DCC Retreat Meg Maley

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Turning Action into Results February 15, 2010 Meg Maley, RN, BSN Chair, Environment Committee Delaware Cancer Consortium

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2nd Annual DCC Retreat

Transcript of DCC Retreat Meg Maley

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Turning Action into Results

February 15, 2010

Meg Maley, RN, BSN

Chair, Environment Committee

Delaware Cancer Consortium

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The Sub-Committees• Early Detection and Prevention • Tobacco and Other Risk Factors

• Disparities

• Quality Cancer Care/Quality of Life

• Data

• Environment

• Communication and Public Education and Workplace/Workforce

• Insurance

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Our Goals• Create comprehensive statewide screening program that would navigate and provide case management to Delawareans through the screening and follow up process

• Reimburse screening and treatment costs for the uninsured

• Achieve 80% Colorectal Cancer Screening rate for Delawareans over age 50

• Improve prostate cancer screening and mortality rates among Delaware’s African-American men

• Reduce colorectal and breast cancer mortality in Delaware among African-American women

• Achieve equal rates of clinical trial participation between minorities and Caucasians

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Our Goals• Maintain DE leadership in comprehensive tobacco programs

• Prevent youth initiation to tobacco products

• Reduce exposure to secondhand smoke

• Decrease social acceptability of tobacco use

• Encourage healthy lifestyles, decrease risky behaviors

• Reduce exposure to carcinogenic substances in the ambient environment

• Coordinate with Department of Labor’s Occupational Safety & Health Office to reduce workplace carcinogenic risk and exposure

• Reduce exposure to carcinogens in the indoor environment

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Our Goals

• Ensure Delawarean’s access to the highest quality cancer screening and cancer care

• Ensure continuity of care through cancer care coordination

• Ensure availability of accurate complete data to allow effective surveillance of cancer incidence, care delivery and treatment

• Eliminate gaps in quality of life services to meet the needs of patients, survivors and co-survivors without duplicating current services

• Support quality of life training and education services for healthcare providers with an emphasis on palliation, survivorship, rehabilitation and end-of-life care

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Our Goals

•Develop and implement health claims data acquisition methods

•Acquire, analyze, and integrate data from electronic sources

•Improve cancer surveillance methods statewide

•Form and maintain a statewide, permanent alliance to coordinate and promote public education on cancer

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Our Accomplishments

Increased Colonoscopy CRC Screening over age 50 Increased from 52% (2002) to 74% (2008) Highest state screening rate in the nation 2008

Since the programs inception navigators have successfully helped 4,168 through the CRC screening process

Over 3,000 CRC screenings through SFL FY02-FY09 1,475 clients had polyps removed 34 Cancers detected and treated

Distributed over 2,600 doses of the HPV vaccine to providers

Added the availability of prostate screenings as a covered screening through the Screening for Life program

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Our Accomplishments

Clean Indoor Air Act passed

Six-fold increase in state excise tax(24¢ to $1.60)

Youth and adult smoking prevalence decreased

Cessation efforts: Quitline & Quitnet

Community outreach: youth programs & mini-grants

Increased awareness and knowledge of tobacco issues

Menu labeling bill

Tanning bed legislation

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Our Accomplishments

Between 2002 and 2008, colorectal cancer screenings among African Americans increased by 53.8%

In Delaware, the colorectal cancer screening rate disparity between African Americans and Caucasians has been eliminated (BRFS 2008, AA 73.5% and White 74.7%)

The national the rates are 58.6% African American and 64.0% White

In Delaware, in 2008, African Americans were significantly more likely than Caucasians to have had a sigmoidoscopy or colonoscopy within the last 12 months (45.5% vs. 27.8%, respectively).

In 2001, only 15% of African American colorectal cancer cases were caught in the local stage; by 2007, this number had increased to 33%.

