Abstract
The Cancer Research Network (CRN) has been a cooperative agreement between the National Cancer Institute (NCI) and nonprofit integrated health care delivery systems, with the participation of the Agency for HealthCare Research and Quality (AHRQ), all committed to conducting research in the public domain focusing on the entire cancer spectrum. Participating in the CRN is one way these health systems contribute to the evidence base for their cancer control programs. Capitated health care systems face strong incentives to develop and deliver cost-effective, affordable cancer prevention, screening, treatment, and survivorship care. The CRN represents a strategic platform for prostate cancer research, including clinical trials, epidemiology studies (including genetics, genomics, and pharmacogenetics), comparative effectiveness research, cost-effectiveness evaluations, and translational research. Their defined populations, sophisticated electronic medical records and other informatics systems, low rates of turnover among cancer patients, and representativeness of their local communities make the CRN well suited for conducting clinical trials and comparative effectiveness research on prostate cancer treatments, as well as behavioral trials on prostate cancer prevention, screening, communications, decision making, and survivorship care planning. Because prostate cancer is a leading cancer among males and advanced prostate cancer cases often receive very high-cost treatments, this disease is a high priority for health plans. Key clinical management challenges include: setting an appropriate investment in prostate cancer screening programs, discriminating slow-growing indolent tumors from aggressive tumors, assisting patients in making evidence-based choices among alternative treatment strategies, supporting survivors in coping with treatment effects (ED, UI, rectal bleeding, loss of cognitive function), and supporting patients with advanced and terminal disease. The rationale for facilitating innovative collaborations in prostate cancer research is finding better approaches to these challenges.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Centers for Disease Control and Prevention. United States Cancer Statistics. 2007. http://apps.nccd.cdc.gov/uscs/. Last accessed 01/212/2011.
National Institutes of Health. RFA CA-97-017: cancer research network across health care systems. 1997. http://grants.nih.gov/grants/guide/rfa-files/RFA-CA-97-017.htm/. Accessed 11 July 2007.
National Institutes of Health. NIH roadmap for medical research: re-engineering the clinical research enterprise. 2007. http://nihroadmap.nih.gov/clinicalresearchtheme/. Accessed 28 Dec 2010.
HMO Research Network. About our organization, 2011. 2010. http://www.hmoresearchnetwork.org/about.htm. Accessed 17 Jan 2011.
Taplin SH, Ichikawa L, Yood MU, et al. Reason for late-stage breast cancer: absence of screening or detection, or breakdown in follow-up? J Natl Cancer Inst. 2004;96:1518–27.
National Institutes of Health. RFA-CA-06-505: cancer research network (U19). 2006. http://grants.nih.gov/grants/guide/rfa-files/RFA-CA-06-505.html/. Accessed 28 Dec 2010.
Wagner EH, Greene SM, Hart G, et al. Building a research consortium of large health systems: the Cancer Research Network. J Natl Cancer Inst Monogr. 2005;35:3–11.
National Cancer Institute, National Institutes of Health, Department of Health & Human Services. The HMO Cancer Research Network (CRN). Capacity, collaboration, and investigation. April 2010 Update. Bethesda: National Cancer Institute; 2010.
Go AS, Magid DJ, Wells B, et al. The Cardiovascular Research Network: a new paradigm for cardiovascular quality and outcomes research. Circ Cardiovasc Qual Outcomes. 2008;1:138–47.
KPNW membership data and Statistical Abstract of the US. Washington, D.C.: US Census Bureau; 2010.
Alexander GL, McClure JB, Calvi JH, et al. A randomized clinical trial evaluating online interventions to improve fruit and vegetable consumption. Am J Public Health. 2010;100:319–26.
Mouchawar J, Laurion S, Ritzwoller DP, et al. Assessing controversial direct-to-consumer advertising for hereditary breast cancer testing: reactions from women and their physicians in a managed care organization. Am J Manag Care. 2005;11:601–8.
