Cancer Control & Population Sciences (CCPS)
The primary objective of the Cancer Control and Population Sciences (CCPS) Program is to provide an organizational infrastructure that facilitates collaborative research among CCPS members and across the Duke Cancer Institute. CCPS research spans the continuum of cancer control research with goals to:
- identify environmental and behavioral factors that affect cancer risk as reflected in epidemiologic, genomic, and carcinogenesis research
- develop, implement, evaluate, and disseminate behavioral, communications, psychosocial, and clinical interventions focused on cancer prevention, quality of life for cancer survivors, and caregivers' models of palliative and end-of-life care
- impact the broader societal contexts of health systems through quality, economic, and policy studies
The specific aim of CCPS is to reduce the cancer burden in the Duke Cancer Institute (DCI)'s catchment area. Of particular note are a large number of investigative leaders who are addressing cancer health disparities and include an international consortium on ovarian cancer in women of African descent, cancer-related exercise and obesity research, tobacco control, palliative care, and outcomes/economics.
Focus Area 1: Risk Identification and Reduction (Co-Leaders: Meira Epplein, Kevin Oeffinger, Qingyi Wei): Research in this area seeks to prevent cancer and detect it earlier through discovering novel risk factors for better risk prediction, developing methods to promote healthy behaviors, and expanding early detection strategies.
Focus Area 2: “Patient Outcomes and Survivorship” (Co-Leaders: Laura Porter, Yousuf Zafar, Bryce Reeve): Research in this area seeks to optimize cancer care delivery from diagnosis and treatment through to outcomes and policy by improving cancer patients’ and family members’ experiences, health, transitions of care, and end-of-life support.
Kathryn Pollak, PhD, is a professor in the Department of Community and Family Medicine. She brings critical behavioral sciences expertise to program leadership. Pollak is a cancer-focused social psychologist who has been PI on six R01s which investigate behavioral interventions to promote smoking cessation and improve doctor-patient communication both in primary and palliative care.
Meira Epplein, PhD, MS, MA, is an established epidemiologist specializing in cancer etiology, with a focus on modifiable risk factors, including infection. She brings to DCI two R01s to investigate the heterogeneity of the bacteria Helicobacter pylori and risk of gastrointestinal cancers. As co-leader of the Risk Identification and Reduction Focus Area she particularly seeks to build consequential epidemiological research within the program.
Gary Bennett, PhD, conducted a trial that was the first demonstration of a successful weight gain prevention intervention in the primary care setting called the "maintain, don't gain" obesity treatment approach1. He also conducted an mHealth trial in China which showed significant effect on weight loss.
- [Steinberg, DM, Levine, EL, Lane, I, Askew, S, Foley, PB, Puleo, E, and Bennett, GG. "Adherence to self-monitoring via interactive voice response technology in an eHealth intervention targeting weight gain prevention among Black women: randomized controlled trial." Journal of Medical Internet Research 16, no. 4 (April 29, 2014): e114-.]
Laura Havrilesky, MD, MHSc, Michaela Dinan, PhD, and Evan Myers, MD, MPH, looked at costs, effectiveness, and workload impact of management strategies for women with an adnexal mass. They used a microsimulation model to compare five referral strategies and reported on willingness to pay.
- [Havrilesky, LJ, Dinan, M, Sfakianos, GP, Curtis, LH, Barnett, JC, Van Gorp, T, and Myers, ER. "Costs, effectiveness, and workload impact of management strategies for women with an adnexal mass." Journal of the National Cancer Institute 107, no. 1 (January 2015): 322-.]
Evan Myers, MD, MPH, Patricia Moorman, PhD, MSPH, Jennifer Gierisch, PhD, and Laura Havrilesky, MD, MHSc, analyzed data on costs and benefits for mammography among women aged 40-49. Based on their simulation analyses, the American Cancer Society changed their recommendations stating now that women starting at age 45 get mammograms.
- [Myers, ER, Moorman, P, Gierisch, JM, Havrilesky, LJ, Grimm, LJ, Ghate, S, Davidson, B, Mongtomery, RC, Crowley, MJ, McCrory, DC, Kendrick, A, and Sanders, GD. "Benefits and Harms of Breast Cancer Screening: A Systematic Review." JAMA 314, no. 15 (October 2015): 1615-1634.]
