and opportunities in conducting research in lung cancer screening. These projects are now joined by a fourth, led by Mike Simoff and Chris Neslund-Dudas of the Henry Ford Health System. The ongoing projects are led by Michael Gould (KP Southern California), Deb Ritzwoller (KP Colorado), and Lori Sakoda (KP Northern California). Collectively, these projects promise to provide substantial insight into the possibilities and potential hurdles in using health systems and their research, clinical and data resources to conduct research to understand and improve the effectiveness of screening for lung cancer.

Survivorship SIG survives!

The CRN's Cancer Survivorship Scientific Interest Group and listserv have been revived! The goal of the group is to foster the development of survivorship-related grants and the success of survivorship-related projects with the CRN. The hope is to gather a group of equally engaged people for true collaboration.

Please contact Jessica Chubak with any questions you have about this group and for information on how to join the listserv.

ACS Grant awarded to Chun Chao

The American Cancer Society has recently awarded Chun Chao at KP Southern California a grant for her proposal entitled "Chronic health problems in survivors of adolescent and young adult cancer." The goal of this project is to evaluate the long-term health outcomes, including mortality, second cancer and comorbidities among survivors of adolescent and young adult cancer. The magnitude of risk increase of specific late effects associated with specific cancer therapeutic exposure will also be characterized.


The Health Care Systems Research Network, within which the CRN is nested, is changing its name to the Health Care Systems Research Network (HCSRN), as of August 3. This change is implemented in part because the HCSRN member institutions include not just research groups embedded in health maintenance organizations (in the traditional sense of that term), but also those aligned with other types of health systems.

Save the Date: HCSRN Annual Meeting, April 14-16

Although it may seem many months away, it's not too early to mark your calendars for the HCSRN Annual Meeting, which will be held April 14-16, 2016, in Atlanta, Georgia, co-hosted by our research colleagues at Marshfield Clinic and Henry Ford Health System. In addition to the many activities that typically occur during the HSCRN Annual Meeting, the CRN is organizing a symposium for the last day of the conference, Saturday, August 16, on the topic of precision medicine in cancer. More information can be found below.

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The CRN and Precision Medicine in Cancer

With increased national interest in precision medicine, the CRN will be directing resources toward exploring the contributions the CRN can make in this area, and to positioning the CRN to be a leader in population-based and health-care-system-based research in precision medicine and cancer. This will include data development, compilation of biospecimen resources, and workshops to explore the contributions of the CRN in this area.

The CRN is organizing a Precision Medicine in Cancer Symposium in conjunction with the HCSRN Annual Meeting on Saturday, April 16, 2016 in Atlanta. This promises to be a ground-breaking symposium highlighting the contributions of the CRN and national directions in precision medicine.

If you are interested in contributing to these discussions on Precision Medicine in Cancer, please contact the Coordinating Center.

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Mentored Training in Dissemination and Implementation Research in Cancer (MT-DIRCExternal Web Site Policy) is a week-long summer training program on D&I research. Each cohort of fellows attends the summer institute twice and are matched to a faculty mentor in the field of D&I science for ongoing mentoring for the duration of the program. Neetu Chawla, a current CRN Scholar and KP Northern California Investigator was recently sponsored by the CRN to be a 2015 fellow in the program. Here are some of her highlights:

"My experiences as part of the MT-DIRC program have taught me about many different aspects of D&I research, including theoretical frameworks, study designs, potential grant mechanisms, and relevant study sections. This program has also given me access to leading national experts and I have found their mentorship and feedback invaluable in guiding my knowledge and efforts towards building expertise in this emerging area of research."

Another CRN Investigator, Matt Nielsen, was also a member of the 2015 cohort. You can read about his experience at "Summer Camp for Grownups"External Web Site Policy on the MT-DIRC Blog. Past fellows supported by the CRN include Melodie Eide at Henry Ford Health System, and Erin Hahn at KP Southern California.

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Kaiser Permanente and the CRN, with support from the National Institutes of Health (National Cancer Institute, National Institute of Diabetes and Digestive and Kidney Diseases, National Heart, Lung, and Blood Institute, and the Office of Behavioral and Social Sciences Research) and the U.S. Department of Veterans Affairs recently hosted the Training Institute for Dissemination and Implementation Research in Health (TIDIRH)External Web Site Policy in Pasadena, CA July 27-31. This 5-day training institute provided participants with a thorough grounding in conducting dissemination and implementation (D&I) research in health across all areas of healthcare.

