Mixed News: Cancer Rates Drop, But More Younger Patients Affected

The latest cancer statistics report from the American Cancer Society (ACS) paints a complex picture of our struggle against the disease. While cancer mortality rates are declining, a worrying trend emerges: younger people are being diagnosed at an increasing rate. This bittersweet news highlights both the progress we’ve made and the challenges that lie ahead.

This week, the Wall Street Journal delved into this story, seeking expert insights from several scientists, including Dr. Karen Glanz, a Penn cancer epidemiology powerhouse. Dr. Glanz, co-leader of the Penn Medicine Abramson Cancer Center’s (ACC) cancer control research program, provided independent commentary on the ACS report, shining a light on both the good and the not-so-good news.

The encouraging side?

The report reveals that 42% of cancers in the US can be attributed to modifiable risk factors like smoking, diet, and lack of exercise. This means that through proactive measures, we can potentially prevent nearly half of all cancer cases. “If we focused on physical activity, diet, and obesity as major risk factors for some cancers, the payoff could be enormous,” Dr. Glanz emphasized.

Dr. Glanz’s leads the Penn Prevention Research Center and the Center for Health Behavior Research and co-leads the Cancer Control Program at ACC. Her ongoing studies focus on promoting physical activity and reducing obesity, directly addressing the modifiable risk factors we can control.

Engage and Collaborate

But Dr. Glanz’s work is also driven by a passion for community engagement. Her leadership in the Philadelphia Communities Conquering Cancer collaboration is a testament to this. This initiative unites leading cancer centers with local leaders, empowering Philadelphians to fight cancer disparities through community-based interventions, resource sharing, and research.

So, while the ACS report reveals a sobering reality for younger cancer patients, it also underscores the immense potential for prevention. By focusing on modifiable risk factors and empowering communities, we can turn the tide on this disease. Research by Dr. Glanz and her colleagues provides a beacon of hope, a testament to the power of research, community engagement, and a relentless pursuit of a healthier future.

City-Wide Cancer Disparities Conference

We heard very moving personal stories from some cancer survivors and ‘pep rally’ encouragement from a former Eagles player.
Everyone gave input into helping us process the Listening Sessions and think about our future research and program priorities to reduce cancer disparities in Philadelphia.

Karen Glanz, PhD, MPH

PC3 Academic Partner, Abramson Cancer Center at Penn Medicine, University of Pennsylvania

On June 15, 2023 representatives from health systems, cancer centers, stakeholders, and Philadelphia community members discussed concerns about cancer in the region and charted a path forward to reduce disparities in our city.

The group was assembled by the Philadelphia Communities Conquering Cancer (PC3) collaboration, whose mission is to empower Philadelphians to reduce cancer disparities through community engagement, resource alignment, information sharing, research, and prevention. An opportunity funded by PCORI.

The Patient-Centered Outcomes Research Institute (PCORI) is a nonprofit organization authorized by Congress to fund comparative clinical effectiveness research, or CER. The studies funded are designed to produce reliable, useful information that will help patients, family caregivers, clinicians, employers, insurers, policy makers, and others make better informed health and healthcare decisions. The work is guided by a Board of Governors representing the entire healthcare community. The coalition is made up of representatives from Abramson Cancer Center at Penn Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, and Fox Chase Cancer Center. The funded project is “Building Capacity for Patient Centered Outcomes Research through a City-Wide Cancer Coalition.” Community members, patients, and stakeholders are the cornerstone of the project. The SAC guides all proposed activities and play key roles in planning, implementation, and dissemination. Additional community members and stakeholders host the listening sessions, participate in the consensus conference, and speak during the research advocate training program.

Visit the website to learn more about the programs, leadership, and community partners.

A Tobacco-Free Penn Campus

The Student Health Service/Campus Health department at the University of Pennsylvania created videos to accompany their tobacco-free campus campaign. Watch their video, supported by the University of Pennsylvania Prevention Research Center (UPenn PRC), to learn more about their plans to improve health and create a more beautiful and sustainable campus.

 

Visit their website for more information on this ongoing project and look for the signage that alerts students and staff that Penn is Tobacco Free. Student Health Services has also provided a Tobacco Cessation Resources brochure to help students quit smoking.

