BY JANE BLACK
Duke University is one of three sites that have been awarded a total of $4.4 million in National Institutes of Health/National Cancer Institute Cancer Intervention and Surveillance Modeling Network (CISNET) comparative modeling funding. Duke will receive $1.2 million.
The CISNET grant will be used to study ways of reducing uterine cancer mortality through primary prevention, screening and treatment approaches. In addition to Duke, the other research sites that are part of the study cohort are Columbia University (lead site) and Mt. Sinai Medical Center. CISNET is a consortium of National Cancer Institute (NCI)-sponsored investigators who use simulation modeling to improve the understanding of cancer control interventions in prevention, screening and treatment and their effects on population trends in incidence and mortality. These models can be used to guide public health research and priorities, and they can aid in the development of optimal cancer control strategies (more information at cisnet.cancer.gov.
Duke’s CISNET investigators are Laura Havrilesky, MD, MHSc (Gyn. Onc.); Evan Myers, MD, MPH (Women’s Community & Population Health); Haley Moss, MD, MBA (Gyn. Onc.); and, not pictured, Marc Ryser, PhD (Population Health Sciences and Mathematics).
“Uterine cancer is the fourth most common cancer and the sixth leading cause of cancer mortality among women, but this cancer ranks only 17th in annual NCI funding,” notes Dr. Havrilesky. “Of greater concern, both the incidence and mortality rate of uterine cancer are increasing. The average annual increase in mortality from uterine cancer is greater than from any other malignancy in males or females. Despite a well understood natural history and the availability of diagnostic tests to detect uterine cancer, screening is not routine and evidence-based recommendations for screening and prevention are lacking. And for women diagnosed with uterine cancer, optimal treatment strategies and precision therapeutics are often uncertain.”
In this five-year, multi-site incubator project, the CISNET researchers will develop and apply three independent population-level, natural history models of uterine cancer. They will apply these models to clinical scenarios in which decision making is uncertain; explore how changes in epidemiologic risk factors including the rising obesity rate and declining hysterectomy rate influence current and future incidence and mortality; and develop tools for policymakers to facilitate cancer control and prevention activities.
“We anticipate that this work will be imminently actionable for patients, providers and policy makers. The findings of this work can be quickly utilized to develop strategies for screening and prevention using widely available and emerging tests and therapies,” says Dr. Havrilesky. “These data will provide estimates of the effectiveness and cost-effectiveness for these strategies for populations at varying risk. Similarly, this work will help inform treatment decision making for women with newly diagnosed, metastatic uterine cancer, for adjuvant therapy and for treatment of recurrent disease. Our models will provide precision estimates weighing harms, benefits and costs for patients based on disease characteristics as well as underlying individual characteristics. These models will be leveraged to examine racial disparities including the influence of social determinants of health and population-level changes in obesity and the rate of hysterectomy. We will then utilize this work to develop strategies and an interactive web-based tool to guide state and local cancer control and prevention activities.”
Moss Named Director of VA Women's Cancer Program
BY JULIE POUCHER HARBIN
SENIOR WRITER, DCI
Haley Moss, MD, MBA, recently joined the U.S. Department of Veterans Affairs’ National Oncology Program Office as director of the Breast and Gynecologic Cancer System of Excellence, which aims to advance and expand women veterans’ access to teleoncology and potentially lifesaving clinical trials and treatments.
“In the past two decades, there has been an unprecedented growth of women veterans seeking medical care through the Veterans Health Administration. In response to the ever-growing population of women veterans, the National Oncology Program Office through the VHA has developed the Breast and Gynecologic Cancer System of Excellence,” said Dr. Moss. “We will be establishing partnerships with universities and NCI-designated cancer centers to promote breast and gynecologic cancer research and increase opportunities for these patients to participate on clinical trials. We will provide care coordination services to patients who may need to go between the VA and other health systems as they navigate their cancer care.”
Dr. Moss’ research has focused on the interface of women’s health and policies to improve the value of cancer care.