Charles Lynch - US grants

My proposal requests five years of funding to develop pathologic and epidemologic research activities in cancer etiology and prevention. I have already received a Ph.D. degree in Preventive Medicine, just completed a four year residency in anatomic pathology with board certification, and recently received a joint junior faculty appointment in the Departments of Pathology and Preventive Medicine and Enviromental Health at the University of Iowa. I plan to center my research activities around the State Health Registry, which executes the Surveillance, Epidemiology, and End Results program for the State of Iowa. My basic research approach is based on two primary consideratins: 1) to explore a major area of enviromental epidemologic interest in greater depth; and 2) to bring my special expertise in pathology to bear on the analyses of these studies. The first research area will center around continued investigation of potential assocations between State of Iowa cancer incidence and drinking water contaminatin. The second research area will involve review and systematic recording of pathologic findings in tumorous tissue removed from incident cases participating in my cancer case-control research activities. These findings will initially include tumor characteristics such as level of invasion and grade, as well as host response factors such as degree of desomplasia and type and amount of inflammatory infiltrate. Because of its expense, this type of research activity has infrequently been pursured in cancer case-control studies. Given the time and funds associated with this award, I look forward to idenfiying assocations between risk factor exposures and these specific pathologic findings. Once these associations are found, proposals will be generated to further investigate their significance through more sophisticated pathologic methods such as tissue staining for specific cell markers. Teaching activities will be directed at medical students, graduate students, allied health students, and cancer epidemiology students, and emphasize cancer incidence and survival, risk factors, and preventive measures. Senior faculty members within the Deapartment of Pathology and Preventive Medicine and the Director of the Cancer Education Grant at the University of Iowa will serve as consultants and colleagues in the applicants accomplishment of these research and teaching activities.

The primary objective of this contract is to collect information from cancer patients and population controls in order to increase the statistical power of a current case-control study of cancer risk and drinking water contaminants. In particular, the study conducted under this contract will focus on bladder cancer, which is one of six sites being evaluated in the earlier phase of the study. Results from an earlier investigation (the National Bladder Cancer Study), strongly suggest that certain drinking water contaminants are linked to bladder cancer. The objective of this contract is to gather information, using a mail questionnaire, from an adequate number of bladder cancer patients and a matched group of population controls, to permit evaluation of bladder cancer risk as related to drinking water quality among study subgroups that are exposed, or not exposed, to other bladder cancer risk factors, such as cigarette smoke or occupational carcinogens. Interactive effects of joint exposures will also be evaluated. Information from 900 bladder cancer patients and 900 controls to be collected under this contract will be combined with data gathered from 600 patients and 1500 controls in the earlier phase of the study, for a total of 1500 bladder cancer cases, and 2400 population controls.

longitudinal human study; neoplasm /cancer chemotherapy; cancer risk; neoplasm /cancer relapse /recurrence; cervix neoplasms; radiation dosage; dosage; neoplasm /cancer radionuclide therapy; data collection; female; human subject;

A number of lines of evidence indicate that radon gas (progeny) is a potent lung carcinogen. Indoor radon has recently been reported to be a serious health risk in the U.S. Advisories have been issued indicating it is the second leading risk factor for lung cancer and may be responsible for up to 20,000 lung cancer deaths per year. While radon might be presumed to be a carcinogen in the home environment, it is unclear whether actual empirical evidence will show an increased lung cancer incidence in those non-occupationally but residentially exposed. A population-based case-control study is proposed to evaluate the association between residential radon exposure and the incidence of lung cancer among females in the state of Iowa. Because of the population composition of Iowa, over 98% of the cases will be of the white race. This 5-year study will involve 600 cases and 600 controls between the ages of 40 and 84. It will have three major components: 1) a cage-control mailed/telephone follow-up questionnaire; 2) a residential radon exposure assessment; and 3) independent histopathologic review of lung cancer tissues. Eligibility criteria will include the requirement of 25 years or more of residence in the same home at time of initial diagnosis among cases and at time of initial contact among controls. Our data collection goals will be to obtain at least an 80% response rate from the control group and an 85% response rate from the case group. Recent previous experience indicates these goals are attainable. Although several epidemiologic studies of radon in the home and lung cancer have already been performed or are currently being performed, this study is better designed to address this important health topic for several reasons: 1) a substantial proportion of the population will reside for 25 years or more in the same home; 2) a high quality, statewide cancer surveillance system which will allow for rapid identification of newly diagnosed lung cancer cases; 3) 70% of homes in the state have radon levels exceeding 4 pCi/liter and 4) multiple year-long measurements of radon in a subject's home will yield more accurate estimates of residential radon exposure. All of these reasons are described in further detail within this proposal.

