Skip to main content
SpringerLink
Log in

Population-based Health Systems as a Foundation for Prostate Cancer Control Research: The Cancer Research Network

  • Chapter
  • First Online:
Prostate Cancer: A Comprehensive Perspective

  • 2922 Accesses

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 229.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Centers for Disease Control and Prevention. United States Cancer Statistics. 2007. http://apps.nccd.cdc.gov/uscs/. Last accessed 01/212/2011.

  2. 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.

  3. 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.

  4. HMO Research Network. About our organization, 2011. 2010. http://www.hmoresearchnetwork.org/about.htm. Accessed 17 Jan 2011.

  5. 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.

    Article  PubMed  Google Scholar 

  6. 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.

  7. 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.

    Article  PubMed  Google Scholar 

  8. 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.

    Google Scholar 

  9. 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.

    Article  PubMed  Google Scholar 

  10. KPNW membership data and Statistical Abstract of the US. Washington, D.C.: US Census Bureau; 2010.

    Google Scholar 

  11. 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.

    Article  PubMed  Google Scholar 

  12. 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.

    PubMed  Google Scholar 

  13. 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.

    Article  PubMed  Google Scholar 

  14. Keating NL, Herrinton LJ, Zaslavsky AM, et al. Variations in ­hospice use among cancer patients. J Natl Cancer Inst. 2006;98:1053–9.

    Article  PubMed  Google Scholar 

  15. 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.

    Article  PubMed  Google Scholar 

  16. 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.

    Article  PubMed  Google Scholar 

  17. 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.

    Article  PubMed  Google Scholar 

  18. 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.

    Article  PubMed  Google Scholar 

  19. 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.

    Article  PubMed  Google Scholar 

  20. Field TS, Buist DS, Doubeni C, et al. Disparities and survival among breast cancer patients. J Natl Cancer Inst Monogr. 2005;35:88–95.

    Article  PubMed  Google Scholar 

  21. Doubeni CA, Field TS, Ulcickas YM, et al. Patterns and predictors of mammography utilization among breast cancer survivors. Cancer. 2006;106:2482–8.

    Article  PubMed  Google Scholar 

  22. National Center for Health Statistics. Health, United States, 2006. Hyattsville: US Department of Health and Human Services; 2006.

    Google Scholar 

  23. 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.

    Article  PubMed  Google Scholar 

  24. 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.

    Article  PubMed  Google Scholar 

  25. 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.

    Article  PubMed  Google Scholar 

  26. Geiger AM, Nekhlyudov L, Herrinton LJ, et al. Quality of life after bilateral prophylactic mastectomy. Ann Surg Oncol. 2007;14:686–94.

    Article  PubMed  Google Scholar 

  27. 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.

    Article  PubMed  Google Scholar 

  28. 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.

    Article  PubMed  Google Scholar 

  29. 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.

    Article  PubMed  Google Scholar 

  30. 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.

    Article  PubMed  Google Scholar 

  31. 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.

    Article  PubMed  Google Scholar 

  32. Feldstein AC, Vogt TM, Aickin M, et al. Mammography screening rates decline: a person-time approach to evaluation. Prev Med. 2006;43:178–82.

    Article  PubMed  Google Scholar 

  33. 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.

    Article  PubMed  Google Scholar 

  34. 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.

    Article  PubMed  Google Scholar 

  35. 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.

    Article  PubMed  Google Scholar 

  36. Fenton JJ, Franks P, Reid RJ, et al. Continuity of care and cancer screening among health plan enrollees. Med Care. 2008;46:58–62.

    Article  PubMed  Google Scholar 

  37. 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.

    Article  PubMed  Google Scholar 

  38. 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.

    Article  PubMed  Google Scholar 

  39. 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-­occurring experiment. Genet Med. 2005;7:191–7.

    Article  PubMed  Google Scholar 

  40. 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.

    Article  PubMed  Google Scholar 

  41. 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.

    PubMed  Google Scholar 

  42. 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.

    Article  PubMed  Google Scholar 

  43. 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.

    Article  PubMed  Google Scholar 

  44. 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.

    Article  PubMed  Google Scholar 

  45. 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.

