Cancer Prevention Study-3 (CPS-3)

Research today for a cancer-free tomorrow.

Corporate Workplace Engagement

Outline

• Background and Brief CPS-3 overview

• Corporate Partner Engagement

• Next Steps

Background and Brief CPS-3 Overview

“Everyone knows that cigarette smoking causes lung cancer. Few realize that it took three years, 22,000

volunteers, and 188,000 study participants to prove it.”

Meghan Murphy, The Greeley Tribune; 2007

Years

Participants

Sex

Volunteers

States

Cancer endpoints

Research Emphases

Hammond-Horn

1952-55

188,000

Men

22,000

9

Mortality

Smoking

CPS-I

1959-72

1,000,000

Both

68,000

25

Mortality

Smoking, obesity

CPS-II

1982-

1,200,000

Both

77,000

50

Mortality & incidence

Multiple

Cancer Prevention Studies (CPS)For nearly 60 years, the American Cancer Society has conducted some of the world’s largest cohort studies to understand how cancer develops in a population, identify the causes of cancer and ultimately, learn how to prevent it.

CPS-3

2006-

300,000

Both

25,000

32

Mortality& incidence

Multiple

These Studies Resulted in > 650 Reports, Monographs, Peer-Reviewed Publications

CPS Major Contributions to Public HealthSmoking• Contributions to 21 U.S. Surgeon General Reports on Smoking & Cancer.• Confirm relationship of 2nd hand smoke with lung cancer & heart disease, helping

to motivate smoke-free laws.• Ongoing role in debunking myths from tobacco industry.• Low tar/nicotine cigarettes do not reduce the risk of lung cancer.

Obesity, nutrition, and physical activity• First epidemiological study that overweight/obesity shortens longevity. • Landmark paper linking obesity to increased death rates from 10+ cancer sites.• First US epidemiologic study that sitting time shortens longevity.• Major contributions to IARC Monographs, WCRF/AICR Reports

Other areas• Discovery of the link between aspirin use and lower risk of colon cancer.• Air pollution (small particulates and ozone), increase death rates from heart and

lung conditions; motivate the Environmental Protection Agency to propose more stringent limits on air pollution.

CPS-3 is the Only Contemporary Nationwide US Cohort

• Without U.S. studies, we would have to rely on international studies to inform national public health knowledge, programs, and policies.

• Contemporary U.S. nationwide cohort with biospecimens essential to:

• Identify new risk factors for cancer due to changes in environment, lifestyles, medications and new technologies

• Expand our knowledge of cancer risk factors in U.S. diverse racial/ethnic populations

• Improve our understanding of cancer biology, etiology, and risk prediction

• Provide scientific basis for cancer control, prevention, and policy in the 21st century

CPS-3 GoalsOPERATIONAL• Enroll a diverse group of at least 300,000 men and women aged 30-65

years with no prior history of cancer, by December 2013• At least 25% racial/ethnic minority participation• Geographic diversity• Blood specimens at enrollment

SCIENTIFIC• Examine a wide spectrum of lifestyle, behavioral, environmental, and

genetic factors in relation cancer risk and mortality• Study gene x environment interactions in cancer risk and mortality• Identify and/or validate early markers of disease

The knowledge gap in cancer disparities

• 2011 President’s Cancer Panel concluded:“The current understanding of cancer risk, progression, and outcomes is based largely on studies of non-Hispanic white populations. The risk factors, screening guidelines, and treatment regimens identified through research are often not appropriate for individuals of non-European descent.”

• Without racially/ethnically diverse study populations in place, we can’t improve our understanding of why these differences exist

CPS-3 Recruitment States• States included account for 94% of US population• States selected based on population density, quality of state

tumor registry, or proximity to labs for blood processing

Puerto Rico

Study Participation– Initial enrollment

• In person– Complete brief survey and informed consent– Waist circumference measured– Small blood sample provided

• At home or in person (depends on venue)– Comprehensive baseline survey completed,

collecting information on reproductive, medical & family history, lifestyle and behaviors

– Long-term follow-up • Repeat surveys every few years

Enrollment Venues• Relay For Life and other Society events• Corporate partner worksites• Local Society offices• Community hospitals• Venues for targeted recruitment

Corporate Engagement

How Are Corporate Partners Involved in CPS-3?

• At Relay and other venues, providing enrollment volunteers

• At Relay, “sponsor” of the CPS-3 tent

• Supporting CPS-3 promotion

• Now, the opportunity to host CPS-3 enrollment

Worksite/Corporate Enrollment

WHY GET INVOLVED?• Offers historic opportunity for meaningful and personal employee

engagement in advancing the mission of the American Cancer Society at no cost

• Shared vision for healthier employees and community• Media and other visibility in your local community as a leader in the

fight against cancer

EXAMPLES OF CORPORATE ENROLLMENT TO DATE (2009-2011)• Nucor Steel, Decatur, AL November 2010• Quest Diagnostics, Dallas business unit, November 2009 and Atlanta

business unit, February 2011• UPS, Wayne NJ, November 2010 and Mahwah, NJ May 2011• CVPH-Fitzpatrick Cancer Center, Plattsburgh, NY March 2011• Infomart, Atlanta, GA March 2011

“The opportunity to support a project like the American Cancer Society’s Cancer Prevention Study-3 is a natural fit with the vision and values of Quest Diagnostics.”