Colon Cancer Prevention Month

In honor of Colon Cancer Awareness Month, we’ve assembled some highlights of the work being done by researchers at the UPenn PRC towards colorectal cancer prevention. We’re helping local health clinics increase colorectal screening rates by addressing barriers to screening, such as financial help for uninsured patients or training healthcare workers to follow-up with patients. #ColorectalCancer
 
  • We work with the local American Cancer Society and the Health Federation of Philadelphia (HFP), to help Federally Qualified Health Centers (FQHCs) adopt quality programs that help to increase colorectal cancer screening rates. In addition to increased rates, these programs range from financial help for uninsured clients to changing which personnel are responsible for following up with patients who need to be screened.
  • We’re contributing to an ongoing study with the Cancer Prevention & Control Research Network (CPCRN) FQHC work group, where we administered a survey and conducted interviews about implementation of evidence based interventions to increase CRC screening in FQHCs.
  • Our Community Scholars In-Residence Program matches doctoral candidates, medical students, and postdocs with community programs. They research cancer prevention and control at the community level. This project is supported by CPCRN and the Community Engagement and Research Core (CEAR Core).

Investigator Spotlight

Chyke Doubeni, MD, FRCS, MPH

Dr. Chyke Doubeni examined the barriers to screenings which provide early identification and prevention of colorectal cancer for low-income patients.

Featured Publications:

Singal AG, Corley DA, Kamineni A, Garcia M, Zheng Y, Doria-Rose PV, Quinn VP, Jensen CD, Chubak J, Tiro J, Doubeni CA, Ghai NR, Skinner CS, Wernli K, Halm EA. Patterns and predictors or repeat fecal immunochemical and occult blood test screening in four large health care systems in the United States American Journal of Gastroenterology, Feb. 2018

In a study of over 300,000 patients, Dr. Doubeni and his co-authors found factors in hospitals that are associated with whether patients complete colorectal cancer screenings in the recommended time frame. Their results suggest that screening rates increase if the hospital/clinic focuses their attention and follow-up with patients.

Peterse EFP, Meester RGS, Gini A, Doubeni CA, Anderson DS, Berger FG, Zauber AG, Lansdorp-Vogelaar I.Value Of Waiving Coinsurance For Colorectal Cancer Screening In Medicare Beneficiaries, Health Affairs (Project Hope), Dec. 2017

Dr. Doubeni and his colleagues have also modeled the potential effects of waiving coinsurance payments for Medicare patients who have colorectal cancer screening. They find that even if waiving the coinsurance raises the number of people screened by less than one percent, these measures would strike a good balance between cost and health benefits impacts.

 

UPenn PRC Anniversary Story & Prostate Cancer Evidence Academy: A Year of Progress

              

The University of Pennsylvania Celebrates 30 Years of the CDC’s Prevention Research Center Program

UPenn PRC Anniversary Story

December 2016

Prostate Cancer Evidence Academy: A Year of Progress

 

Prostate cancer is the second leading cause of death from cancer in men; being African American is a key risk factor. Philadelphia, the fifth largest city in the US, is 44% black/ African American and in Pennsylvania, the incidence rate for prostate cancer is 58% higher for African American men than for white men.

These sobering statistics were incentive for UPenn PRC Director and Penn Integrates Knowledge Professor Karen Glanz, PhD, MPH, and Tim Rebbeck, PhD, to host the first Prostate Cancer Evidence Academy at the University of Pennsylvania in November, 2015. Sponsored by the UPenn PRC, the Cancer Prevention and Control Research Network, and the Penn Center for Excellence in Prostate Cancer Disparities, the conference gathered nearly 100 attendees, including health care providers, researchers, policy makers, survivors, and advocates for a comprehensive symposium on prevention, control, awareness, and education.

The goal of the conference was not only to present the latest data but to engage clinicians, public health professionals, policy makers, and patients/survivors in bridging the gap between research and practice.  Bringing together the widest possible range of stakeholders created a unique model for sharing evidence-based research, models, and programs.

Neha Vapiwala, MD, a Penn associate professor of radiation oncology, attended the conference.  Now, she and Glanz are working on a new train-the-trainer project which provides respected and trusted community and religious leaders with basic information about prostate cancer.  The researchers see further applications of this model for other chronic diseases.

“Cultural myths and societal misperceptions about certain stigmatized diseases may prevent people from asking questions, understanding symptoms, or seeking care,” says Vapiwala,“Deep-rooted distrust of the health care system further exacerbates the problem.”  “The conference was a first venture of its kind for us,” Glanz says. “Out of that came some clear needs, and some of them really converged with what Neha had noticed in her clinic.”

 

     

 

 

 

 

 

Tobacco Taxes Help Tackle Smoking Addiction: Cheryl Bettigole, MD

In a recent Philadelphia Inquirer Commentary,  Cheryl Bettigole, MD, UPenn PRC Community Advisory Board member and Director of the Division of Chronic Disease Prevention at the Philadelphia Department of Public Health, advocates broadening the tobacco tax increase adopted by the Pennsylvania legislature last summer.

The tax increase was applied only to cigarettes, e-cigarettes, roll-your-own and smokeless tobacco. Bettigole advocates including cigars and cigarillos.