Thomas LeBlanc, MD, MA, and Arif Kamal, MD, MHS, reported on polypharmacy in patients with advanced cancer and the role of medication discontinuation. This common situation indicates the need to test and implement interventions to reduce polypharmacy for both individual drugs and to combat the cumulative effects of drugs prescribed.
- [LeBlanc, TW, McNeil, MJ, Kamal, AH, Currow, DC, and Abernethy, AP. "Polypharmacy in patients with advanced cancer and the role of medication discontinuation." The Lancet Oncology 16, no. 7 (July 2015): e333-e341.]
Joel Meyer, PhD, conducted a review on what is and is not presently know about the roles of dysregulated metabolism in environmental carcinogenesis and concluded that there is a compelling need for additional basic research to understand the timing of appearance and subsequent natural history of characteristic metabolic changes as well as their mechanistic underpinnings and specific functional contributions to cancer development and progression.
- [Robey, RB, Weisz, J, Kuemmerle, NB, Salzberg, AC, Berg, A, Brown, DG, Kubik, L, Palorini, R, Al-Mulla, F, Al-Temaimi, R, Colacci, AM, Mondello, C, Raju, J, Woodrick, J, Scovassi, AI, Singh, N, Vaccari, M, Roy, R, Forte, S, Memeo, L, Salem, HK, Amedei, A, Hamid, RA, Williams, GP, Lowe, L, Meyer, J, Martin, FL, Bisson, WH, Chiaradonna, F, and Ryan, EP. "Metabolic reprogramming and dysregulated metabolism: cause, consequence and/or enabler of environmental carcinogenesis?." Carcinogenesis 36, no. Suppl 1 (June 2015): S203-S231.]
Laura Porter, PhD, and Frank Keefe, PhD, conducted a randomized controlled trial with couples in which one member was a patient with late-stage GI cancer. They found that a brief, couple-based intervention that specifically targeted communication of cancer-related thoughts and feelings led to improvements in relationship quality and intimacy for couples in which the patient initially reported higher levels of holding back from discussing cancer-related concerns.
- [Porter, LS, Baucom, DH, Keefe, FJ, and Patterson, ES. "Reactions to a partner-assisted emotional disclosure intervention: direct observation and self-report of patient and partner communication." Journal of Marital and Family Therapy 38 Suppl 1 (June 2012): 284-295.]
Jed Rose, PhD, continues to lead the field in innovative smoking cessation techniques and found that smokers who were not helped by patch alone could be "rescued" by using a combination of Chantix or Zyban+patch treatment. Rose recently was awarded both a P01 and an R01 to examine e-cigarette.
- [Rose, JE, and Behm, FM. "Combination treatment with varenicline and bupropion in an adaptive smoking cessation paradigm." The American Journal of Psychiatry 171, no. 11 (November 2014): 1199-1205.]
Patricia Moorman, PhD, MSPH, and Joellen Schildkraut, PhD, (UVA) are conducting the largest study of its kind on African American women with ovarian cancer.
- [Schildkraut, JM, Abbott, SE, Alberg, AJ, Bandera, EV, Barnholtz-Sloan, JS, Bondy, ML, Cote, ML, Funkhouser, E, Peres, LC, Peters, ES, Schwartz, AG, Terry, P, Crankshaw, S, Camacho, F, Wang, F, and Moorman, PG. "Association between Body Powder Use and Ovarian Cancer: The African American Cancer Epidemiology Study (AACES)." Cancer Epidemiology, Biomarkers & Prevention: a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 25, no. 10 (October 2016): 1411-1417.]
Tamara Somers, PhD, Gregory Samsa, PhD, and Frank Keefe, PhD, conducted a pilot study of a mobile health pain coping skills training protocalprotocol for patients with persistent cancer and pain – the first behaviorabehavioral cancer pain intervention to be delivered using videoconferencing. After the intervention, participants reported significantly decreased pain severity, physical symptoms, psychological distress, and pain catastrophizing.