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Our Accomplishments

Between 2001- 2007, the proportion of local stage colorectal cancers detected for African Americans increased 113% compared to 31% for Caucasians

From 1999-2008, African American adult smoking rate declined by 43%

The decline among Caucasians for the same period was 27%

DE’s all site incidence rate for African Americans is declining more than four times faster than for Caucasians

Incidence rates for African Americans and Caucasians are similar for colorectal cancer

Racial disparities in DE’s cancer mortality rates are shrinking

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Our Accomplishments

Cancer Care Coordination Program served over 2,111 patients and their families

Cancer treatment validation study conducted

Delaware Cancer Registry Advisory Committee

Trained nearly 400 nurses in end-of-life care through the End-of-Life Nursing Education Consortium.

Delaware Cancer Registry Advisory Committee’s (DCRAC) active role in guiding improvements in our state’s cancer data collection.

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Our Accomplishments

Conducted an investigation into census tract-level rates of six environmentally-based cancers.

Analyzed data from the Indian River Community-Level Survey (IRCLS).

Reviewed available cancer-screening items included in state- and national-level surveillance efforts (e.g., BRFSS).

Evaluated cancer cluster methodologies used by the Division of Public Health.

Reviewed and refined the methodology for “Cancer Incidence and Mortality in Delaware” and “Delaware’s Cancer Rates by Census Tract” (annual DPH reports).

Initiating an investigation into statewide cancer treatment patterns using a targeted approach

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Our Accomplishments

Implemented education initiative per Delaware Code to inform the public and realtors of the requirement of realtors to distribute radon rights and risk information to potential home buyers

Analyzed source water for pharmaceuticals and radiological contaminants

Completed Phase I and II of the Delaware Air Toxics Assessment Study (DATAS).

Initiated a statewide quarterly quality assessment of the Columbia Aquifer to investigate potential links between drinking water supplied to individual shallow wells and cancer incidence

Increased public awareness of the dangers of eating fish from certain Delaware waterways.

Established an Occupational Health Program to identify populations at risk from occupational exposure to carcinogens

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Our Accomplishments

Outfitted bused in New Castle County with diesel particulate filters

Development of Phase III of the Multi-Media Body Burden study and progress being made on identifying funding to complete Phase I and Phase II of the study

Established a statewide Delaware Cancer Education Alliance

Developed the Delaware Cancer Treatment Program

Increased eligibility from 12 months to 24 months

Connected Delaware Cancer Treatment Program clients with a Cancer Care Coordinator at hospital

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Prevention of Cervical Cancer by large scale adoption of HPV Vaccine

Identify screening coverage barriers for Medicare recipients

Access existing data bases (Medicaid, commercial insurance) to identify and reach unscreened individuals

Funding to claim “Universal Cancer Screening” for all Delawareans

Determining why mortality rates among African Americans remain higher than those of Caucasians

Achieving equal rates of participation in clinical trials between African Americans and Caucasians

Using what we have learned in cancer to eliminate other racial and ethnic health disparities in Delaware

Challenges and Opportunities

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Maintain adequate funding for comprehensive tobacco programs

Sustain interest in tobacco prevention as a major health issue

Seek insurance coverage for cessation

Unify current activities into strategies for nutrition and physical activity

Increase programs for “other” lifestyle risk factors

Challenges and Opportunities - tobacco

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Creating methods/tools to promote primary care cancer screening

Quality “Report Cards”: annual, facility-specific reports to inform Delawareans of performance on quality measures

Extend Cancer Care Coordination services beyond the treatment phase

Collection of complete first course of treatment data in the Delaware Cancer Registry to support studies of quality of cancer care, facilitated by electronic reporting system and insurance claims data merging, etc

Facilitating data exchange with private insurers

Capitalize on Delaware’s (relatively) small number of treatment facilities

Challenges and Opportunities - QCC

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Public interest in and concern about environmental issues has created a sense of urgency to our projects

How to stay focused on current projects, while at the same time being sensitive to public concerns about new environmental challenges

The opportunity to truly help reduce cancer incident rates through the breadth of focus and depth of our resources

The ability to incorporate existing environmental monitoring into new initiatives that are bold and transformative

Challenges and Opportunities

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Awards and Recognition