NCI Community Cancer Centers Program Research Articles

Clinical research in the community.

Most patients with high-risk hematologic malignancies are treated in community oncology practices near their residence. This is partly due to patients' ardent desire to be closer to home and trust in local caregivers. Treatments are increasingly complex, even as initial therapy, and more so upon relapse. Improved outcomes in the past decade are largely available through clinical trials primarily offered through academic medical centers. Limited availability of clinical trials at community oncology practices is a major contributor to outcome disparities among minorities, rural, and elderly patients, all of whom are underrepresented in clinical trials. Between 2003 and 2023, the National Cancer Institute (NCI) established programs to address these challenges: the Community Clinical Oncology Program, Minority- Based Community Clinical Oncology Program, NCI Community Cancer Centers Program, and NCI Community Oncology Research Program. However, disparities have persisted, particularly for pharmaceutical-directed clinical research. Lack of representation in clinical research results in data absenteeism, data chauvinism and hallucination, and a delay in treatment availability for high-risk hematologic malignancies in community practice. To address this, the US Congress enacted the Food and Drug Administration Omnibus Act in 2022 to help establish diversity plans that would broaden clinical trial patient enrollment in the United States. We recommend using these initiatives in community oncology practices, including the adoption of the DRIVE strategy in collaboration with pharmaceutical companies, as well as using the NCI-established programs to promote clinical trial availability for patients with high-risk malignancies treated in community oncology practices.

Creating an optimal care coordination model for patients with lung cancer on Medicaid.

273 Background: The Association of Community Cancer Centers (ACCC) created an Optimal Care Coordination Model (OCCM), which provides a comprehensive self-assessment tool designed to orient cancer programs to achieving patient-centered, multidisciplinary care. The OCCM is designed to help cancer programs, regardless of resources, location, or population, improve care for lung cancer patients, especially those on Medicaid. Methods: An environmental scan was conducted in early 2016 with a focus on coordination of care after lung cancer diagnosis to improve experiences and outcomes for Medicaid beneficiaries. Five ACCC Cancer Program Members each hosted 2-day site visits in mid-2016. Interview sessions were conducted to explore effective practices and current care models for patients with lung cancer insured by Medicaid. Key problems in care coordination were identified, as well as local solutions that had been put in place to overcome these barriers. The NCI Community Cancer Centers Program’s (NCCCP) Multidisciplinary Care (MDC) Assessment Tool was the foundational template to create the OCCM. The MDC Tool included 7 assessment areas that were identified as impactful to establishing multidisciplinary care and includes a Level 1-5 evaluation matrix. Results: The beta version of the OCCM was created in early 2017. The number of Assessment Areas was expanded to better capture current care coordination philosophies; (1) Patient Access to Care; (2) Prospective Multidisciplinary Case Planning; (3) Financial, Transportation, and Housing; (4) Management of Comorbid Conditions; (5) Care Coordination; (6) Treatment Team Integration; (7) Electronic Health Records (EHR) and Patient Access to Information; (8) Survivorship Care; (9) Supportive Care; (10) Tobacco Cessation; (11) Clinical Trials; (12) Physician Engagement; (13) Quality Measurement and Improvement. Conclusions: Seven ACCC Cancer Program Members are currently validating the model by each implementing at least one program-specific quality improvement project focused on an Assessment Area over a 12-month time period. All programs are collecting extensive data to determine the extent their program improved within an assessment area. Final results will be available for dissemination in 2019.

Impact of National Cancer Institute (NCI) Community Cancer Centers Program (NCCCP) and NCI Community Oncology Research Program (NCORP) on clinical trial (CT) activities in a community cancer center.

e18500Background: Within past decade NCI has implemented two major initiatives to improve CT participation and quality of cancer care in the community setting. Catholic Health Initiatives (CHI) St....

The National Cancer Institute Community Cancer Centers Program (NCCCP): Sustaining Quality and Reducing Disparities in Guideline-Concordant Breast and Colon Cancer Care.

