The overall goal of the Research Center is the creation of a research unit that can evaluate the complete colorectal cancer (CRC) screening process. The specific goal is the characterization of remediable failures of the two most commonly used screening tests (optical colonoscopy and fecal immunochemical tests [FIT]). Two important problems in CRC are over-screening and under-diagnosis: 1) >95% of people will not die of CRC, thus, for most patients, screening results only in worry &risk;yet 2) many CRC deaths occur despite CRC screening (i.e. in persons with prior screening). It is unclear how many deaths result from remediable failures of the screening process. Our center will evaluate a community-based cohort that includes detailed CRC screening and medical data for >2 million screening-eligible people/year;>10 years of data;large numbers of outcomes (38,000 cancers);geographic diversity (>35 medical centers across California);demographic diversity (140,000 African Americans, 320,000 Hispanics, and 200,000 Asian-Americans among current members);socioeconomic diversity;diversity of screening methods;access to tissue/cancer blocks;and a full spectrum of individual cancer risk. Project 1 will evaluate FIT, an effective and efficient noninvasive screening method. Project 2 will evaluate colonoscopy, a sensitive, widely used test that is the final common exam for all CRC screening strategies. Projects 1 &2 will both evaluate patterns of use, especially: screening failures (cancers diagnosed despite screening);surveillance failures, and surveillance over-use. We will investigate physician and patient components for these failures using a recently developed systematic process that includes establishing bases for interventions that target barriers in healthcare settings. Project 1 will also evaluate clinically available genetic markers to evaluate for potential biological differences between FIT detected vs. screen failure cancers. Project 3 will model the effectiveness of colonoscopy vs. FIT utilizing community-based data from the full screening process acquired in Projects 1 &2, in collaboration with a proven NCI consortium Cancer Intervention and Surveillance Modeling Network (CISNET) site, including different screening strategies for different patient populations, tailored to risk. The Center includes a trans-disciplinary group of researchers including gastroenterologists, oncologists, family physicians, population scientists, modeling experts, quality experts, behavioral experts, and experts in health care delivery. The Center can efficiently evaluate the full screening process and can provide substantial human, institutional, and patient resources for collaborative projects within the PROSPR network.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Specialized Center--Cooperative Agreements (U54)
Project #
5U54CA163262-04
Application #
8715704
Study Section
Special Emphasis Panel (ZCA1-SRLB-R)
Project Start
Project End
Budget Start
2014-06-01
Budget End
2015-05-31
Support Year
4
Fiscal Year
2014
Total Cost
$318,608
Indirect Cost
$57,709
Name
Kaiser Foundation Research Institute
Department
Type
DUNS #
150829349
City
Oakland
State
CA
Country
United States
Zip Code
94612
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Doubeni, Chyke A; Gabler, Nicole B; Wheeler, Cosette M et al. (2018) Timely follow-up of positive cancer screening results: A systematic review and recommendations from the PROSPR Consortium. CA Cancer J Clin 68:199-216
Levin, Theodore R; Corley, Douglas A; Jensen, Christopher D et al. (2018) Effects of Organized Colorectal Cancer Screening on Cancer Incidence and Mortality in a Large Community-Based Population. Gastroenterology 155:1383-1391.e5
Chubak, Jessica; McLerran, Dale; Zheng, Yingye et al. (2018) Receipt of Colonoscopy Following Diagnosis of Advanced Adenomas: An Analysis within Integrated Healthcare Delivery Systems. Cancer Epidemiol Biomarkers Prev :
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Hillyer, Grace Clarke; Jensen, Christopher D; Zhao, Wei K et al. (2017) Primary care visit use after positive fecal immunochemical test for colorectal cancer screening. Cancer 123:3744-3753
Meester, Reinier G S; Doubeni, Chyke A; Zauber, Ann G et al. (2017) Impact of adenoma detection on the benefit of faecal testing vs. colonoscopy for colorectal cancer. Int J Cancer 141:2359-2367
Fedewa, Stacey A; Corley, Douglas A; Jensen, Christopher D et al. (2017) Colorectal Cancer Screening Initiation After Age 50 Years in an Organized Program. Am J Prev Med 53:335-344
Lee, Jeffrey K; Jensen, Christopher D; Levin, Theodore R et al. (2017) Accurate Identification of Colonoscopy Quality and Polyp Findings Using Natural Language Processing. J Clin Gastroenterol :
Balasubramanian, Bijal A; Garcia, Michael P; Corley, Douglas A et al. (2017) Racial/ethnic differences in obesity and comorbidities between safety-net- and non safety-net integrated health systems. Medicine (Baltimore) 96:e6326

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