Several KP leaders, as well as D&I experts from across the country, shared their knowledge and experience with trainees throughout the week. Participants are expected to return to their home institutions prepared to share what they have learned at the institute to help grow the field of D&I research (e.g., giving talks, leading seminars, forming new collaborations, mentoring, and submitting D&I grant proposals etc). This year’s TIDIRH was co-chaired by Karen Emmons (KFRI), Rachel Gold (KPNW) and Michael Gould (KPSC). Other CRN-affiliated faculty and lecturers were Brian Mittman, current C&D SWG lead, Kim Danforth, current CRN Scholar, and Borsika Rabin, former C&D SWG co-lead.

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Pilot Work featured in JAMA Oncology

Jennifer Mack, at Dana Farber Cancer Institute, received a CRN pilot grant in 2013-14 to garner initial data on end-of-life care among adolescents and young adults with cancer. In partnership with Chun Chao and her team at KP Southern California, she developed a cohort of 663 adolescents and young adults aged 15-39 who died between 2001-2010 after receiving cancer care at KPSC. Pilot work included evaluation of the intensity of end-of-life care, defined according to existing measures as chemotherapy in the last 2 weeks of life as well as intensive care unit care, hospitalizations, or more than one emergency room visit in the last month of life. They also conducted in-depth medical record review for 111 cohort patients in order to evaluate the feasibility of evaluating patient-centered measures such as care preferences, and to validate our cohort selection process.

A manuscript from this initial workExternal Web Site Policy, available online at JAMA Oncology, showed that more than two-thirds of adolescent and young adult patients received intensive measures in the last month of life. A second manuscript based on medical record abstraction data is now under review. This June the team submitted an R01 application in hopes of expanding this work. The R01 proposes expanding the cohort to KPNC, in collaboration with Larry Kushi; examining additional quality measures at the end of life for adolescent and young adult patients; and using patient and caregiver interviews to develop a patient-centered definition of high quality end-of-life care for young people.

The CRN setting provides a unique opportunity to study cancer in young people, and little is known about end-of-life care among adolescents and young adults. "We hope this will be the start of ongoing work to explore the care needs of young people approaching the end of life," says Dr. Mack.

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Recent Publications

Henderson LM, Benefield T, Nyante SJ, Marsh MW, Greenwood-Hickman MA, Schroeder BF. Performance of digital screening mammography in a population-based cohort of black and white women. Cancer Causes Control 2015 Jul 17. [Epub ahead of print] [View Abstract]

Sun V, Grant M, Wendel CS, McMullen CK, Bulkley JE, Altschuler A, Ramirez M, Baldwin CM, Herrinton LJ, Hornbrook MC, Krouse RS. Dietary and Behavioral Adjustments to Manage Bowel Dysfunction After Surgery in Long-Term Colorectal Cancer Survivors. Ann Surg Oncol 2015 Jul 10. [Epub ahead of print] [View Abstract]

Mack JW, Chen LH, Cannavale K, Sattayapiwat O, Cooper RM, Chao CR. End-of-Life Care Intensity Among Adolescent and Young Adult Patients With Cancer in Kaiser Permanente Southern California. JAMA Oncol 2015 Jul 9. [Epub ahead of print] [View Abstract]

Bandera EV, Lee VS, Rodriguez-Rodriguez L, Powell CB, Kushi LH. Impact of Chemotherapy Dosing on Ovarian Cancer Survival According to Body Mass Index. JAMA Oncol 2015 Jul 2. [Epub ahead of print] [View Abstract]

Lee CI, Bogart A, Hubbard RA, Obadina ET, Hill DA, Haas JS, Tosteson AN, Alford-Teaster JA, Sprague BL, DeMartini WB, Lehman CD, Onega TL. Advanced Breast Imaging Availability by Screening Facility Characteristics. Acad Radiol 2015 Jul;22(7):846-52. [View Abstract]