The National Cancer Institute Community Cancer Centers Program (NCCCP) pilot was designed to improve quality of cancer care and reduce disparities at community hospitals. The NCCCP's primary intervention was the implementation of the Commission on Cancer Rapid Quality Reporting System (RQRS). The RQRS is a hospital-based data collection and evaluation system allowing near real-time assessment of selected breast and colon cancer quality of care measures. Building on previous NCCCP analyses, this study examined whether improvements in quality cancer care within NCCCP hospitals early in the program were sustained and whether improvements were notable for minority or underserved populations. We compared changes in concordance with three breast and two colon cancer quality measures approved by the National Quality Forum for patients diagnosed at NCCCP hospitals from 2006 to 2007 (pre-RQRS), 2008 to 2010 (early-RQRS), and 2011 to 2013 (later-RQRS). Data were obtained from NCCCP sites participating in the Commission on Cancer Rapid Quality Reporting System. Logistic regression analyses were performed to identify predictors of concordance with breast and colon cancer quality measures. The sample included 13,893 breast and 5,546 colon cancer patients. After RQRS initiation, all five quality measures improved significantly and improvements were sustained through 2013. Quality of care measures showed sustained improvements for both breast and colon cancer patients and for vulnerable patient subgroups including black, uninsured, and Medicaid-covered patients. Quality improvements in NCCCP hospitals were sustained throughout the duration of the program, both overall and among minority and underserved patients. Because many individuals receive cancer treatment at community hospitals, facilitating high-quality care in these environments must be a priority. Quality improvement programs often improve practice, but the methods are not maintained over time. The implementation of a real-time quality reporting system and a network focused on improving quality of care sustained quality improvement at select community cancer centers. The NCCCP pilot increased numbers of patients receiving guideline-concordant care for breast and colon cancer in community settings, and initial improvements noted in earlier years of RQRS were sustained into later years, both overall and among minority and underserved patients. National initiatives that improve care for diverse patient groups are important for reducing and eliminating barriers to care.

Experience of the National Cancer Institute Community Cancer Centers Program on Community-Based Cancer Clinical Trials Activity.

A goal of the National Cancer Institute Community Cancer Centers Program (NCCCP) was to improve cancer research capacity in community settings. We examined research capacity development during the pilot phase of the NCCCP within the context of national trends in clinical trial activity with respect to the number and phase of trials, total accrual, and accrual of underserved populations. We examined self-reported data from NCCCP sites during 2007 to 2010, supplemented with data from the National Cancer Institute Cancer Therapy Evaluation Program. Trial availability and accrual improved more quickly at NCCCP sites compared with national trends. Phase III trial availability increased 8% nationally versus 16% across NCCCP sites, and accrual increased 30% nationally versus 133% across NCCCP sites. Accrual of racial and ethnic minorities rose 82%, from 83 to 151 patients, and accrual of patients age ≥ 65 years rose by 221%, from 200 to 641 patients. Change in trial portfolio and accrual differed by sophistication of the site and by prior experience in conducting clinical trials at the site. Despite the short duration, the NCCCP pilot resulted in an increase in the number of open trials as well as patient accrual at a faster rate than that observed nationally. These results, coupled with insights into the relative success of sites with varying sophistication at the outset, provide promise that lessons learned can be applied more broadly to increase research participation.

The strategic case for establishing public-private partnerships in cancer care.

