Planting the Seeds of Prevention - Siteman Cancer Center

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To improve access, Siteman’s mobile mammography van visits churches and community clinics in underserved areas. In 2008, the van screened 6,149 women, including more than 2,600 who received mammograms free or at a reduced cost. 2 The Alvin J. Siteman Cancer Center Promising Field Effective Interventions Rooted in Prevention Research Advances in medical science are making it possible to customize cancer care for each patient, taking into account the specific form of the disease and the patient’s DNA to arrive at the most effective treatment. At the Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital, parallel efforts drive the latest work in cancer prevention and control. Researchers identify targets for effective intervention by integrating disease information, individual influences such as home setting and dietary choices, and environmental forces such as neighborhood access to resources. The goal is to make populations healthier and reduce the burden of cancer. The payoff: A single, effective intervention can improve thousands of lives. “We target the many people who are at risk but don’t have the disease and define ways to identify various risk levels so we can intervene to prevent cancer most effectively,” says Graham Colditz, MD, DrPH, associate director of prevention and control at Siteman. Colditz came to Siteman from Harvard University, where he was director of the Harvard Center for Cancer Prevention. Joining Siteman in November 2006, he assumed the Niess-Gain Professorship in the School of Medicine, established by Hilda Gain Niess, an Illinois native
who battled cancer. Her gift to Washington University also set up an endowed research fund attached to the professorship. The Barnes-Jewish Hospital Foundation provides additional ongoing funding for Colditz’s work. Prevention scientists know more than 50 percent of all cancer is avoidable. They also know the simple formula that eliminates most avoidable cancer: Don’t smoke, eat a diet heavy in fresh fruits and vegetables, maintain an appropriate weight, exercise every day and take advantage of screening services. But applying this knowledge is difficult; people must overcome deeply ingrained habits to make lifestyle changes. Colditz and his colleagues are profoundly motivated when they consider what is possible. “By actively translating prevention research into practice, we can implement strategies that work with clinicians, that work at the community level and that work with individuals,” he says. “We can have an impact on our community, the region and beyond.” They also are aware that if they do nothing, by 2050, the number of cancer patients will double as the population ages. That is a situation for which the medical infrastructure and caregivers are unprepared. “We would be completely overwhelmed,” Colditz says. So prevention experts at Siteman undertake efforts like those based in the Program for the Elimination of Cancer Disparities (PECaD). Recognizing that African Americans and other minorities suffer disproportionately from breast, prostate, lung and colorectal cancers, the program aims to reduce and eliminate differences in cancer burden through community partnerships, outreach and education, and research. The work is supported by core funding from the National Cancer Institute and grants from the WellPoint Foundation, Harrah’s Foundation and others. PECaD’s effects have been significant. During 2008, the program helped provide nearly 1,700 PSA screenings for prostate cancer at no charge and educated hundreds of men about the disease and the importance of informed decision-making related to screening. A speakers’ bureau trains prostate cancer survivors to bolster the general outreach strategy. The program gains insight into women’s decisions to get screened through the Mammography Outreach Registry, a database that tracks patients who have received services on Siteman’s mobile mammography van. A quarterly newsletter keeps the community advised about PECaD’s endeavors and upcoming outreach events. PECaD’s efforts benefit from recent research conducted by Mario Schootman, PhD, co-leader of Siteman’s prevention and control research program. Analyzing data from 1996 to 2004, Schootman outlined cancer disparities by race in Missouri. He found the overall rate of new cancer cases was 18 percent higher for African Americans than for whites in 1996 but that the difference had declined to 6 percent by 2003. He speculates the change reflects a reduction in smoking rates, an increase in prostate cancer screening and other preventive measures. Although the overall decline is good news, disparities still exist when the focus shifts to specific types of cancer, says Schootman, associate professor of epidemiology and medicine and chief of health behavior research. By focusing efforts on the cancer types that did not show a decrease in disparity — colorectal cancer, for instance — prevention and control experts might maximize the effects of their work. Objective: Use research to reduce cancer risk www.siteman.wustl.edu 3
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Planting the Seeds of Prevention - Siteman Cancer Center

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