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Cancer Society Grants $1M to URMC for Racial Disparity Research

Thursday, January 10, 2008

Kevin Fiscella, M.D.

The American Cancer Society today awarded $1 million to a University of Rochester Medical Center physician for a four-year project to improve the rates of cancer screenings among poor and minority patients in Rochester.

Kevin Fiscella, M.D., M.P.H., associate professor of Family Medicine, Community and Preventive Medicine and Oncology at the University of Rochester, will lead a research team to implement clinician and patient reminders, patient recall systems and outreach to promote breast or colon cancer screening tests among underserved people. Healthy individuals who have never been screened or who were screened at some point but are in need of follow-up would be eligible for the study.

Researchers in Rochester and across the country are concerned about the disparities that persist in cancer prevention and treatment. The American Cancer Society (ACS) reported this month that blacks continue to get inferior treatment compared to whites, despite efforts taken by some doctors and hospitals during the past decade to address the problem.

Both colorectal cancer and breast cancer are associated with higher death rates among African Americans. Reasons for this might include less use of cancer screening tests, a lack of knowledge about the benefits of screening, or lack of trust in the medical establishment. Regardless of the reasons, when people are not screened properly, they do not gain the benefits of early cancer detection and the opportunity to be cured.

Studies have shown that people do respond when they are reminded that it’s time to get a colonoscopy or a mammogram. However, some physician practices lack the resources to remind patients and doctors about cancer screening, let alone call back patients and provide outreach to unscreened patients.

Fiscella and his team are adapting a community outreach program that was successful in Rochester to improve disparities in adult and childhood immunizations. The Reminders, Recall and Outreach (RRO) program employs community-health workers who work with primary care doctors to reach people eligible for cancer screening through letters, phone calls, and face-to-face visits. They assist practices in combing through charts to find patients who are overdue for tests, implement tracking systems, and increase the intensity of the outreach if low-level prompts do not suffice. The intensity is designed to meet patient barriers or need, Fiscella said.

Researchers will randomly assign patients to early or delayed RRO efforts, which will enable them to assess the impact of the RRO program on reducing disparities and increasing screening rates. The focus will be on colorectal cancer screening because rates are significantly lower in Rochester than for breast cancer screening, Fiscella said.

Co-investigators on the study are Samantha Hendren, M.D., assistant professor of Surgery and Oncology, in the Division of Colorectal Surgery at the James P. Wilmot Cancer Center; and Sharon Humiston, M.D., M.P.H., associate professor of Emergency Medicine and Pediatrics, who collaborated on the immunization studies. 

The $1,060,000 ACS award runs from January 2008 through December 2011. Donald Distasio, CEO of the American Cancer Society of New York and New Jersey, and Mark Cronin, regional vice president for the American Cancer Society’s Lakes Region, presented the funds to Fiscella. The grant is the second largest award to the Medical Center from the regional ASC office. In 2001 the ASC provided $1.7 million to Gary Morrow, Ph.D., to investigate the causes and control of cancer-related nausea.

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