BackgroundIn 2007, the National Cancer Institute (NCI) launched the NCI Community Cancer Centers Program (NCCCP) as a public-private partnership with community hospitals with a goal of advancing cancer care and research. In order to leverage federal dollars in a time of limited resources, matching funds from each participating hospital were required. The purpose of this paper is to examine hospitals’ level of and rationale for co-investment in this partnership, and whether there is an association between hospitals’ co-investment and achievement of strategic goals.MethodsAnalysis using a comparative case study and micro-cost data was conducted as part of a comprehensive evaluation of the NCCCP pilot to determine the level of co-investment made in support of NCI’s goals. In-person or telephone interviews with key informants were conducted at 10 participating hospital and system sites during the first and final years of implementation. Micro-cost data were collected annually from each site from 2007 to 2010. Self-reported data from each awardee are presented on patient volume and physician counts, while secondary data are used to examine the local Medicare market share.ResultsThe rationale expressed by interviewees for participation in a public-private partnership with NCI included expectations of increased market share, higher patient volumes, and enhanced opportunities for cancer physician recruitment as a result of affiliation with the NCI. On average, hospitals invested resources into the NCCCP at a level exceeding $3 for every $1 of federal funds. Six sites experienced a statistically significant change in their Medicare market share. Cancer patient volume increased by as much as one-third from Year 1 to Year 3 for eight of the sites. Nine sites reported an increase in key cancer physician recruitment.ConclusionsDemonstrated investments in cancer care and research were associated with increases in cancer patient volume and perhaps in recruitment of key cancer physicians, but not in increased Medicare market share. Although the results reflect a small sample of hospitals, findings suggest that hospital executives believe there to be a strategic case for a public-private partnership as demonstrated through the NCCCP, which leveraged federal funds to support mutual goals for advancing cancer care and research.

ReCAP: Impact of Multidisciplinary Care on Processes of Cancer Care: A Multi-Institutional Study.

The role of multidisciplinary care (MDC) on cancer care processes is not fully understood. We investigated the impact of MDC on the processes of care at cancer centers within the National Cancer Institute Community Cancer Centers Program (NCCCP). The study used data from patients diagnosed with stage IIB to III rectal cancer, stage III colon cancer, and stage III non–small-cell lung cancer at 14 NCCCP cancer centers from 2007 to 2012. We used an MDC development assessment tool—with levels ranging from evolving MDC (low) to achieving excellence (high)—to measure the level of MDC implementation in seven MDC areas, such as case planning and physician engagement. Descriptive statistics and cluster-adjusted regression models quantified the association between MDC implementation and processes of care, including time from diagnosis to treatment receipt. A total of 1,079 patients were examined. Compared with patients with colon cancer treated at cancer centers reporting low MDC scores, time to treatment receipt was shorter for patients with colon cancer treated at cancer centers reporting high or moderate MDC scores for physician engagement (hazard ratio [HR] for high physician engagement, 2.66; 95% CI, 1.70 to 4.17; HR for moderate physician engagement, 1.50; 95% CI, 1.19 to 1.89) and longer for patients with colon cancer treated at cancer centers reporting high 2MDC scores for case planning (HR, 0.65; 95% CI, 0.49 to 0.85). Results for patients with rectal cancer were qualitatively similar, and there was no statistically significant difference among patients with lung cancer. MDC implementation level was associated with processes of care, and direction of association varied across MDC assessment areas.

Impact of the National Cancer Institute Community Cancer Centers Program on Clinical Trial and Related Activities at a Community Cancer Center in Rural Nebraska.

Although 85% of patients with cancer are diagnosed and treated in the community setting, only 3% are enrolled onto clinical trials. Lack of adequate time, infrastructure, resources, incentives, and reimbursement adversely affect clinical trial participation. In July 2007, Saint Francis Cancer Treatment Center (SFCTC) in Grand Island, Nebraska, was selected as one of the initial 16 sites for the National Cancer Institute Community Cancer Centers Program (NCCCP). Clinical trial and related activities data at SFCTC 5 years before and 5 years during the NCCCP were gathered and compared. Data included information on patients in clinical trials, number and type of trials, ratio of underserved patients, staffing, collection and storage of tissue samples, availability of new cancer services, and organizational infrastructure and linkage to National Cancer Institute-designated cancer centers. The number and percentage of patients enrolled onto clinical trials increased from 89 (3.2%) to 640 (23%; P<.001). All enrollees were rural Nebraskans, with 70%age > 65 years. Available treatment and nontreatment (eg, prevention, biospecimen,cancer control) trials increased from eight and three per year to 28 and 12 per year (P=.012), respectively. Staffing increased from 1.2 to 3.9 full-time equivalents (P=.012). A genetic counselor, smoking cessation counselor, and outreach project coordinator and two nurse navigators were hired. The number of tissue samples collected and/or stored increased from 26 (19%) to 320 (52%; P<.001). NCCCP participation had a direct and positive impact on all activities, with enhanced access to expanded types of trials and cancer care services. Our data demonstrate the feasibility of successful implementation of an expanded spectrum of clinical trials and programs in a rural community.

