NCI's Community Cancer Centers Program: Recovery Act Investment Report
Public Health Burden of Cancer
Cancer is the second leading cause of death in the United States after heart disease. In 2009, it is estimated that nearly 1.5 million new cases of invasive cancer will be diagnosed in this country and more than 560,000 people will die of the disease.
NCI's Community Cancer Centers Program (NCCCP) and ARRA
In 2007, NCCCP was initiated as a 3-year pilot project to create a national network of community cancer centers to expand cancer research and to deliver the latest, most-advanced cancer care to more Americans in their home communities. Currently, 16 community hospitals located in 14 states across the country are participating in NCCCP. ARRA funds are being used to support a significant expansion of this initiative because yearly progress reports for the pilot project have shown promising results.
Addition of New NCCCP Sites(1)
Fourteen new cancer centers will be competitively awarded to reach larger numbers of underserved populations and to connect community cancer centers with the state-of-the-art care provided by NCI-designated Cancer Centers. Seven independent community cancer centers and seven NCI-designated Cancer Centers in partnership with community cancer centers will be funded.
Enhancing Support for Current NCCCP Sites
ARRA funding will also provide additional support to the current NCCCP sites for projects in the following areas:
- Clinical Trials: Many cancer patients are unable to access the best cancer care and participate in cancer clinical trials because too much travel and too much time away from family and work are required. Patients at NCCCP hospitals have greater opportunities to participate in clinical trials. ARRA funds will support the development of an infrastructure for early phase clinical trials and facilitate patient access to such trials through collaboration with NCI's Early Phase Drug Development Program. In addition, strategies for enhancing the accrual of Native American populations to clinical trials and engaging community physicians in minority communities will be identified.
- Health Disparities: A major focus of the NCCCP is to reduce the burden of cancer among underserved populations by bringing more patients into a system of high-quality cancer care and achieving a better understanding of why some populations experience higher cancer rates than others. ARRA funds will support efforts aimed at improving the effectiveness of NCCCP Community Outreach Programs in addressing cancer health disparities and in developing partnerships with NCI Community Networks Program (CNP) institutions to increase cancer screening in racial/ethnic minority and other underserved populations.
- Quality of Care: NCCCP sites are investigating approaches to enhance the quality of cancer care, such as defining high-quality cancer care in a community setting and identifying ways to measure cancer healthcare quality. ARRA funds will support new projects that will provide an infrastructure for multidisciplinary care and evaluate the impact of multidisciplinary care on the processes and outcomes of cancer care. In addition, a quality oncology practice initiative will be developed to enhance quality improvement activities in the practices of private physicians. Furthermore, electronic patient-reported outcomes will be tested in community settings.
- Survivorship and Palliative Care: During the past twenty years, major advances have been made in various aspects of cancer research. This progress has lead to improved screening and diagnostic methods and better treatment for many types of cancer. As a result, many more people today are surviving and living longer with cancer. Community cancer centers have a critical role to play in enhancing the quality of life of cancer survivors and in supporting cancer survivorship research. ARRA funding will support new projects in this area that will help survivors transition to life after treatment and promote smoking cessation among cancer survivors.
- Information Technology: Although less than 2 percent of U.S. hospitals have a comprehensive Electronic Health Record (EHR) system in place, evidence is emerging that EHRs can improve the quality and efficiency of medical care and cancer research. NCCCP sites have started the migration from decentralized, paper-based records systems to computerized systems, and ARRA funds will be used to expand an initiative known as the Electronic Health Record in Oncology, which will demonstrate what is needed to integrate EHRs into the workflow of community health care systems.
- Biospecimens: Standardized collection of voluntarily donated tissue and other medical specimens for research purposes is critical in advancing genomic research. Three NCCCP pilot sites are already collecting cancer biospecimens for The Cancer Genome Atlas (TCGA) project, a collaborative effort involving NCI and the National Human Genome Research Institute (NHGRI). The sites are the first community hospitals in the United States to participate in this project to accelerate our understanding of the molecular basis of cancer through the application of genome analysis technologies, including large-scale genome sequencing. The three sites are involved in TCGA working groups to develop disease site-specific protocols for collecting rare, limited tumor specimens, including specimens from breast, esophageal, and pancreatic tumors. ARRA funds will be used to support these activities.