    Article  PubMed  Google Scholar 

  46. 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.

    Article  PubMed  Google Scholar 

  47. 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.

    Article  PubMed  CAS  Google Scholar 

  48. 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.

    Article  Google Scholar 

  49. Buist DS, Ichikawa L, Prout MN, et al. Receipt of appropriate ­primary 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.

    Article  PubMed  Google Scholar 

  50. 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.

    Article  PubMed  Google Scholar 

  51. Geiger AM, Prout MN, Silliman RA. Adjuvant radiation and ­hormonal therapy prevent recurrences and second primary breast cancers in older women. The American Journal of Hematology/Oncology. 2007;6:400–5.

    Google Scholar 

  52. 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.

    Article  PubMed  Google Scholar 

  53. 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.

    Article  PubMed  Google Scholar 

  54. 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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  56. 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.

    Article  PubMed  Google Scholar 

  57. 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.

    Article  PubMed  Google Scholar 

  58. 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.

    Article  PubMed  Google Scholar 

  59. Geiger AM, West CN, Nekhlyudov L, et al. Contentment with ­quality of life among breast cancer survivors with and without contralateral prophylactic mastectomy. J Clin Oncol. 2006;24:1350–6.

    Article  PubMed  Google Scholar 

  60. 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.

    Article  PubMed  Google Scholar 

  61. 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.

    Article  PubMed  Google Scholar 

  62. Lash TL, Fox MP, Buist DS, et al. Mammography surveillance and mortality in older breast cancer survivors. J Clin Oncol. 2007;25:3001–6.

    Article  PubMed  Google Scholar 

  63. Barton MB, West CN, Liu IL, et al. Complications following bilateral prophylactic mastectomy. J Natl Cancer Inst Monogr. 2005;35:61–6.

    Article  PubMed  Google Scholar 

  64. 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.

    Article  PubMed  Google Scholar 

  65. 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.

    Article  PubMed  Google Scholar 

  66. Hornbrook MC, Hart G, Ellis JL, et al. Building a virtual cancer research organization. J Natl Cancer Inst Monogr. 2005;35:12–25.

    Article  PubMed  Google Scholar 

  67. 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.

    Article  PubMed  Google Scholar 

  68. 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.

    PubMed  Google Scholar 

  69. 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.

    Article  PubMed  Google Scholar 

  70. 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.

    Article  PubMed  Google Scholar 

  71. 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.

    Article  PubMed  Google Scholar 

  72. 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.

    Article  PubMed  Google Scholar 

  73. Newton KM, Buist DS, Yu O, et al. Hormone therapy initiation after the Women’s Health Initiative. Menopause. 2008;15:487–93.

    Article  PubMed  Google Scholar 

  74. 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.

    Article  PubMed  Google Scholar 

  75. 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.

  76. 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.

  77. Greene SM, Hart G, Wagner EH. Measuring and improving performance in multicenter research consortia. J Natl Cancer Inst Monogr. 2005;35:26–32.

    Article  PubMed  Google Scholar 

  78. 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.

    Article  PubMed  Google Scholar 

  79. 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.

    Article  PubMed  Google Scholar 

  80. 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.

    PubMed  CAS  Google Scholar 

  81. 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.

    Article  PubMed  Google Scholar 

  82. 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.

    Article  PubMed  Google Scholar 

  83. 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.

    Article  PubMed  Google Scholar 

  84. 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.

    PubMed  Google Scholar 

Download references

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

  1. The Center for Health Research, Northwest/Hawaii/Southeast, Kaiser Permanente, 3800 North Interstate Avenue, Portland, OR, 97227, USA

    Mark C. Hornbrook Ph.D. & Joan Holup M.A.

Authors
  1. Mark C. Hornbrook Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joan Holup M.A.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mark C. Hornbrook Ph.D. .

Editor information

Editors and Affiliations

  1. New York Presbyterian Hospital, Brady Urologic Health Center, Weill Cornell Medical Center, East 68th Street 525, New York, 10021, New York, USA

    Ashutosh Tewari

Rights and permissions

Reprints 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)

Publish with us

Policies and ethics

Search

Navigation