Nguyen TT, Somkin CP, Ma Y, et al. Participation of Asian-American women in cancer treatment research: a pilot study. J Natl Cancer Inst Monogr. 2005;35:102–5.
Keating NL, Herrinton LJ, Zaslavsky AM, et al. Variations in Âhospice use among cancer patients. J Natl Cancer Inst. 2006;98:1053–9.
Rolnick S, Hensley AS, Kucera GP, et al. Racial and age differences in colon examination surveillance following a diagnosis of colorectal cancer. J Natl Cancer Inst Monogr. 2005;35:96–101.
Haque R, Quinn VP, Habel LA, et al. Correlates of screening sigmoidoscopy use among men in a large nonprofit health plan. Cancer. 2007;110:275–81.
Stopponi MA, Alexander GL, McClure JB, et al. Recruitment to a randomized web-based nutritional intervention trial: characteristics of participants compared to non-participants. J Med Internet Res. 2009;11:e38.
Wei F, Miglioretti DL, Connelly MT, et al. Changes in women’s use of hormones after the Women’s Health Initiative estrogen and progestin trial by race, education, and income. J Natl Cancer Inst Monogr. 2005;35:106–12.
Enger SM, Thwin SS, Buist DS, et al. Breast cancer treatment of older women in integrated health care settings. J Clin Oncol. 2006;24:4377–83.
Field TS, Buist DS, Doubeni C, et al. Disparities and survival among breast cancer patients. J Natl Cancer Inst Monogr. 2005;35:88–95.
Doubeni CA, Field TS, Ulcickas YM, et al. Patterns and predictors of mammography utilization among breast cancer survivors. Cancer. 2006;106:2482–8.
National Center for Health Statistics. Health, United States, 2006. Hyattsville: US Department of Health and Human Services; 2006.
McClure JB, Greene SM, Wiese C, et al. Interest in an online smoking cessation program and effective recruitment strategies: results from Project Quit. J Med Internet Res. 2006;8:e14.
Boudreau DM, Yu O, Buist DS, et al. Statin use and prostate cancer risk in a large population-based setting. Cancer Causes Control. 2008;19:767–74.
Geiger AM, Yu O, Herrinton LJ, et al. A population-based study of bilateral prophylactic mastectomy efficacy in women at elevated risk for breast cancer in community practices. Arch Intern Med. 2005;165:516–20.
Geiger AM, Nekhlyudov L, Herrinton LJ, et al. Quality of life after bilateral prophylactic mastectomy. Ann Surg Oncol. 2007;14:686–94.
Hazlehurst B, Sittig DF, Stevens VJ, et al. Natural language processing in the electronic medical record: assessing clinician adherence to tobacco treatment guidelines. Am J Prev Med. 2005;29:434–9.
Quinn VP, Stevens VJ, Hollis JF, et al. Tobacco-cessation services and patient satisfaction in nine nonprofit HMOs. Am J Prev Med. 2005;29:77–84.
Ritzwoller DP, Goodman MJ, Maciosek MV, et al. Creating standard cost measures across integrated health care delivery systems. J Natl Cancer Inst Monogr. 2005;35:80–7.
Vogt TM, Feldstein AC, Aickin M, et al. Electronic medical records and prevention quality: the prevention index. Am J Prev Med. 2007;33:291–6.
Elmore JG, Reisch LM, Barton MB, et al. Efficacy of breast cancer screening in the community according to risk level. J Natl Cancer Inst. 2005;97:1035–43.
Feldstein AC, Vogt TM, Aickin M, et al. Mammography screening rates decline: a person-time approach to evaluation. Prev Med. 2006;43:178–82.
Fenton JJ, Barton MB, Geiger AM, et al. Screening clinical breast examination: how often does it miss lethal breast cancer? J Natl Cancer Inst Monogr. 2005;35:67–71.
Fenton JJ, Reid RJ, Baldwin LM, et al. Influence of primary care use on population delivery of colorectal cancer screening. Cancer Epidemiol Biomarkers Prev. 2009;18:640–5.
