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Cancer Control

Study Examples | Key Publications | Intro

From pioneering work in breast cancer surveillance to recent findings in colorectal and prostate cancer screening, Group Health Center for Health Studies (CHS) continues to discover how patients, providers, and organizations can help improve outcomes along with the quality and delivery of cancer care. CHS cancer researchers explore questions that span cancer’s natural history—including biology, prevention, early detection, treatment, and providing care at the end of life.

Answering these questions demands a multidisciplinary approach. The Center’s extensive expertise in epidemiology, health services, biostatistics, economics, and behavioral medicine gives scientists in the CHS cancer group a comprehensive foundation for a variety of interventions. The focus of their projects ranges from the most prevalent cancers—of the breast, lung, colon, and prostate—to such rare and highly fatal cancers as those of the pancreas, esophagus, and ovary.

Group Health established one of the nation’s first prospective, individually tailored, population-based breast cancer screening programs in 1986. Since then, CHS investigators have helped the program to develop and improve based on evidence collected at Group Health and elsewhere. "Translation (diffusing research findings into practice) permeates our research," says Diana Miglioretti, PhD, associate investigator at CHS.

"The national impact of the Center has grown in recent years thanks in part to its involvement in multi-site collaborative studies such as the Breast Cancer Surveillance Consortium (BCSC), the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium, and the Cancer Research Network (CRN)," says Margaret T. Mandelson, PhD, associate investigator at CHS.

CHS founded and oversees the CRN, a consortium of 12 health care organizations that was created to study the effectiveness of cancer control interventions. The participating sites have access to large, stable, and diverse patient populations, and together, the CRN sites represent nearly 4 percent of the U.S. population. The CRN is designed to conduct research in cancer epidemiology, prevention, early detection, and control in the context of health care delivery systems. It has the capacity to study patient-, provider-, and organization-level factors that affect the quality and delivery of cancer care among the more than 10 million people enrolled in the member organizations nationwide. The CRN’s rich integrated databases facilitate studies with lengthy periods of follow-up, and results from CRN research are promoting changes to health care delivery. CHS investigators are providing administrative and scientific leadership for a variety of investigations supported by $42 million from the National Cancer Institute (NCI) over eight years. MacColl Institute director and CHS senior investigator Edward H. Wagner, MD, MPH, leads the CRN. A recent development, supported in part by the CRN platform, is that CHS is emerging as a leader in health plan-based etiologic research on rare cancers and cancer biology.

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Study Examples | Key Publications | Intro