‘Everyone is an Individual’: Providing Individualized Treatment in Oncology

Michael A Thompson* speaks to Stella Bennett, Commissioning Editor: Michael A Thompson, MD, PhD is a hematologist/oncologist and researcher at Aurora Health Care (AHC) and the Aurora Research Institute (ARI). Dr Thompson is a native of Minnesota. He received his BS degree in Molecular Biology from the University of Wisconsin – Madison, his MD from Mayo Medical School and PhD in Molecular Pharmacology and Experimental Therapeutics from the Mayo Graduate School. He completed his Internal Medicine Residency at the Mayo Clinic College of Medicine. He obtained his Hematology/Oncology Fellowship at the University of Texas MD Anderson Cancer Center. Dr Thompson received the American Society of Clinical Oncology (ASCO) Young Investigator Award in 2006 and the American Society of Hematology Clinical Research Training Institute (ASH CRTI). After fellowship, he moved back to the Midwest, where he served as the Medical Director of Cancer Research at ProHealth Care Regional Cancer Center, as well as the local site Clinical Trials Lead Investigator of the NCI Community Cancer Centers Program (NCCCP) and national Co-Chair of the NCCCP Clinical Trials Portfolio/Accrual Log Working Group. He also was on the NCCCP Early Phase Working Group which focused on bringing new drugs to the community setting. In 2013 he joined AHC as the Medical Director of the Early Phase Cancer Research Program. Dr Thompson was a recipient of a Vince Lombardi Cancer Foundation (VLCF) funded Aurora Cancer Care Research Award (ACCRA) 'The Immune Response Following Vaccination in Multiple Myeloma Patients' which is an ongoing Aurora-based research study. In 2014, AHC received the NCI Community Oncology Research Program (NCORP) grant. Dr Thompson is the co-primary investigator. Dr Thompson has studied and published in the area of hematologic malignancies – myeloma, lymphoma, leukemia and other cancers. He is on the ECOG Myeloma Core Committee and the NCI Myeloma Steering Committee. He has a strong interest in clinical research in hematologic cancers as well as in new drug development in a variety of cancer types. He is currently on the ASCO Cancer Research Committee, ASCO Community Research Forum, and on various research subcommittees. He is active in social media (Twitter: @mtmdphd) with national presentations on the topic of the use of social media in oncology.

Integrating early palliative care into cancer care: A qualitative analysis of implementation models, barriers, and strategies in community settings.

36 Background: There is a paucity of research providing evaluation of implementation strategies contributing to provision of high quality early palliative care. Data from the NCI Community Cancer Centers Program (NCCCP) offers insight into ways in which patients, providers, and systems negotiate the provision of early palliative care in the community setting. The purpose of this project was to test the implementation of early palliative care programs for patients diagnosed with a high lethality cancer in participating NCCCP centers. Methods: Thirteen of 21 NCCCP sites elected to participate. Data on project activities and progress was gathered quarterly between July 2012 and June 2014. Qualitative data were evaluated using inductive and deductive methods and models of care, barriers and strategies were identified. Results: Models of care described included group education visits for patients and caregivers, outpatient clinics, and electronic consultation referral triggers. Irrespective of the model of care, sites reported barriers at the patient, provider and system levels. Barriers included reluctance by both patients and providers to consider palliative care services due to the perception of "giving up," and inadequate staffing and clinic space were also cited as systemic barriers. Strategies for facilitating implementation included integrating palliative care staff into existing cancer center programs (e.g., multi-disciplinary clinics), electronic referrals, and utilizing navigation services, as well as a variety of programs targeted to increase oncologist "buy-in." Conclusions: These results provide guidance for both researchers and clinicians in designing future multi-level interventions to facilitate the delivery of early palliative care, and the importance of identifying and utilizing provider and system resources in program design, development and promotion. Provider buy-in is an essential factor, but patient and system resources are equally important components of a successful implementation strategy.