longitudinal human study; neoplasm /cancer chemotherapy; cancer risk; neoplasm /cancer relapse /recurrence; cervix neoplasms; radiation dosage; dosage; neoplasm /cancer radionuclide therapy; data collection; female; human subject;

This contract will support a prospective epidemiological study of cancer among farmers and their dependents and other pest control workers. The study will establish a large cohort to be followed prospectively for 10 years or more to obtain detailed information on agricultural exposures, diet, cooking practices, and other factors of etiologic interest for cancer and other diseases. The cohort will include men and women who are either farm owners/operators, their spouses and dependents, or commercial or non-commercial pesticide applicators. The work will be carried out by one Coordinating Center and two Field Stations, each supported under separate contracts. This contract will establish a Field Station in the state of Iowa to select pesticide applicators for inclusion in the cohort, to collect data from pesticide applicators, to monitor cancer incidence and mortality in the portion of the cohort in the state of Iowa, and to fulfill the goals of the study, i.e., to evaluate cancer risks among farmers producing grains and livestock. This five-year study is being conducted by the Office of the Associate Director (OAD), Epidemiology and Biostatistics Program (EBP), Division of Cancer Etiology (DCE), National Cancer Institute (NCI) to explain why farmers experience an excess of several cancers.

human therapy evaluation; radiotracer; radiation therapy dosage; radiation dosage; neoplasm /cancer radiation therapy; neoplasm /cancer chemotherapy; cancer risk; ovary neoplasms; neoplasm /cancer radionuclide diagnosis; testis neoplasms; neoplasm /cancer radionuclide therapy; ionizing radiation; radiation related neoplasm /cancer; drug related neoplasm /cancer; antineoplastics; cancer registry /resource; male; human subject; female;

The objective of this contract will be to operate the Field Station already established in Iowa in support of the next five years of the Agricultural Health Study. The Field Station will be primarily responsible for updating exposure data on the cohort previously established through administration of a questionnaire, linking the cohort cohort members to vital status and disease registries in the state, coordinating all activities with the Coordinating Center, obtaining buccal swabs on a large fraction of the cohort for processing at the Coordinating Center, coordinating the activities of the U.S. EPA environmental assessment teams with a selected sample of farmers in the study, and related activities as described in the Statement of Work. This study is being issued by the Occupational Epidemiology Branch (OEB), Epidemiology & Biostatistics Program (EPB), Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI) to continue to obtain data to explain why farmers experience an excess of several cancers.

Description: This core was formerly named the Cancer Core (and before that the Epidemiology and Biometry core). The change in the name and organization of the core to its current one is designed to reflect an expanded interest and effort in reproductive outcomes and statistical genetics. The goal of this research core is to promote and participate in environmental epidemiology research, services, and training related to the rural and agricultural population of Iowa. The core is designed to provide epidemiologic, biostatistical, statistical genetic, and pathology services to Center investigators and to support the Pilot Project Program. To reflect the broadened scope of the core, six new investigators have been added: Drs. Trudy Burns (biostatistics and co-director), Jeff Murray (reproductive outcomes), Paul Romitti (Director of Iowa Birth Defects Registry), Audrey Saftlas (cancer and pregnancy outcomes), Elaine Smith (molecular epidemiology of cancer), and Veronica Vieland (statistical genetics). An additional change in this core is the removal of the environmental engineering component in 1996 to the Environmental Assessment and Control Core, in response to the review for the last renewal, which indicated a poor fit of this component in this Core. A final change is that Dr. Burmeister has moved to the Occupational Health Core, which better reflects his interest, provides statistical expertise to that Core, and facilitates collaboration of these two Cores. The core has completed 34 projects ($27.2 million in funding) and has 38 currently active projects ($82.4 million in funding). Investigators in the core have also produced 168 publications. Future initiatives for this core largely involve its ties to the Health Registry Facility to examine candidate genes and gene-environment (especially pesticides) interactions in relation to reproductive outcomes and cancer, develop better biologic sample collection methods, collect family history information, develop improved questionnaires, develop a sampling and survey unit within the Department of Epidemiology, and improve record linkage of existing databases.

