Elizabeth Brown, Ph.D, MPH – Co-Leader
Laura Q. Rogers, M.D., MPH – Co-Leader
The overall scientific goals of the Cancer Control and Population Sciences Program are to reduce the burden of cancer through hypothesis-driven observational and interventional research that spans the bench-to-bedside-to-community at large, and which targets all stages of neoplasia, from primary, secondary and tertiary prevention, through to end-of-life care. The CCC primarily serves the population of Alabama, but efforts are also made to serve the entire region, as demonstrated by our community-based participatory research projects in the Deep South Network (DSN), the Transdisciplinary Collaborative Center (TCC) for Health Disparities Research, the UAB-Morehouse School of Medicine-Tuskegee partnership, and distance medicine-based interventions that target high-risk populations and cancer survivors. Because UAB is the sole NCI-designated comprehensive cancer center within the Deep South region of the United States, the research performed by CCPS investigators often expands into Mississippi, Louisiana, Georgia, and the Florida panhandle.
The most defining characteristics of the state and the region as a whole are poverty and the health (cancer) disparities tied to social class and race. Although Alabama (and the states that surround it) have cancer incidence rates that are somewhat higher than most states in the country, it is the excessive cancer mortality rate that is most noteworthy, i.e., a rate of 194.0/100,000 as compared to 173.8/100,000 for the nation as a whole. Cancer-related mortality is largely driven by the even higher death rates among African-Americans who comprise 26.3% of our general population. Other major contributing factors are lack of education, resources, and access to care. The Centers for Disease Control (CDC) also show that Alabama consistently is among the states with the lowest fruit and vegetable consumption and levels of physical activity, and the highest rates of obesity. In 2014, over 70% of Alabamians were either overweight or obese. The greater incidence of many of the cancers that are elevated in the state (e.g., colorectal, esophageal, and pancreatic cancers), as well as higher mortality rates due to breast, colorectal, ovarian, pancreatic and prostate cancer are attributed at least in part to these excessive rates of obesity. Because the prevalence of obesity is much greater among African Americans, obesity has been ascribed as a factor that also contributes to the higher cancer mortality rates among African Americans.
To address these issues the CCPS program brings together 41multidisciplinary investigators who hold faculty appointments in 14 departments and 6 schools, with cancer-relevant expertise in diverse areas, including molecular and genetic epidemiology, cancer health disparities, behavioral science, health and cancer outcomes, nutrition and obesity, quality of life and end-of-life care, and cancer survivorship research. To effectively harness this expertise, the program leaders worked with the program members to identify areas of research that would have greatest impact in the catchment area. This led to the formulation of the three specific aims that provide the needed focus and have guided the development of the program since 2011. The effectiveness of this approach in enhancing the program is demonstrated by 361 published manuscripts of which 25% were intra-programmatic, 18% inter-programmatic, and 68% inter-institutional.
The scientific goals of the CCPS Program will be accomplished through the following three specific aims. For each aim, the elimination of cancer disparities is a cross-cutting theme:
Aim 1. Study the impact of body weight status and factors that influence energy balance on cancer risk and outcomes.
Aim 2. Identify host and environmental factors that affect cancer risk through epidemiologic, genomic and cancer research and develop approaches for risk reduction, early detection and treatment of cancer.
Aim 3. Determine factors that influence cancer-related outcomes and develop behavioral interventions to reduce cancer risk and progression, and improve quality of life in cancer survivors.