Program development in palliative care: Results from the NCI Community Cancer Centers Program (NCCCP).

42 Background: Growing national attention to the need for metrics to document delivery of quality palliative care has resulted in a proliferation of measures and standards (e.g., Commission on Cancer, Quality Oncology Practice Initiative). While these standards offer benchmarks to strive for, there are few resources for programs to self-assess development of organizational infrastructure to achieve them. Methods: The NCCCP Cancer Palliative Care Matrix (PCM) is a performance measure and evaluation tool to aid palliative care program development in the community setting. The PCM was completed annually by 21 NCCCP sites from 2010 to 2013. Four domains related to quality measures are reported here. Proportional-odds logistic regression models were used to evaluate the relationship between year and level of response. Results: Variations in program development were seen in the quality domains of symptom assessment, palliative care services offered across the continuum of care, identification for palliative care services, and use of quality measures. In 2010, 13/21 sites reported that symptom assessment were not performed or performed inconsistently. By 2013, 13 sites reported consistent assessment with standardized tools, with 5 of these 13 able to review sequential patient assessment (p=0.002). Similar gains were seen in the domains of providing services across the continuum of cancer care and utilization of quality measures such as patient/provider satisfaction and service utilization (p=0.004, p&lt;0.0001). Despite three years of effort, little change was seen in patient identification processes for palliative care services with only 6 of 21 sites in 2013, compared to 5 in 2010, reporting improvement in "upstream" patient identification regardless of cancer stage (p=0.065). Conclusions: Data suggest the utility of the PCM to evaluate process and quality outcomes in palliative care program development. In addition, identification of challenge and growth areas can be used to develop interventions to address quality performance in both clinical and research contexts.

NCI Community Cancer Centers Program (NCCCP): Percent improvement in guideline-concordant breast and colon cancer care for disparate patient populations.

182 Background: The NCI Community Cancer Center Program (NCCCP) pilot launched in 2007 to improve quality and reduce disparities in patients receiving care in community hospital-based cancer centers. This study assessed the percent improvement in guideline-concordant cancer care since NCCCP initiation, overall and for disparate patient populations. Methods: We conducted a retrospective analysis of patients diagnosed and receiving treatment at one of 12 NCCCP sites. We compared percent improvement in concordance for NQF-approved quality measures: 3 breast (BCS-radiation following breast conserving surgery; HT-hormonal therapy; and MAC-multi-agent chemotherapy) and 2 colon (12RLN-12 regional lymph nodes examined during surgery; and ACT-adjuvant chemotherapy). Sample included patients diagnosed 2006 to 2007 (baseline, or pre-NCCCP) and 2008 to 2013 (NCCCP). Percent improvement was defined as the difference in concordance between baseline and NCCCP periods divided by baseline concordance. Results: Between baseline and NCCCP periods, improvement was noted for all 5 measures. The HT concordance rate improved by 55.1% (from 58.2% to 90.3%). For all breast measures, Black patients showed significantly larger than average percent improvement (p&lt;.05). For BCS and ACT, Medicaid and uninsured patients showed significantly larger than average percent improvement (p&lt;.05). Larger than average improvement was also noted in hospitals in high-poverty markets and in markets with few physicians. Conclusions: The percent of patients receiving guideline concordant breast or colon cancer care increased significantly since Program initiation, particularly among certain disparate patient subgroups. Future analyses will examine issues of disparities in timeliness of treatment.Funded by NCI Contract HHSN261200800001E. [Table: see text]

The clinical trial assessment of infrastructure matrix tool (CT AIM) to improve the quality of research conduct in the community.