Abstract Not Provided.

SEER Patterns of Care Studies describe, characterize, and compare practice patterns and treatments provided for cancer in different geographic areas of the United States. SEER Patterns of Care Studies are conducted to satisfy a Congressional directive (under Public Law 100-607, Sec. 413 (a)(2)(C) adopted November 4, 1988) to the National Cancer Institute to [unreadable]assess the incorporation of state-of-the-art cancer treatments into clinical practice and the extent to which cancer patients receive such treatments and include the results of such assessment in the biennial reports[unreadable][unreadable]. To select the cancers to satisfy this directive, the Division of Cancer Control and Population Sciences has been working closely with the Division of Cancer Treatment. This year[unreadable]s Pattern[unreadable]s of Care (POC) Study will investigate state-of-the-art therapies for prostate cancer, chronic lymphocytic leukemia, non-Hodgkin lymphoma, and gastrointestinal stromal tumors.

Research in the Cancer Epidemiology Program uses epidemiologic data to enhance our understanding of cancer incidence and therapy, and to explore how we can use this information to decrease cancer incidence and improve outcome. The overall goal of the members of this program is to perform epidemiologic research that will provide additional knowledge for educational and service-oriented activities aimed at decreasing cancer incidence, increasing survival, and improving quality of life. There are five major overlapping focus areas within the umbrella of the Program's research. Theme 1 - Cancer etiology Theme 2 - Cancer health services and outcomes Theme 3 - The epidemiology of head and neck cancer Theme 4 - Cancer prevention and control Theme 5 - Cancer and aging. Examples of major accomplishments of the Cancer Epidemiology Program over the past funding period include (a) description of novel findings regarding pesticides and cancer from the Agricultural Health Study cohort, (b) reporting of stronger dose-response odds ratios for residential radon and lung cancer likely due to more accurate exposure assessment, (c) the Women's Health Initiative findings on hormone therapy that concluded with a recommendation that hormone therapy not be taken to prevent heart disease, and (d) the discovery that stress mechanisms are related to angiogenic cytokines in ovarian cancer. There are numerous past and present productive collaborations both between members of the Program, and with members of other Cancer Center Programs. Current examples include the lung cancer care outcomes/surveillance consortium study, the Lymphoma SPORE, the Cancer and Aging P20, the Health Effectiveness Research Center, studies of human papillomavirus and cancer, the Iowa Comprehensive Cancer Control Consortium, and the Iowa Cancer Registry. The program consists of 26 members from 13 departments and 5 colleges. Current, peer-reviewed, cancer-related research, annual direct funding for this program totals $6,020,366 with $2,334,604 coming from the NCI.

The Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute (NCI) is an authoritative source of information on cancer incidence and survival in the United States. SEER currently collects and publishes cancer incidence and survival data from population-based cancer registries covering approximately 26 percent of the US population. SEER coverage includes 23 percent of African Americans, 40 percent of Hispanic Americans, 42 percent of American Indians and Alaska Natives, 53 percent of Asians, and 70 percent of Hawaiian and Pacific Island Americans. The current SEER data maintained at NCI includes records on 5.4 million cancers. The database serves as important resource for reporting on the burden of cancer, and is utilized by researchers both within and outside of NCI for the purpose of conducting descriptive epidemiologic studies. The SEER Program is a core component of the NCI's surveillance activities which provide information used for planning cancer control and research programs, and for evaluating the impact of such programs on cancer rates. The SEER Program was initiated in 1972 in response to requirements of the National Cancer Program for assessing the magnitude of the cancer burden in the United States, and for identifying factors related to cancer risk and/or patient survival. The SEER Program has among its objectives: 1. To assemble and report, on a periodic basis, estimates of cancer incidence. 2. To monitor annual cancer incidence trends to identify unusual changes in specific forms of cancer occurring in population subgroups defined by geographic, demographic, and social characteristics. 3. To provide continuing information on changes over time in extent of disease at diagnosis, trends in therapy, and changes in cancer patient survival. 4. To identify the occurrence of possible iatrogenic cancers, i.e., cancers that are caused by cancer therapy. 5. To serve as a research resource to the National Cancer Institute, and conduct studies dealing with current cancer control issues as well as problems related to the operation of the SEER Program.

