Demystifying Cancer Research to Increase Demand for Evidencebased Cancer Control

Jon F. Kerner, PhD, Deputy Director, Research Dissemination and Diffusion

In the mid-1980s, Dr. Louis Sullivan, then Secretary of DHHS, gave the plenary at the dedication of Memorial Sloan-Kettering Cancer Center’s new Basic Science Research Building. Dr. Sullivan noted how this new research infrastructure would greatly enhance the contributions made to and by basic science in our efforts to prevent and control cancer. Yet, he said, the new building’s windows "did not open." He challenged the research community to "throw open the windows and doors" to our "temples of science" and help the American people understand how and why the investment of their tax dollars in biomedical research was such a good investment.

Despite large increases to NIH and NCI budgets in the intervening years, this challenge remains—particularly as the NIH and NCI budgets have flattened out and have actually declined for the first time in more than 30 years. If we are to increase the demand by patients and their families, practitioners, the public health practice community, and the public for additional investments in science and the use of evidencebased cancer control interventions, we must demystify cancer research. Three approaches to accomplishing this are:

• Increase NCI support for communitybased participatory research so that individuals, institutions, and communities that are the subjects of study are also partners in the study design, implementation, results review, and publication.



• Expand support for diffusion and dissemination research on interventions tested in NCI-funded efficacy trials, in collaboration with entities such as the American Cancer Society and the Centers for Disease Control and Prevention, which have many valuable community-based channels for dissemination and implementation.



• Expand NCI partnerships with federal and state service delivery agencies and organizations to increase adoption of evidencebased interventions and to understand how infrastructure and delivery resource barriers to cancer control can be overcome with cost-effective interventions.

Considerable progress has been made toward creating science and evidence-based interventions that are compelling. NCI’s Translating Research into Improved Outcomes (TRIO) program was initiated to:

1. Better communicate cancer surveillance data to motivate action and track progress. For example:
   • State Cancer Profiles was launched in April 2003 on the Cancer Control P.L.A.N.E.T. Web portal to facilitate easy access by public health practitioners to state and county cancer incidence and mortality data and behavioral risk factor data. In April 2004, at the request of thousands of users, data from additional cancer sites were added to State Cancer Profiles, and in May 2005 a county mortality mapping feature was added to facilitate graphic communication of cancer burden within states.
   
   
   
   • The 2007 online Cancer Trends Progress Report provides users with a menu to select sections of the report they wish to print, and the ability to produce data tables and PowerPoint files from any portion of the report for greater dissemination flexibility.


2. Expand partnerships with other federal agencies and national voluntary and philanthropic organizations to increase demand for and adoption of evidence-based cancer control intervention programs and products. For example:
   • DCCPS is working with the Lance Armstrong Foundation and the American Legacy Foundation to develop PRIME (Program Resources for Implementation, Management, and Evaluation). This Web tool will link the Cancer Control P.L.A.N.E.T. Web-based resources to individual philanthropic organization grant application forms to enhance the ability of community-based organizations to develop evidence-based cancer prevention and control service delivery funding requests.


3. Identify special regional and local partnership opportunities for model programs to address significant infrastructure barriers to the adoption of evidence-based cancer control.
   • DCCPS worked with ACS and CDC to develop a new Web site entitled CancerPlan.org. This Web site will provide states a forum for sharing their best practices and finding state and local resources for comprehensive cancer control. As such, it is designed to complement the research-tested information available on the Cancer Control P.L.A.N.E.T. Web portal, with the information based on field experiences at the state and local levels.

Integrating the lessons learned from science with the lessons learned from public health and clinical practice experience is the key to closing the gap between research discovery and program delivery. To ensure a continued public interest in discovery, NCI must continue to grow its investment in supporting partnerships with public health and clinical practice delivery systems that reach all people at risk of developing, suffering, and dying from cancer.