6512 Background: ASCO described minimum standards and exemplary attributes for CT sites to improve research quality (Zon et al JCO 2008, JOP 2011; Baer et al JOP 2010). Based on these attributes, the NCI Community Cancer Centers Program (NCCCP) developed and piloted the CT AIM Tool to facilitate research program improvements through self-assessment and benchmarking. The tool identified 9 attributes (see Table) each with 3 progressive levels for research sites to “score” their program from less (Level 1) to more (Level 3) exemplary CT infrastructure (e.g. Level 1- only phase 3 treatment trials open vs. Level 3 – Phase 1/2/3, cancer control and prevention trials open). Methods: From 2011-13, 21 NCCCP sites self assessed their CT programs annually using the tool. Results: See Table. Conclusions: Statistically significant increases (p < 0.0001) occurred in Level 3 (more exemplary) infrastructure ratings from 2011 to 2013 across all 9 attribute categories assessed at the 21 sites. Statistically significant gai...

Effect of hospital-physician alignment on changes in quality, research, and health disparities at community cancer centers.

e17605 Background: The NCI Community Cancer Centers Program (NCCCP) pilot was launched in 2007 with aims to: improve quality, reduce disparities and increase clinical trial (CT) participation. Hosp...

Impact of the NCI Community Cancer Centers Program (NCCCP) on clinical trial (CT) activities in a community cancer center in rural Nebraska.

6511 Background: 85% of cancer patients (pts) are diagnosed/treated in the community, but only 3-5% are enrolled on CTs. Community oncologists lack adequate time, resource, infrastructure, reimburs...

Sustaining quality cancer care in the NCI Community Cancer Centers Program (NCCCP).

6536 Background: In 2007, the NCCCP pilot program launched with 16 sites and a goal to improve quality of care, reduce cancer disparities and increase participation in clinical trials. In 2008, NCC...

Improving quality of care within the NCI Community Cancer Centers Program (NCCCP) network.

178 Background: The National Cancer Institute (NCI) Community Cancer Centers Program (NCCCP) was initiated to expand cancer research and deliver quality cancer care in communities. A program goal was support of quality care initiatives. Twenty-one community sites in 16 states participated in the network providing care to approximately 40,000 cancer patients/year. We describe strategies for implementation of a structured quality program within our network. Methods: Four components served as the foundation for quality efforts: 1) increasing multidisciplinary care (MDC) programs; 2) ASCO QOPI participation; 3) Commission on Cancer Rapid Quality Reporting System (RQRS) participation; and 4) expansion of genetic counseling/services. A Quality of Care subcommittee formed to guide quality efforts within the network. Clinicians from the network served as subcommittee leadership and each site designated a quality of care lead. The subcommittee met by teleconference monthly, developed goals, shared best practices, developed processes to accomplish goals and documented improvements in priority areas. Results: Strategies employed to improve quality included: assessment tool development, participation in national quality reporting initiatives, review and monitoring of network data, and network performance improvement projects. Conclusions: The NCCCP identified areas of needed quality improvement. In addition, the network developed implementation strategies and created benchmarks that measure program quality. Participants benefitted from the opportunity to interface with one another and set network goals, while adopting strategies to best fit their own practices and community sites. [Table: see text]

Partnering to build a statewide cancer disparities program.