Compared to younger and older aged cancer populations, SEER data suggest that the adolescent and young adult (AYA) population between the ages of 15 and 39 years has seen little or no improvement in cancer survival rates for decades. In 2005, the National Cancer Institute partnered with the Lance Armstrong Foundation and developed a Progress Review Group (PRG) to address the special research and cancer care needs of the AYA cancer population. The PRG identified important potential factors related to cancer care delivery that may contribute to the poorer relative outcome for many AYA cancer patients including: the patient access to care, delays in diagnosis, the cancer treatment setting and specific treatment practices used by care providers. Using the data provided by SEER the recent Progress Review Group (PRG) Report on Cancer in Adolescent and Young Adults (AYA) determined that follow-up of AYA was a high priority. While survival has been increasing for most age groups, it has not for AYA. Therefore, the PRG suggested a special emphasis should be placed on collection of current and complete treatment data for these individuals diagnosed with cancer. These patients too frequently fall into a [unreadable]no man's land[unreadable] between pediatric and adult oncology. Research on AYAs has been further constrained by their exceedingly low participation in the relatively few clinical trials available to them, in part because diagnosing physicians seldom refer these patients to trials. Inconsistency in care, coupled with insufficient research data, has prevented the development of guidelines for treating and monitoring AYAs with cancer, and few tools exist to measure the efficacy of treatment and psychosocial interventions delivered in diverse settings. The PRG determined that research in this population was a high scientific priority. To address these gaps, we have assembled a trans-NCI and extramural team to plan a feasibility study to include approximately 500 AYA patients beginning in October 2007.

The Surveillance, Epidemiology, and End Results (SEER) Program was established by the National Cancer Institute (NCI) to collect and report periodically on population-based cancer incidence and survival data. It is a core component of the NCI's surveillance activities which provide information used for planning cancer control and research programs, and for evaluating the impact of such programs on cancer rates. The SEER Program was initiated in 1972 in response to requirements of the National Cancer Program for assessing the magnitude of the cancer burden in the United States, and for identifying factors related to cancer risk and/or patient survival. Objectives of the SEER Program include: 1. Assemble and report, on a periodic basis, estimates of cancer incidence. 2. Monitor annual cancer incidence trends to identify unusual changes in specific forms of cancer occurring in population subgroups defined by geographic, demographic, and social characteristics. 3. Provide continuing information on changes over time in extent of disease at diagnosis, trends in therapy, and changes in cancer patient survival. 4. Identify the occurrence of possible iatrogenic cancers, i.e., cancers that are caused by cancer therapy. 5. Serve as a research resource to the National Cancer Institute, and conduct studies dealing with current cancer control issues as well as issues related to the operation of the SEER Program which may lead to improved and/or more cost-effective operating procedures.

SEER Patterns of Care Studies describe, characterize, and compare practice patterns and treatments provided for cancer in different geographic areas of the United States. SEER Patterns of Care Studies are conducted to satisfy a Congressional directive (under Public Law 100-607, Sec. 413 (a)(2)(C) adopted November 4, 1988) to the National Cancer Institute to ¿assess the incorporation of state-of-the-art cancer treatments into clinical practice and the extent to which cancer patients receive such treatments and include the results of such assessment in the biennial reports¿¿. To select the cancers to satisfy this directive, the Division of Cancer Control and Population Sciences has been working closely with the Division of Cancer Treatment. This year¿s Pattern¿s of Care (POC) Study will investigate state-of-the-art therapies for with metastatic melanoma, mesothelioma, astocytoma/oligodendroglioma, ovarian cancers, and neuroblastoma