Fenton JJ, Cai Y, Weiss NS, et al. Delivery of cancer screening: how important is the preventive health examination? Arch Intern Med. 2007;167:580–5.
Fenton JJ, Franks P, Reid RJ, et al. Continuity of care and cancer screening among health plan enrollees. Med Care. 2008;46:58–62.
Puleo E, Zapka JG, Goins KV, et al. Recommendations for care related to follow-up of abnormal cancer screening tests: accuracy of patient report. Eval Health Prof. 2005;28:310–27.
Leyden WA, Manos MM, Geiger AM, et al. Cervical cancer in women with comprehensive health care access: attributable factors in the screening process. J Natl Cancer Inst. 2005;97:675–83.
Mouchawar J, Hensley-Alford S, Laurion S, et al. Impact of direct-to-consumer advertising for hereditary breast cancer testing on genetic services at a managed care organization: a naturally-Âoccurring experiment. Genet Med. 2005;7:191–7.
Mouchawar J, Taplin S, Ichikawa L, et al. Late-stage breast cancer among women with recent negative screening mammography: do clinical encounters offer opportunity for earlier detection? J Natl Cancer Inst Monogr. 2005;35:39–46.
Puleo E, Zapka J, White MJ, et al. Caffeine, cajoling, and other strategies to maximize clinician survey response rates. Eval Health Prof. 2002;25:169–84.
Reisch LM, Fosse JS, Beverly K, et al. Training, quality assurance, and assessment of medical record abstraction in a multisite study. Am J Epidemiol. 2003;157:546–51.
Weinmann S, Taplin SH, Gilbert J, et al. Characteristics of women refusing follow-up for tests or symptoms suggestive of breast cancer. J Natl Cancer Inst Monogr. 2005;35:33–8.
Zapka JG, Puleo E, Taplin SH, et al. Processes of care in cervical and breast cancer screening and follow-up–the importance of communication. Prev Med. 2004;39:81–90.
Zapka JG, Puleo E, Taplin S, et al. Breast and cervical cancer screening: clinicians’ views on health plan guidelines and implementation efforts. J Natl Cancer Inst Monogr. 2005;35:46–54.
Ayanian JZ, Chrischilles EA, Fletcher RH, et al. Understanding cancer treatment and outcomes: the Cancer Care Outcomes Research and Surveillance Consortium. J Clin Oncol. 2004;22:2992–6.
Aiello EJ, Buist DS, Wagner EH, et al. Diffusion of aromatase inhibitors for breast cancer therapy between 1996 and 2003 in the Cancer Research Network. Breast Cancer Res Treat. 2008;107:397–403.
Aiello EJ, Tuzzio L, Ritzwoller DP, et al. Accuracy and complexities of using automated clinical data for capturing chemotherapy administrations: implications for future research. Med Care. 2009;47:1091–7.
Buist DS, Ichikawa L, Prout MN, et al. Receipt of appropriate Âprimary breast cancer therapy and adjuvant therapy are not associated with obesity in older women with access to health care. J Clin Oncol. 2007;25:3428–36.
Buist DS, Chubak J, Prout M, et al. Referral, receipt, and completion of chemotherapy in patients with early-stage breast cancer older than 65 years and at high risk of breast cancer recurrence. J Clin Oncol. 2009;27:4508–14.
Geiger AM, Prout MN, Silliman RA. Adjuvant radiation and Âhormonal therapy prevent recurrences and second primary breast cancers in older women. The American Journal of Hematology/Oncology. 2007;6:400–5.
Geiger AM, Thwin SS, Lash TL, et al. Recurrences and second primary breast cancers in older women with initial early-stage disease. Cancer. 2007;109:966–74.
Herrinton LJ, Barlow WE, Yu O, et al. Efficacy of prophylactic mastectomy in women with unilateral breast cancer: a cancer research network project. J Clin Oncol. 2005;23:4275–86.
