CDC National Comprehensive Cancer Control Program Grant: Enhancing Evidence-Based Cancer Survivorship Interventions

A cancer survivor is a person diagnosed with cancer, from the time of diagnosis throughout the person’s lifespan. As of 2008, nearly 12 million cancer survivors were living in the United States; this number is expected to increase to 18 million in 2020. Cancer survivors have long-term adverse physical and psychosocial effects from their diagnosis and treatment, and have a greater risk for additional cancer diagnoses compared with persons without a cancer history. Cancer survivors commonly report negative behavioral, medical, and health care access issues that may contribute to poor long-term medical and psychosocial outcomes. An analysis of over 45,000 U.S. cancer survivors showed that: 1) 15% of cancer survivors continue to use tobacco; 2) 20-25% do not receive recommended cancer screenings; 3) 31% do not engage in any leisure time physical activity; 4) 40 to 50% do not receive flu or pneumonia vaccines; 5) 60% do not have a summary of their cancer treatment; and 6) 25% do not have any instructions (written or oral) for their treatment or follow-up care .
CDC’s National Comprehensive Cancer Control Program (NCCCP) supports collaborative cancer control and prevention efforts in all states, the District of Columbia, tribal organizations, territories, and Pacific Island jurisdictions to address the cancer burden in their jurisdictions. In 2010, NCCCP developed six priorities areas of focus for the greatest public health impact; one of the six priorities is to address the public health needs of cancer survivors.
The purpose of this FOA is to implement a broad set of evidence-based survivorship strategies in a subset of NCCCP grantees that will have the short-term results of increasing knowledge of cancer survivor needs, increasing survivor knowledge of treatment and follow-up care, and increasing provider knowledge of guidelines pertaining to treatment of cancer. Intermediate outcomes include the development of best practices in survivorship among NCCCP grantees, and identification of capacity needed to sustain a broad program of survivorship interventions. The long-term outcome is the widespread adoption of practice-and evidence-based, sustainable, survivorship activities across many NCCCP grantees, leading to increases in the duration and quality of life of cancer survivors.
Strategies employed in this FOA reflect evidence-based methods to address cancer survivor needs, and are designed to increase surveillance and community/clinical linkages. They include identifying cancer survivors and their needs through the Behavioral Risk Factor Surveillance system (BRFSS), using local cancer registry data to populate survivorship care plans [SCPs], and increasing the development or adoption of standardized, measurable patient navigation programs to assist cancer survivors in receiving appropriate cancer treatment and follow-up care, and increasing education of providers on survivor care through the existing survivorship E-learning series. Together, these strategies help to specifically identify and characterize the survivor population, and address survivor needs from diagnosis through treatment and post-treatment.