The Surveillance, Epidemiology, and End Results (SEER) Program was established by the National Cancer Institute (NCI) to collect and report periodically on population-based cancer incidence and survival data. It is a core component of the NCI's surveillance activities which provide information used for planning cancer control and research programs, and for evaluating the impact of such programs on cancer rates. The SEER Program was initiated in 1972 in response to requirements of the National Cancer Program for assessing the magnitude of the cancer burden in the United States, and for identifying factors related to cancer risk and/or patient survival. Objectives of the SEER Program include: 1. Assemble and report, on a periodic basis, estimates of cancer incidence. 2. Monitor annual cancer incidence trends to identify unusual changes in specific forms of cancer occurring in population subgroups defined by geographic, demographic, and social characteristics. 3. Provide continuing information on changes over time in extent of disease at diagnosis, trends in therapy, and changes in cancer patient survival. 4. Identify the occurrence of possible iatrogenic cancers, i.e., cancers that are caused by cancer therapy. 5. Serve as a research resource to the National Cancer Institute, and conduct studies dealing with current cancer control issues as well as issues related to the operation of the SEER Program which may lead to improved and/or more cost-effective operating procedures.

SEER Patterns of Care Studies describe, characterize, and compare practice patterns and treatments provided for cancer in different geographic areas of the United States. SEER Patterns of Care/Quality of Care Studies are conducted to satisfy a Congressional directive (under Public Law 100-607, Sec. 413 (a)(2)(C) adopted November 4, 1988) to the National Cancer Institute to ?assess the incorporation of state-of-the-art cancer treatments into clinical practice and the extent to which cancer patients receive such treatments and include the results of such assessment in the biennial reports??. To select the cancers to satisfy this directive, the Division of Cancer Control and Population Sciences has been working closely with the Division of Cancer Treatment. This year?s Pattern?s of Care (POC) Study shall investigate state-of-the-art therapies for patients with cancers of sites: sarcoma for all ages and for ages 15-39 non-Hodgkin lymphoma, Hodgkin lymphoma, acute lymphocytic leukemia and female breast cancer.

The Surveillance, Epidemiology, and End Results (SEER) Program was established by the National Cancer Institute (NCI) to collect and report periodically on population-based cancer incidence and survival data. It is a core component of the NCI's surveillance activities which provide information used for planning cancer control and research programs, and for evaluating the impact of such programs on cancer rates. The SEER Program was initiated in 1972 in response to requirements of the National Cancer Program for assessing the magnitude of the cancer burden in the United States, and for identifying factors related to cancer risk and/or patient survival. Objectives of the SEER Program include: 1. Assemble and report, on a periodic basis, estimates of cancer incidence. 2. Monitor annual cancer incidence trends to identify unusual changes in specific forms of cancer occurring in population subgroups defined by geographic, demographic, and social characteristics. 3. Provide continuing information on changes over time in extent of disease at diagnosis, trends in therapy, and changes in cancer patient survival. 4. Identify the occurrence of possible iatrogenic cancers, i.e., cancers that are caused by cancer therapy. 5. Serve as a research resource to the National Cancer Institute, and conduct studies dealing with current cancer control issues as well as issues related to the operation of the SEER Program which may lead to improved and/or more cost-effective operating procedures.

SEER Patterns of Care Studies describe, characterize, and compare practice patterns and treatments provided for cancer in different geographic areas of the United States. SEER Patterns of Care/Quality of Care Studies (POC/QOC) are conducted to satisfy a Congressional directive (under Public Law 100-607, Sec. 413 (a) (2) (C) adopted November 4, 1988) to the National Cancer Institute (NCI) to ?assess the incorporation of state-of-the-art cancer treatments into clinical practice and the extent to which cancer patients receive such treatments and include the results of such assessment in the biennial reports??. To select the cancers to satisfy this directive, the Division of Cancer Control and Population Sciences has been working closely with the Division of Cancer Treatment. This year?s Patterns of Care (POC) Study shall investigate state-of-the-art therapies for patients with cancers of sites: Stage IV colon cancer, Chronic lymphocytic leukemia (CLL), and multiple myeloma.

The SEER Program was initiated in 1972 in response to requirements of the National Cancer Program for assessing the magnitude of the cancer burden in the United States, and for identifying factors related to cancer risk and/or patient survival. The SEER Program has among its objectives: 1. To assemble and report, on a periodic basis, estimates of cancer incidence, especially among the following key cancer sites: breast cancer, lung cancer, colorectal cancer, prostate cancer, pancreatic cancer, and urinary bladder cancer. 2. To monitor annual cancer incidence trends to identify unusual changes in specific forms of cancer occurring in population subgroups defined by geographic, demographic, and social characteristics. 3. To provide continuing information on changes over time in extent of disease at diagnosis, trends in therapy, and changes in cancer patient survival. 4. To identify the occurrence of possible iatrogenic cancers, i.e., cancers that are caused by cancer therapy. 5. To serve as a research resource to the National Cancer Institute, and conduct studies dealing with current cancer control issues as well as problems related to the operation of the SEER Program.