- Quest Diagnostics national vice president

Resources and Process

• Estimated time for implementation is 3-4 months• Estimated time obligation for corporate CPS-3 liaison 1-2 hours/week

CPS-3 presented to corporate partner

Corporate “CPS-3 liaison”:• Lead internal promotion

• Recruit 3-4 employee “volunteers”• Secure space and other needs

ACS CPS-3 Study Coordinator:• Facilitate implementation

• Provide promotional material to liaison• Oversee development of appointment

scheduling site

Enrollment:Liaison & Coordinator train and oversee

Post-Event Wrap-Up:Corporate recognition plaque

Media and Publicity

Types of CPS-3 Enrollment at Worksite• “Closed” enrollment site

– Enrollment available to employees only– Worksite with at least 750 employees– Internal promotion only (by hospital)– Generally, single or two-day enrollment session– Implementation requires 3-4 months

• “Open” enrollment site– Enrollment available to community at-large– Wide-scale promotion to the community and within the

worksite to staff (requires both ACS and worksite support for outreach)

– Enrollment “sessions” will take place for a few days– Implementation requires 4-5 months

Selection Standards• 750 or more employees at one physical location (for closed model only)

• Relationship with corporate partner well-established

• CPS-3 employee lead at corporate worksite available

• Physical space (conference room with 7-8 tables and 30-35 chairs)

• Corporate leadership willing to promote enrollment opportunity

• Corporate partner willing and able to provide 3-4 day-of enrollment volunteers

• Corporate partner willing to have Quest Diagnostics onsite

• Corporate partner understands employee participation is confidential If applicable, no union or IRB issues

• Preferably (not required), employees actively engaged with American Cancer Society initiatives

• Preferably (not required), the corporate partner has a wellness program or hosts other health-related activities

• Preferably, corporate leadership willing to provide time at work for employees to enroll

Host Corporate Partner’s Role

• Provide space for individuals to enroll (large auditorium, conference center, atrium, etc.)

• Promotion to employees and constituents(templates provided by ACS)

- E-communication- Leadership meetings- Team meetings- Newsletters, etc. - Billstuffers

• Allowing employees time to enroll (preferably)

• Assist with day-of volunteers (if possible)

American Cancer Society’s Role

• Provide all study materials, including:- Promotional materials and templates (brochures, fliers, posters, etc.) - All

surveys, consent forms, and day-of enrollment needs

• Onsite training and oversight- A member of the Epidemiology Research Program will be onsite during enrollment and

will oversee all logistics and training of day-of volunteers

• Create appointment scheduling website

• Manage all direct communication with study participants after the initial enrollment

• Work with ACS partner on community-wide promotion (if choosing open model)

Costs to the Host Site

• No direct costs

• Staff time costs for the “lead” and other enrollment volunteers (3-4 total)

• Staff time to enroll (if employees permitted to enroll while at work)

Other Logistical Considerations

• Phlebotomy– Quest Diagnostics, Inc. contracted nationally for CPS-3

blood collection, transport, and processing– Staff trained to follow CPS-3 scientific protocol to

maintain standardized process across venues– Hospital must be willing to have Quest onsite– Phlebotomy staffing coordinated from NHO

• Confidentiality issues

Protection of CPS-3 Participants Approval and oversight by Emory University Institutional Review Board Data are de-identified by assignment of unique study ID Limited access to study data by authorized research personnel All CPS-3 research staff, volunteers and vendors sign confidentiality

forms Participant identity will never be disclosed within or outside ACS,

without participant approval Individual results will not be shared with participants or their family,

physicians, employers, insurance companies or other third parties Privacy and confidentiality are addressed on the CPS-3 informed

consent form

• Note: Employees should use personal email if concerned about the possibility of corporate email monitoring

Implementation Process• Once a worksite has agreed to host CPS-3:

– 3-5 months prior: CPS-3 Study Coordinator assigned to site Date, time, location of enrollment confirmed Scheduling site built for enrollment appointments Promotional plan developed

– 4-8 weeks prior: Scheduling site “goes live” Internal/external study promotion and media Enrollment volunteers recruited (3-4 needed per 4 hour shift) Remaining logistics confirmed (parking, shipping, etc.)

– Week of enrollment: Final promotional push Enrollment materials shipped

– Day of enrollment: Onsite volunteer training (or day prior) Conduct enrollment

Post Enrollment

• Recognition and thanks

• CPS-3 Study Coordinator and ACS Staff Liaison present host site with recognition plaque

• Communicate successes of enrollment

• Data in aggregate can be shared with host site

Summary and Next Steps• The American Cancer Society’s Cancer Prevention Studies demonstrate

the Society’s long-term and continued support of innovative, public health research

• Findings from these studies have made and will continue to make significant contributions to our scientific understanding and public health

• CPS-3 is a unique opportunity to meaningfully engage our corporate partners and their employees in creating a world with less cancer

• CPS-3 corporate-based enrollment work to date has proven feasibility and highlighted factors for successful implementation

• If this is feasible at your institution, the next steps would be:– Gain necessary leadership approvals and support– Determine who would be the primary contact at the hospital– Provide this information to your American Cancer Society contact or email

Dr. Alpa Patel at apatel@cancer.org

“I have already signed up to participate myself, as this study offers a unique opportunity to be a

part of some of the most pioneering medical advances of our time.”

Dr. John Seffrin, American Cancer Society National CEO

For more information:

Visit cancer.org/cps3,

Email cps@cancer.org, or

Call 1-888-604-5888

Cancer Prevention Study-3: Leading the Way to a World with Less Cancer and

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