Gard CC, Aiello Bowles EJ, Miglioretti DL, Taplin SH, Rutter CM. Misclassification of Breast Imaging Reporting and Data System (BI-RADS) Mammographic Density and Implications for Breast Density Reporting Legislation. Breast J 2015 Jul 1. [Epub ahead of print] [View Abstract]

Kenzik K, Pisu M, Johns SA, Baker T, Oster RA, Kvale E, Fouad MN, Martin MY. Unresolved Pain Interference among Colorectal Cancer Survivors: Implications for Patient Care and Outcomes. Pain Med 2015 Jul;16(7):1410-25. [View Abstract]

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Meetings and Calls for Abstracts

PopMedNet User Group ConferenceExternal Web Site Policy
Meeting date July 27 & 28, 2015 in Boston MA.

Eighth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically UnderservedExternal Web Site Policy
Abstracts due Aug 6, 2015. Meeting date Nov 13-16, 2015, Atlanta, GA.

NIH/AcademyHealth Eight Annual Conference on the Science of Dissemination & ImplementationExternal Web Site Policy
Abstracts due Aug 20, 2015. Meeting date December 14-15, 2015, Washington DC.

The Cancer Survivorship Symposium: Advancing Care and ResearchExternal Web Site Policy
Co-sponsored by American Academy of Family Physicians, the American College of Physicians, and the American Society of Clinical Oncology.
Abstracts due Sept 1, 2015. Meeting date Jan 15-16, 2016, San Francisco, CA.

Precision Cancer Screening in the General Population: Evidence, Epidemiology, and Next Steps - Sept 29, 2015
This free day-long symposium will be held in Rockville, MD and will bring together experts in cancer screening, risk prediction, epidemiology, and other related disciplines to discuss what is known and what is not known about the effectiveness of precision cancer screening for breast, cervical, colorectal, lung, and prostate cancers in the general population. Registration is free, but is required for participation. Note that attendance is limited to the first 150 registrants.

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Additional Funding Opportunities

Multidisciplinary Studies of HIV/AIDS and Aging - R01, R03, R21
Standard AIDS-related grant submission due dates (Sep 7, Jan 7, May 7)

NCI as a participating institute seeks to foster research studies to help understand how aging in the presence of chronic HIV infection affects the risk, spectrum and biology of cancer (AIDS-defining and non-AIDS-defining cancers). Recent data indicates an increase in the non-AIDS-defining cancers that is driven to a large extent by the growth and aging of the HIV/AIDS population. Aging is by itself a key factor promoting the development of many cancers, and there is a lack of data on the interplay between aging, HIV, long-term exposure to antiretroviral drugs, and other factors promoting cancer development in the aging population. In addition, there is little understanding of the interplay between host factors and immune perturbations that occur in aging and how these interactions affect cancers that are mostly seen in older people (e.g., Kaposi's sarcoma and Merkel cell carcinoma).

Department of Defense Breast Cancer Research Program - Breakthrough Award Level 3 (PDF) External Web Site Policy
LOI due Sept 18, 2015

The intent of the Breakthrough Award is to support promising research that has high potential to lead to or make breakthroughs in breast cancer. The critical components of this award are Impact and Research Scope. Impact: Research supported by the Breakthrough Award will have the potential for a major impact and accelerate progress toward ending breast cancer. The impact may be near-term or long-term, but must be significant and move beyond an incremental advancement. Applications must articulate the pathway to making a clinical impact for individuals with, or at risk for, breast cancer, even if clinical impact is not an immediate outcome. Research Scope for this Funding Level 3: Advanced translational studies that have potential for near-term clinical investigation.

Pancreatic Cancer Detection Consortium - U01
Application Due Dates Nov 25, 2015, May 26, 2016, and others.

This Funding Opportunity Announcement (FOA) invites applications from multi-disciplinary teams of researchers and clinicians to establish the Pancreatic Cancer Detection Consortium (PCDC) to conduct research to improve the detection of early stage pancreatic ductal adenocarcinoma (PDAC) and characterization of its precursor lesions. This initiative addresses one of the four research priorities identified in the National Cancer Institute's 2014 Scientific Framework for Pancreatic Ductal Adenocarcinoma. The PCDC is intended to support research for the development and testing of new molecular and imaging biomarkers for identifying patients at high risk for PDAC (because of genetic factors or the presence of precursor lesions) who could be candidates for early intervention.

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