The National Cancer Institute Surveillance, Epidemiology and End Results (SEER) Program is interested in developing a SEER-linked Virtual Tissue Repository (VTR). A SEER VTR, with its population representativeness and large sampling frame would be a unique resource for assembling robust collections of biospecimens even for rare tumors and outcomes. SEER demographic and clinical data can be augmented with custom annotation of data including detailed chemotherapy, time to recurrence, and body mass index. The objectives of the VTR Pilot Study are to assess the ability of SEER Registries To serve as a resource for biospecimen research To locate cases with biospecimens in pathology laboratories and determine the requirements to retrieve those biospecimens To provide custom annotation of specified data items The VTR Pilot will also capture costs to identify and annotate these biospecimens.

Cancer survivors often deal with a myriad of physical, psychological, financial and social consequences, some predictable and others unknown. Information on long-term effects of new therapies is sparse, especially for vulnerable populations under-represented in clinical trials such as the elderly, minorities, and those with multiple co-morbid conditions. The proposed pilot study will develop methods to enhance cancer surveillance through the SEER registries by exploring the opportunity to use cancer registries as a base that will support collection of broader information, consistent with the mission of the NCI and the SEER Program, to support investigations into how to improve clinical cancer outcomes. The objectives of this study are: 1) Collaborate with NCI staff in developing a common protocol and questionnaires to identify, contact and assess the patient's willingness to provide information and to participate in future investigations, 2) Define barriers and challenges related to contacting patients and obtaining self-reported information and consent to access medical records, 3) Assess the process of identifying, contacting, recruiting and consenting newly diagnosed patients who are undergoing treatment and cancer survivors to provide additional information to support future registry data collection, including requirements of institutional review boards (IRB) and methods of contact (e.g., direct contact or via health care provider), 4) Assess the willingness of patients in cancer registries to allow access to medical records and tumor specimens, and potentially contribute other biospecimens such as blood samples; and identify resources needed to accomplish these tasks.

The SEER Program was initiated in 1972 in response to requirements of the National Cancer Program for assessing the magnitude of the cancer burden in the United States, and for identifying factors related to cancer risk and/or patient survival. The SEER Program has among its objectives: 1. To assemble and report, on a periodic basis, estimates of cancer incidence. 2. To monitor annual cancer incidence trends to identify unusual changes in specific forms of cancer occurring in population subgroups defined by geographic, demographic, and social characteristics. 3. To provide continuing information on changes over time in extent of disease at diagnosis, trends in therapy, and changes in cancer patient survival. 4. To identify the occurrence of possible iatrogenic cancers, i.e., cancers that are caused by cancer therapy. 5. To serve as a research resource to the National Cancer Institute, and conduct studies dealing with current cancer control issues as well as problems related to the operation of the SEER Program.

The goal of the Cancer Epidemiology and Population Science (CEPS) Program is to conduct population-based research that improves our understanding of factors that cause cancer, and the morbidity and mortality from cancer. To accomplish this, the CEPS has three central research themes: 1) Cancer Etiology, 2) Cancer Health Services and Outcomes, and 3) Cancer Prevention and Control. The CEPS has 30 full members and 9 associate members across 6 colleges (Dentistry, Liberal Arts & Sciences, Pharmacy, Public Health, Medicine, and Nursing) and 17 departments. Annual CEPS total funding for peer-reviewed research in the last budget year was $5.17 million ($0.96 NCI funding) and $1.07 million for non-peer-reviewed research projects. CEPS members gain great benefit from a robust and unique peer-reviewed infrastructure support. This funding has a clear and positive impact on research taking place within CEPS. However, per guidelines, much of the support for major cancer epidemiology and population health projects and centers is ZY-coded (non-programmatically aligned). This ZY-coded funding totals $7.59 million ($4.12 from the NCI). CEPS members are highly collaborative. CEPS full and associate members have authored or co-authored 383 cancer-related peer- reviewed publications since April 1, 2011 with 34% (n=129) of these addressing cancer etiology, 50% (n=193) addressing cancer health services and outcomes, and 16% (n=61) addressing cancer prevention and control. 25% (n=97) were intra-programmatic, 20% (n=76) inter-programmatic, and 65% (n=250) inter-institutional. 33 manuscripts were published in high impact journals (impact factor ?10). Research in CEPS is particularly relevant for the catchment area of the HCCC which is the state of Iowa. In the Cancer Etiology theme, research advances have focused on lymphoma, colorectal cancer, human papillomavirus-related cancers, agricultural exposure-related cancers, chlorinated biphenyls, and breast cancer. Advances in the Cancer Health Services and Outcomes theme include pain assessment, biobehavioral factors, patterns of care and treatment delivery, prognostic factors, and cognition. Advances in the Cancer Prevention and Control theme have focused on tobacco control, residential radon, nutrition and weight management, and colorectal cancer screening.