“More than 10 percent of high school boys now smoke cigars and the failure to tax these products is likely to make them disproportionately cheap and hence more attractive to teens. Like e-cigarettes, cigarillos come in a multitude of flavors that seem designed to draw kids in, and are often displayed in Philadelphia’s neighborhood stores next to displays of candy and gum.”

Flavored tobacco products are a particular draw to young people.  According to Bettigole, seven out of ten teens who start smoking begin with a flavored tobacco product. Bettigole notes, “More than 90 percent of smokers start as teens and that addiction, once begun, can be impossible to break.”

 

Federal Law Fix Needed for Colorectal Cancer Screening: PRC Researcher Chyke Doubeni

Writing in the Philadelphia Inquirer about a loophole in the Affordable Care Act which disadvantages those who need colorectal cancer screening most,  PRC Researcher Chyke A. Doubeni, MD, suggests that “this unfortunate scenario occurs in part because the U.S. Congress unfairly limits the ability of low-income Medicare beneficiaries to receive screening. This compounds other barriers and perpetuates long-standing disparities in mortality from colon cancer for seniors.”

Doubeni notes that misclassifiying colonoscopy as a “one-time activity” rather than including it in the screening menu of “a series of clinical activities involved in identifying and testing patients and performing diagnostic confirmation when necessary” makes the test available only to Medicare patients who can afford supplemental policies.

PRC Researcher Chyke Doubeni on Health Disparities for Colorectal Cancer Screening

 

In the May 2016 issue of Gastroenterology, UPenn PRC Researcher Chyke Doubeni examines the barriers to screenings which provide early identification and prevention of colorectal cancer for low-income patients.  Colorectal cancer is the second leading cause of cancer death in the United States; about 70% of those deaths occur in Medicare age-eligible patients.

Doubeni reviews the Affordable Care Act provisions intended to benefit low-income patients and examines why providers’ interpretations of those benefits have lead to confusion about insurance status of patients, insurance coverage for different steps of screening procedures, and reimbursement expectations.  Doubeni’s recommendations include Congressional action to amend and clarify the provisions.

 

Rural Cancer Prevention Center at the University of Kentucky Reaches Poorest Regions of the State

Our fellow Prevention Research Center at the University of Kentucky, the Rural Cancer Prevention Center, was featured in an important story on the challenges of tackling cancer in rural Kentucky. The feature airs on PBS’s NewsHour on Friday, March 26, 2016. The Rural Cancer Prevention Center is credited with advancing cancer screening and education in some of the poorest regions of the state.

See the story here:

https://www.pbs.org/newshour/show/why-cancer-is-so-hard-to-fight-in-rural-kentucky

Graphic Warning Labels on Cigarette Packs More Effective than Text

In a PLOS ONE report, Andrew Strasser, PhD, Co-Investigator on the UPenn PRC Skin Cancer Communication project, shows that graphic warning labels are more effective that text. Strasser, along with Daniel Romer, Ph.D, research director at the Annenberg Public Policy Center, and fellow researchers reported on the first naturalistic clinical trial which shows that only warnings in encouraging smokers to consider quitting and in educating them about smoking’s risks.

Dr. Strasser’s tobacco regulatory research program examines the impact of advertising, marketing and labeling on risk perceptions and tobacco product use,  He has been project leader on 9 NIH/FDA funded projects and is currently an Associate Editor of Nicotine and Tobacco Research.

 

Read the article here.

Read the brief by Annenberg Public Policy Center here.

Karen Glanz, PhD, MPH, UPenn PRC Director, Keynote Speaker at Int’l Conference on Skin Cancer Prevention

UPenn PRC Director Karen Glanz, PhD, MPH, was a Keynote Speaker at the 3rd International Conference on UV and Skin Cancer Prevention in Melbourne Australia, Dec 7 – 11, 2015.

 

Speaking on the topic, “Effectiveness of Prevention on Melanoma and Non-Melanoma Reduction,” Dr. Glanz also was a panelist with Melanie Wakefield, PhD, of the Cancer Council, Victoria, Australia, and a consultant on the UPenn PRC Skin Cancer Prevention Communication Project, and Louisa Gordon, MPH, PhD, of Griffith University, NSW, Australia

 

 

 

Link between red and processed meat and cancer on Knowledge@Wharton

On SiriusXM’s Knowledge@Wharton, Karen Glanz, PhD, MPH, UPenn PRC Director and Professor of Epidemiology, and Jason Riis, PhD, Marketing Lecturer at the Wharton School of the University of Pennsylvania, discussed how the World Health Organization came to its conclusions about a link between red & processed meats and colorectal cancer, how important it is to understand the measurements that were used, and how cancers and diseases other than colorectal cancer should be considered among the health risks.

Read the WHO Q & A here.

https://businessradio.wharton.upenn.edu/bestof/knowledge-@wharton/?h=jra57