216 Background: People of color die from cancer in disproportionately higher rates than Caucasians. As an NCI Community Cancer Centers Program (NCCCP) network member, we utilized American Recovery and Reinvestment Act (ARRA) funding to develop a unique partnership. Hartford Hospital’s Helen and Harry Gray Cancer Center (GCC) has worked closely with our statewide comprehensive cancer control coalition, the Connecticut Cancer Partnership (CCP), to address racial and ethnic health disparities across the state of Connecticut. Methods: We provided a Disparities Project Coordinator (DPC) to work for the CCP as a loaned executive. In this role, the DPC leveraged GCC resources, shared best practices, convened and coordinated statewide activities, and provided oversight for statewide implementation of evidence-based disparities- related cancer projects. This project has been funded in whole or in part with Federal Funds from the National Cancer Institute, National Institutes of Health, under Contract No. HHSN261200800001E. Results: The DPC worked within the CCP structure to inform decision-making, initiate educational activities, and spearhead innovative projects such as a disparities internship with local universities and the evidence-based Body and Soul program in churches. Beyond CCP integration, the DPC represents CCP and the GCC on key statewide bodies to influence and inform policy affecting racial and ethnic minorities. Conclusions: This unique partnership is an example of a successful private-public partnership that has resulted in increased minority involvement in the state coalition and creation of multiple key partnerships with private, non-profit and state agencies. The accomplishments of the DPC have resulted in sustainability for this position and the establishment of an effective partnership model to address cancer disparities in the state.

Implementation of a high-quality biospecimen program to support molecular medicine.

200 Background: The successful implementation of a tumor genomics program relies heavily upon the collection of high quality tumor tissue samples. Although there has been an evolution towards utilizing formalin-fixed paraffin embedded (FFPE) tissue, many research centers continue to rely upon frozen fresh tissue for these types of analyses. A comprehensive effort is required to supply high-volume and high-quality tissue for research. Most community hospitals, even with superb pathology departments, are not well suited to deliver consistent tissue samples without a concerted programmatic effort. As part of the NCI Community Cancer Centers Program (NCCCP), we undertook the development of such capability at our hospital. In addition, as a member of H. Lee Moffitt Cancer Center’s Total Cancer Care program, we received grant funding to help support this comprehensive effort. Our patients and clinicians expressed a strong desire to participate in this type of translational research. This project has been funded in part with federal funds from the National Cancer Institute, National Institutes of Health, under Contract No. HHSN261200800001E. Methods: We developed a comprehensive staffing model to implement this program, including a program coordinator, consenters, pathology assistant, lab aide, and data manager. We developed superb relationships with surgeons, interventional radiologists, pathologists and staffs to assure appropriate referrals and processes, and implemented quality checks as a standard. We developed relationships with Moffitt, The Cancer Genome Atlas, and other research efforts, which help provide funding. Results: We successfully implemented a program which resulted in high levels of patient and provider satisfaction, high numbers of fresh frozen and FFPE tissues (nearly 3,000 over 3 years), high quality pass rates, low ischemia time, and high satisfaction on the part of our research partners. We have incorporated best practices in our tissue handling protocols. Conclusions: We successfully implemented a comprehensive cancer genomics bio-specimen program utilizing dedicated staff, working with patients and clinicians closely, and assuring careful coordination of all efforts.

Survivorship care plans: Is there buy-in from oncology providers?

8 Background: The Institute of Medicine advised that cancer survivors and their primary care providers receive survivorship care plans (SCPs) to summarize cancer treatment and plan ongoing care. However, the use of SCPs remains limited. Methods: Oncology providers at 14 National Cancer Institute Community Cancer Centers Program (NCCCP) hospitals completed a survey regarding their perceptions of SCPs, including barriers to implementation, strategies for implementation, the role of oncology providers, and the importance of topics in SCPs (diagnosis, treatment, recommended ongoing care, and the aspects of ongoing care that the oncology practice will provide). Results: Among 245 providers (70% response rate), a minority reported ever providing an SCP or any of its components to patients. The most widely reported barriers were personnel to creating SCPs and time (69% and 64% of respondents, respectively). The most widely endorsed strategy among those using SCPs was the use of a template with pre-specified fields; 94% of those who used templates found them helpful. For each topic of an SCP, while 87%-89% of oncology providers felt it was very important for primary care providers to receive the information, only 58%-65% of respondents felt it was very important for patients to receive the information. Further, 33%-38% of respondents had mixed feelings about whether it was oncology providers’ responsibility to provide SCPs. Conclusions: Practices need additional resources to overcome barriers to implementing SCPs. We found resistance toward SCPs, particularly the perceived value for the survivor and the idea that oncology providers are responsible for SCP dissemination.