SEER Patterns of Care Studies describe, characterize, and compare practice patterns and treatments provided for cancer in different geographic areas of the United States. SEER Patterns of Care/Quality of Care Studies (POC/QOC) are conducted to satisfy a Congressional directive (under Public Law 100-607, Sec. 413 (a) (2) (C) adopted November 4, 1988) to the National Cancer Institute (NCI) to ?assess the incorporation of state-of-the-art cancer treatments into clinical practice and the extent to which cancer patients receive such treatments and include the results of such assessment in the biennial reports??. To select the cancers to satisfy this directive, the Division of Cancer Control and Population Sciences has been working closely with the Division of Cancer Treatment. This year?s Patterns of Care (POC) Study shall investigate state-of-the-art therapies for patients with cancers of sites: female breast, colorectal and lung.

SEER Patterns of Care Studies describe, characterize, and compare practice patterns and treatments provided for cancer in different geographic areas of the United States. SEER Patterns of Care/Quality of Care Studies (POC/QOC) are conducted to satisfy a Congressional directive (under Public Law 100-607, Sec. 413 (a) (2) (C) adopted November 4, 1988) to the National Cancer Institute (NCI) to ?assess the incorporation of state-of-the-art cancer treatments into clinical practice and the extent to which cancer patients receive such treatments and include the results of such assessment in the biennial reports??. To select the cancers to satisfy this directive, the Division of Cancer Control and Population Sciences has been working closely with the Division of Cancer Treatment. This year?s Patterns of Care (POC) Study shall investigate state-of-the-art therapies for patients with cancers of sites: corpus uteri, head and neck and pancreas.

PROJECT SUMMARY/ABSTRACT The Cancer Epidemiology and Population Science (CEPS) research program focuses primarily on cancer in Iowa, the Holden Comprehensive Cancer Center (HCCC) catchment area, while recognizing that its impact extends well beyond the state. The primary goal of the CEPS is to conduct population-based research that improves our understanding of cancer etiology, morbidity, and mortality in order to explore interventions for reducing cancer incidence and mortality and improving quality of life for cancer survivors. This is accomplished through three related research aims centered on 1) cancer etiology, 2) primary and secondary cancer prevention and 3) cancer health care services and outcomes. Recent influential CEPS publications have addressed lymphoma, chronic lymphocytic leukemia, contralateral breast cancer, pancreatic and breast cancer survival, stress, and end-of-life issues, as well as United States Preventive Services Task Force recommendations for cancer prevention and screening. CEPS membership includes 28 full and nine associate members spanning 17 departments across five colleges. Annual total direct funding for peer-reviewed research in the last budget year was $4.3 million with $1.5 million from the NCI. CEPS members are highly productive, having authored or co-authored 372 cancer-related peer-reviewed publications since 2016, and highly collaborative, with 24% (n=91) intraprogrammatic, 18% (n=70) interprogrammatic, and 63% (n=235) interinstitutional publications. Fifty-two of these publications appeared in high impact journals (Impact Factor >10). Successful intra/interprogrammatic and multi-institutional collaborations are generating important cancer- related advances in knowledge about pesticide and polychlorinated biphenyl exposures; lymphoma, sarcoma, and cancers of the breast, ovary, and colorectum; HPV-related cancer and vaccination; multimorbidity science; cancer screening; and tobacco cessation.