Owusu C, Buist DS, Field TS, et al. Predictors of tamoxifen discontinuation among older women with estrogen receptor-positive breast cancer. J Clin Oncol. 2008;26:549–55.
Yood MU, Owusu C, Buist DS, et al. Mortality impact of less-than-standard therapy in older breast cancer patients. J Am Coll Surg. 2008;206:66–75.
Geiger AM, Buist DS, Greene SM, et al. Survivorship research based in integrated healthcare delivery systems: the Cancer Research Network. Cancer. 2008;112:2617–26.
Field TS, Cernieux J, Buist D, et al. Retention of enrollees following a cancer diagnosis within health maintenance organizations in the Cancer Research Network. J Natl Cancer Inst. 2004;96:148–52.
Altschuler A, Nekhlyudov L, Rolnick SJ, et al. Positive, negative, and disparate–women’s differing long-term psychosocial experiences of bilateral or contralateral prophylactic mastectomy. Breast J. 2008;14:25–32.
Geiger AM, West CN, Nekhlyudov L, et al. Contentment with Âquality of life among breast cancer survivors with and without contralateral prophylactic mastectomy. J Clin Oncol. 2006;24:1350–6.
Nekhlyudov L, Bower M, Herrinton LJ, et al. Women’s decision-making roles regarding contralateral prophylactic mastectomy. J Natl Cancer Inst Monogr. 2005;35:55–60.
Field TS, Doubeni C, Fox MP, et al. Under utilization of surveillance mammography among older breast cancer survivors. J Gen Intern Med. 2008;23:158–63.
Lash TL, Fox MP, Buist DS, et al. Mammography surveillance and mortality in older breast cancer survivors. J Clin Oncol. 2007;25:3001–6.
Barton MB, West CN, Liu IL, et al. Complications following bilateral prophylactic mastectomy. J Natl Cancer Inst Monogr. 2005;35:61–6.
Mouchawar J, Valentine GK, Somkin C, et al. Guidelines for breast and ovarian cancer genetic counseling referral: adoption and implementation in HMOs. Genet Med. 2003;5:444–50.
Hartsfield CL, Connelly MT, Newton KM, et al. Health system responses to the Women’s Health Initiative findings on estrogen and progestin: organizational response. J Natl Cancer Inst Monogr. 2005;35:113–5.
Hornbrook MC, Hart G, Ellis JL, et al. Building a virtual cancer research organization. J Natl Cancer Inst Monogr. 2005;35:12–25.
Doubeni CA, Field TS, Buist DS, et al. Racial differences in tumor stage and survival for colorectal cancer in an insured population. Cancer. 2007;109:612–20.
Rolnick SJ, Hart G, Barton MB, et al. Comparing breast cancer case identification using HMO computerized diagnostic data and SEER data. Am J Manag Care. 2004;10:257–62.
Thwin SS, Clough-Gorr KM, McCarty MC, et al. Automated inter-rater reliability assessment and electronic data collection in a multi-center breast cancer study. BMC Med Res Methodol. 2007;7:23.
Lash TL, Fox MP, Thwin SS, et al. Using probabilistic corrections to account for abstractor agreement in medical record reviews. Am J Epidemiol. 2007;165:1454–61.
Rolnick SJ, Jackson J, Nelson WW, et al. Pain management in the last six months of life among women who died of ovarian cancer. J Pain Symptom Manage. 2007;33:24–31.
West CN, Geiger AM, Greene SM, et al. Race and ethnicity: comparing medical records to self-reports. J Natl Cancer Inst Monogr. 2005;35:72–4.
Newton KM, Buist DS, Yu O, et al. Hormone therapy initiation after the Women’s Health Initiative. Menopause. 2008;15:487–93.
Hazlehurst B, Frost HR, Sittig DF, et al. MediClass: a system for detecting and classifying encounter-based clinical events in any electronic medical record. J Am Med Inform Assoc. 2005;12:517–29.
