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Summer 2016

Breast Cancer In Black Women

The largest study ever to investigate how genetic and biological factors contribute to breast cancer risk among black women was launched July 6. This collaborative research project will identify genetic factors that may underlie breast cancer disparities. The effort is funded by the National Cancer Institute (NCI), part of the National Institutes of Health.

The Breast Cancer Genetic Study in African-Ancestry Populations initiative does not involve new patient enrollment but builds on years of research cooperation among investigators who are part of the African-American Breast Cancer Consortium, the African-American Breast Cancer Epidemiology and Risk (AMBER) Consortium, and the NCI Cohort Consortium. These investigators, who come from many different institutions, will share biospecimens, data, and resources from 18 previous studies, resulting in a study population of 20,000 black women with breast cancer.

Survival rates for women with breast cancer have been steadily improving over the past several decades. However, these improvements have not been shared equally; black women are more likely to die of their disease. Perhaps of most concern is that black women are more likely than white women to be diagnosed with aggressive subtypes of breast cancer. The rate of triple-negative breast cancer, an aggressive subtype, is twice as high in black women as compared to white women.

The exact reasons for these persistent disparities are unclear, although studies suggest that they are the result of a complex interplay of genetic, environmental, and societal factors, including access to health care. Large studies are needed to comprehensively examine these factors, and NCI is supporting several such efforts.
 Read more here:

New colorectal cancer screening guidelines reinforce the idea that the best test is the one that gets done
 
I n response to updated colorectal cancer screening recommendations released on June 15 by the United States Preventive Services Task Force, (USPSTF) Durado Brooks, MD, MPH, managing director of cancer control intervention, prevention and early detection for the American Cancer Society issued the following statement.

The primary difference is the addition of computed tomography (CT) colonography and multitargeted stool DNA (FIT-DNA) to the list of recommended screening strategies. With regard to the expanded menu of screening strategies [the Task Force] pointed out that nearly one-third of U.S. adults have never been screened and indicate that "offering choice in colorectal cancer screening strategies may increase screening uptake". 
 
The 2016 USPSTF recommendations are very similar to those made by the joint guideline from the American Cancer Society , U.S. Multi-Society Taskforce on Colorectal Cancer and American College of Radiology in 2008. 

These new guidelines reinforce the value and importance of screening for colorectal cancer.  Providing individuals with a broader menu of screening options may accelerate momentum toward the goal of a nationwide colorectal cancer screening rate of 80% by 2018.
1999-2013 United States Cancer Statistics Report Released
 
includes the official federal statistics on cancer incidence from registries that have high-quality data, and cancer mortality statistics, produced by the Centers for Disease Control and Prevention  and the National Cancer Institute (NCI). This report shows that in 2013, 1,536,119 Americans received a new diagnosis of invasive cancer, and 584,872 Americans died of this disease (these counts do not include   in situ  
cancers or the more than 1 million cases of basal and squamous cell skin cancers diagnosed each year).

This year's report features information on invasive cancer cases diagnosed during 2013, the most recent year of incidence data available. Incidence data are from CDC's National Program of Cancer Registries (NPCR) and NCI's Surveillance, Epidemiology, and End Results (SEER) Program. 

The report also provides cancer mortality data collected and processed by CDC's National Center for Health Statistics, based on records of deaths that occurred during 2013, are available for all 50 states and the District of Columbia.

The report also includes incidence rates and counts for Puerto Rico for 2009 through 2013 by sex and age, as well brain tumor and childhood cancer data.
USCS data are presented in the following applications-

  A Snapshot of Cancer Spending and Outcomes
 
In a recent article published in the Journal of the American Medical Association  a report done for the Kaiser Family Foundation provides details on cancer spending and outcomes in the United States. It states "The U.S. cancer mortality rate, 203 deaths per 100,000 population, was slightly lower than in comparable countries in 2010. Among cancers, lung cancer is the largest contributor to disease burden for both men and women. The United States spent $124 billion to treat cancer in 2012, which accounted for about 7% of the nation's disease-based health expenditures. However, growth in cancer spending contributed only 6.3% to the nation's medical services expenditure growth, while the top 3 diseases contributed 36%. During that time, per capita spending on cancer increased 5%, which was slightly lower than the average for all diseases. Cancer medications were among the top 3 for specialty drug spending in 2015, behind medications for inflammatory conditions and multiple sclerosis." 

For the complete article, click here
Changes Needed to Address Older Survivors' Needs
The aging of the U.S. population will result in a substantial increase in the number of older cancer survivors over the next quarter century, particularly those 85 and older, according to a new study by NCI researchers.


