Our community is in need of improved care for patients with malignant diseases, especially our minority population. Our long-term goals are to bring the advantages of cancer control and state-of-the-art cancer treatment to a much larger number of patients in our target population. In order to enhance the accrual of patients, especially minority patients, we need to dramatically expand our support structure. We have a strong history of a multi-disciplinary effort in cancer care by a large number of health care professionals, which can potentially reduce the morbidity and mortality as well as the cancer incidents in this targeted population. Unfortunately, we have had a dearth of support personnel required to expand our work. This proposal aims to dramatically increase the Data Management personnel and support structure needed to provide ample opportunity to expand our clinical cancer research. Our multi-center approach allows us access to two of the three largest urban areas with the highest concentration of minorities. This is important since minority accrual to NCI cancer research protocols has been so poor. By enrolling more of this underserved population to national trials, it is hoped that the overall care of this population can be improved. This is an ambitious multi-center approach, using a centralized data management system, to recruit and follow-up patients. Epidemiologists at our institution have identified excess mortality compared to the incidence of many cancers. Excess mortality is especially found among the minority population of the state. Efforts are underway within the state to determine the high mortality compared to incidence for these cancers but the main factor appears to be delay in diagnosis. Access to care, per se, is not a factor since Louisiana is unique among states in having a state-wide, state-run system for indigent care. Despite this system, patients do not appear to present for diagnosis in a timely fashion. Factors which could effect patient delay in diagnosis are lack of information about cancer screening. LSU has participated in several cooperative trial groups and has a proven commitment to enrollment of all investigators into one organizational structure with centralized data management, thus eliminating duplication. Streamlining this operation will allow greater access to new populations in the southern part of the state. Increasing enrollments in cancer treatment and control trials should have an enhanced effect in promoting screening and earlier access to care for all the citizens of the state, especially the minority populations.
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