USDHHS. Certification programs. 2011. http://healthit.hhs.gov/portal/server.pt?open=512&objID=2884&parentname=CommunityPage&parentid=357&mode=2&in_hi_userid=12059&cached=true. Accessed 21 Jan 2011.
Armstrong, L. HMO cancer research network. Evaluation of end-of-life care for prostate cancer in the managed care environment. 2011. http://crn.cancer.gov/projects/projects.php. Accessed 19 Jan 2011.
Greene SM, Hart G, Wagner EH. Measuring and improving performance in multicenter research consortia. J Natl Cancer Inst Monogr. 2005;35:26–32.
Greene SM, Geiger AM. A review finds that multicenter studies face substantial challenges but strategies exist to achieve Institutional Review Board approval. J Clin Epidemiol. 2006;59:784–90.
Gold JL, Dewa CS. Institutional review boards and multisite studies in health services research: is there a better way? Health Serv Res. 2005;40:291–307.
Stryer D, Tunis S, Hubbard H, et al. The outcomes of outcomes and effectiveness research: impacts and lessons from the first decade. Health Serv Res. 2000;35:977–93.
Tunis S, Clancy C, Helms WD, et al. Roundtable on expanding capacity for comparative effectiveness research in the United States: discussion took place on June 3, 2007, at the AcademyHealth Annual Research Meeting in Orlando, FL. Health Serv Res. 2009;44:327–42.
Mullins CD, Whicher D, Reese ES, et al. Generating evidence for comparative effectiveness research using more pragmatic randomized controlled trials. Pharmacoeconomics. 2010;28:969–76.
Schneeweiss S, Rassen JA, Glynn RJ, et al. High-dimensional propensity score adjustment in studies of treatment effects using health care claims data. Epidemiology. 2009;20:512–22.
Somkin CP, Altschuler A, Ackerson L, et al. Organizational barriers to physician participation in cancer clinical trials. Am J Manag Care. 2005;11:413–21.
Acknowledgments
Supported by the National Cancer Institute Cooperative Agreement No. 2U19CA79689, Increasing Effectiveness of Cancer Control Interventions (Cancer Research Network), Edward H. Wagner, M.D., Principal Investigator.
We thank all the scientists and staff of the CRN who have conducted research and acknowledge in particular the leadership of the Site Principal Investigators of the CRN: Terry Field, DSc, MPH (Fallon); Edward H. Wagner, MD, MPH (GH); Suzanne W. Fletcher, MD, MSc (HPHC); Cheri Rolnick, PhD (HPRF); Thomas J. Flottemesch, PhD (HPRF); Christine C. Johnson, PhD (HFHS); Debra P. Ritzwoller, PhD (KPCO); Douglas Roblin, PhD (KPG); Thomas M. Vogt, MD, MPH (KPH); Andrew Williams, PhD (KPH); Lisa Herrinton, PhD (KPNC); Lawrence H. Kushi, ScD (KPNC); Mark C. Hornbrook, PhD (KPNW); Virginia P. Quinn, PhD (KPSC); Margaret J. Gunter, PhD (LCFR); Herbert (Bert) Davis, PhD (LCFR); Robert D. Langer, PhD (GHS); Azadeh Stark, PhD, MSc (GHS); and Robert Greenlee, PhD, MPH (MCRF). We also thank our many colleagues at the National Cancer Institute, particularly our project officer Martin L. Brown, PhD.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag London
About this chapter
Cite this chapter
Hornbrook, M.C., Holup, J. (2013). Population-based Health Systems as a Foundation for Prostate Cancer Control Research: The Cancer Research Network. In: Tewari, A. (eds) Prostate Cancer: A Comprehensive Perspective. Springer, London. https://doi.org/10.1007/978-1-4471-2864-9_26
Download citation
DOI: https://doi.org/10.1007/978-1-4471-2864-9_26
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-4471-2863-2
Online ISBN: 978-1-4471-2864-9
eBook Packages: MedicineMedicine (R0)