This group will represent nearly three-quarters of cancer survivors by 2040, the researchers reported in a study published July 1 in Cancer Epidemiology, Biomarkers & Prevention.

The number of long-term cancer survivors has continued to grow over the past several decades. With this growth has come the recognition that many cancer survivors have unique health care needs as a consequence of their cancer or the treatments they received.

Concerns have been raised about whether the health care system has the capacity to satisfy the growing demand for cancer and survivorship care, with physician organizations forecasting shortages of oncologists and family physicians, both of which represent the primary medical providers for cancer survivors.

And the strain on the system is only expected to worsen as the U.S. population ages. Every day, thousands of "baby boomers" are turning 65 years old, and many of those with cancer will also have other medical conditions, from cardiac and respiratory diseases to diabetes and rheumatologic conditions.Read the report here:

ASCO: No Abatement Seen in Aggressive End-of-Life Cancer Care
HealthLeaders Media News,  June 7, 2016
      
Guidelines from the American Society of Clinical Oncology (ASCO) strongly advise "against cancer-directed therapy... in patients with advanced solid tumors who are unlikely to benefit from them."

Despite evidence-based   Choosing Wisely   recommendations, cancer patients under the age of 65 continue to receive aggressive care in the last 30 days of life, according to analysis presented in June  at the   ASCO meeting in Chicago.   
 
Aggressive end-of-life care includes "cancer-directed procedures and therapies; emergency room and ICU admissions and in-hospital deaths," according to researchers from the University of North Carolina at Chapel Hill.

The researchers looked at data from 2007 to 2014 and found no reduction in the use of aggressive end of life care after ASCO issued the guidelines in 2012. They also saw an increase in end of life care for lung, pancreatic, and prostate cancer patients after 2012.  
  
The researchers analyzed claims data for 29,000 patients enrolled in either Blue Cross and Blue Shield, or both, in 14 states  for patients diagnosed with metastatic lung, colon, breast, pancreatic, and prostate cancers.
They found that 71% to 76% received aggressive care within the last 30 days of life. Between 30% and 35% died in the hospital. The rate of hospitalization during the study ranged from 61% for lung cancer and 65% for colon cancer.

The authors concluded: "There is substantial overuse of aggressive end-of-life care among younger patients with incurable cancers. Aggressive care did not decrease following the 2012 ASCO Choosing Wisely recommendations."

Read more here about the persistence of end-of-life  Aggressive Care.

The Connecticut Cancer Partnership unites the members of our state's diverse cancer community--academic and clinical institutions, state and local government health agencies, industry and insurers, advocacy and community groups, and cancer survivors. Together, the coalition has developed and is now implementing a comprehensive plan to reduce the suffering and death due to cancer, and improve the quality of life of cancer survivors throughout Connecticut.



SAVE THE DATE
13th Annual Meeting
Dec. 6, 2016
Sheraton In Rocky Hill

Health Policy and Cancer:   Diversity, Financing, Ethics 




Connecticut Cancer Partnership
Work groups

The Partnership has active work groups meeting regularly on the topics of colorectal screening, palliative care, HPV vaccination, medical education, and survivorship care plans.

Quick Note:
In the July issue of Morbidity and Mortality Weekly Report, the CDC estimated that

that approximately 30,700 new cancers were attributable to HPV, including 19,200 among females and 11,600 among males.

HPV  vaccination is cancer prevention 

 

Submissions

Please submit articles and/or suggestions to:

 

Lucinda Hogarty

 

CA CONNections
is produced by the

Connecticut Cancer Partnership

Editorial Staff

Renee Gaudette

Lucinda Hogarty

Marion Morra

 

P 203-379-4860
F 203-379-5052
www.ctcancerpartnership.org

Connecticut Cancer Partnership to 
Publish Emerging Issues Briefs

The Connecticut Cancer Partnership is launching a series of occasional publications called Emerging Issues Briefs. Our counterparts in New Hampshire have been doing this since 2011 and have highlighted the statewide efforts of cancer control efforts in a number of areas of interest.  NH Emerging Issues Briefs

We would like to feature work being done in Connecticut on timely, relevant cancer-related topics. Our editorial panel will review, edit and select submissions. Articles should be original, 500 - 1500 words in length, with a short resource section and a few footnotes, including disclosure of any author conflicts of interest.  Suggestions for additional distribution would be helpful.

Please submit a short abstract (200 words or less) on the topic to be covered and you will be notified whether the concept has been approved for consideration for publication. [Submit abstracts here.]

The Partnership will publish the Briefs on its website and make them available electronically for other distribution outlets. they would also be printed and distributed at the annual meeting and other meetings as appropriate.