Cancer, in all its many forms, is a significant public health problem in North Carolina and globally. Consider these statistics:
- Every year, nearly 1.5 million Americans are diagnosed with cancer and approximately 562,340 will die each year from cancer.
- In North Carolina, cancer has overtaken heart disease as the leading cause of death.
- An estimated 40 percent of North Carolinians will develop cancer during their lifetimes.
- African-Americans in North Carolina experience higher incidence and mortality from cancers compared with other groups.
While advances in prevention, early detection, medical care and treatment have had a notable impact on improving cancer outcomes for some cancers and populations, we still face enormous challenges in closing the gap between what we know works to reduce cancer burden and what we actually do. In other areas, we lack fundamental knowledge.
The UNC Gillings School of Global Public Health is a leader in investigating a wide range of important issues in cancer including determining risk factors for cancer, discovering ways to reduce cancer risk, informing treatment options, improving quality of life among cancer survivors and disseminating information and best practices to stakeholders. Moreover, the School’s cancer research and practice community has placed a high priority on reducing disparities in cancer risk, prevention and survival among the citizens of North Carolina. These research and practice efforts have engaged faculty, staff and students across all departments of the School.
The School’s efforts have been greatly aided by a long-standing relationship with the UNC-Chapel Hill’s Lineberger Comprehensive Cancer Center. In August 2007, the North Carolina General Assembly established the University Cancer Research Fund (UCRF), which provides $50 million a year from the state’s Tobacco Trust Fund for cancer research. The UCRF provides the critical mass of resources needed for North Carolina to significantly improve cancer outcomes, which range from prevention to better quality of life among those living with cancer, throughout this decade.
The School is playing a major role in the planning and implementation of the goals of the UCRF. These efforts will conceptualize North Carolina as a “laboratory” by enabling researchers to discover, develop and disseminate effective population-based strategies to turn the tide on cancer in communities and health care settings across the state.
Optimizing Cancer Outcomes in North Carolina
A major UCRF strategic planning effort directed by faculty from the Gillings School of Global Public Health led to the development of important new initiatives to improve cancer outcomes for North Carolina. These will be groundbreaking research and resource development projects with far-reaching implications for the state and will serve as a model for the nation. Highlights of the strategic plan components include:
- The foundation for optimizing cancer outcomes in North Carolina and beyond will be provided by a unique, comprehensive cancer information system called the North Carolina Integrated Cancer Surveillance and Information System (ICISS). By tapping multiple data sources through time, ICISS will prospectively create valid and replicable measures of outcomes of cancer control activities especially among vulnerable subgroups and communities that have been traditionally underserved. ICISS will continually link statewide incidence and mortality data with other key data sources such as the North Carolina cancer care databases, information on other outcomes (e.g., quality of life), and demographic, social, geographic, and environmental data. By greatly enhancing the ability of researchers to gather and share information across disciplines, ICISS can help North Carolinians make more informed choices about cancer prevention and control whether they lead community-based organizations, state and county health departments, university or industry-based research teams or health policy organizations. No such integrated population-based cancer informatics system exists at the state or national levels in the United States. As envisioned, ICISS could become a model for rational cancer planning in this country and beyond.
- One of the key research priorities of the University Cancer Research Fund is to initiate a repository of specimens and data on UNC cancer patients. The UNC Health Registry will prospectively identify and rapidly recruit 10,000 patients with appointments at the N.C. Cancer Hospital into a registry. This study will integrate clinical, epidemiological and interview data with repositories of biologic specimens and tumor tissue obtained from each patient through a comprehensive database. The UNC Health Registry will form the basis of a survivor cohort, which is a valuable resource making future studies of survivorship feasible.
- We will build a state-of-the-art system to evaluate interventions to improve cancer outcomes in multiple formats accessible to all North Carolina residents. Health-E-NC will harness the power of health information and other communications technologies to prevent cancer and to improve quality of life and other appropriate outcomes for those living with cancer. The goals are to target cancer risk factors (tobacco use, dietary behavior, physical activity, obesity), cancer screening and referrals (breast, cervical), decision support (colorectal screening, prostate screening) and uptake of tested prevention and treatment interventions such as HPV vaccination. An array of proven intervention delivery approaches will be employed such as message tailoring, social marketing, peer counseling/coaching, health provider interventions and community participatory strategies. Interventions will be delivered through multiple channels including print, small media, the Web, social networks, mobile devices, peer and professional leaders and health systems. Health-E-NC will provide fertile ground for novel research on various intervention delivery methods as well as test dissemination approaches to accelerate the population uptake of evidence-based approaches.
Read more about our School’s cancer research and involvement:
- Carolina Public Health magazine explores how we are conquering cancer and fighting health disparities.
- The Department of Health Policy and Management has a Cancer Care Quality Training Program.
- Cancer epidemiology is a major research focus of the Department of Epidemiology.
- Abdominal fat affects breast cancer survival.
- The UNC Nutrition Obesity Research Center examines diet’s affect on cancer risk.
- High-fruit, low-meat diets may reduce cancer risk.