- [Somers, TJ, Abernethy, AP, Edmond, SN, Kelleher, SA, Wren, AA, Samsa, GP, and Keefe, FJ. "A Pilot Study of a Mobile Health Pain Coping Skills Training Protocol for Patients With Persistent Cancer Pain." Journal of Pain and Symptom Management 50, no. 4 (October 2015): 553-558.]
Corrine Voils, PhD, conducted a systematic review of patient and referring practitioner characteristics associate with the likelihood of undergoing bariatric surgery and noted that primary care practitioners who were more knowledgeable about bariatric surgery were more likely to refer patients for bariatric surgery and that this referral is a top predictor of patients considering surgery.
- [Funk, LM, Jolles, S, Fischer, LE, and Voils, CI. "Patient and Referring Practitioner Characteristics Associated With the Likelihood of Undergoing Bariatric Surgery: A Systematic Review." JAMA Surgery 150, no. 10 (October 2015): 999-1005.]
Qingyi Wei, MD, PhD, is conducting research on DNA repair and apoptosis phenotypes and the underlying genetic basis as a susceptibility marker for risk of developing lung cancer, head and neck cancer, and skin cancers cancers in US populations as well as whole exome sequencing to identify disease-specific variants and mutations in Chinese populations for lung cancer cancer and gastric cancer. His research team started to investigate genetic predictors for clinical response of these patients to chemotherapy and radiotherapy using GWAS analyses that are likely linked to these cancers.
- [Yin, J, Liu, H, Liu, Z, Wang, LE, Chen, WV, Zhu, D, Amos, CI, Fang, S, Lee, JE, and Wei, Q. "Genetic variants in fanconi anemia pathway genes BRCA2 and FANCA predict melanoma survival." The Journal of Investigative Dermatology 135, no. 2 (February 2015): 542-550)]
- [Li C, Gao Z, Li F, Li X, Sun Y, Wang M, Li D, Wang R, Li F, Fang R, Pan Y, Luo X, He J, Zheng L, Xia J, Qiu L, He J, Ye T, Zhang R, He M, Zhu M, Hu H, Shi T, Zhou X, Sun M, Tian S, Zhou Y, Wang Q, Chen L, Yin G, Lu J, Wu R, Guo G, Li Y, Hu X, Li L, Asan, Wang Q, Yin Y, Feng Q, Wang B, Wang H, Wang M, Yang X, Zhang X, Yang H, Jin L, Wang CY, Ji H, Chen H, Wang J, Wei Q. Whole Exome Sequencing Identifies Frequent Somatic Mutations in Cell-Cell Adhesion Genes in Chinese Patients with Lung Squamous Cell Carcinoma. Nature Sci Rep. 2015 Oct 27;5:14237.]
Kevin Weinfurt, PhD, was awarded one of six primary research sites for the PROMIS (Patient-Reported Outcomes Measurement Information System) network, an NIH Roadmap initiative to develop a unified approach for assessing PROs using computerized testing. The Duke network focused on the development of the PROMIS and other PRO tools and evaluation of the appropriate use of these tools in both the clinic and in clinical research as well as development and testing of cancer-specific PRO measures. One such measure, the Sexual Function and Satisfaction scale, was developed and successfully validated.
- [Weinfurt, KP, Lin, L, Bruner, DW, Cyranowski, JM, Dombeck, CB, Hahn, EA, Jeffery, DD, Luecht, RM, Magasi, S, Porter, LS, Reese, JB, Reeve, BB, Shelby, RA, Smith, AW, Willse, JT, and Flynn, KE. "Development and Initial Validation of the PROMIS(®) Sexual Function and Satisfaction Measures Version 2.0." The Journal of Sexual Medicine 12, no. 9 (September 7, 2015): 1961-1974.]
Yousuf Zafar, MD, and Peter Ubel, MD, are examining the financial toxicity of cancer care and collaborating with Dr. Kathryn Pollak to develop an mHealth app to help patients learn about how to talk to their doctors about the cost of their care.
Yousuf Zafar, MD, with collaborators at the Duke Global Health Institute and funded by NCI, is developing a regional cancer registry in Tanzania. Zafar has completed a study of diagnostic delay in Uganda among patients with Kaposi Sarcoma and he will be studying the role of traditional healers in treatment of cancer in Tanzania.
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