Grant Details
Grant Number: |
5UM1CA221940-05 Interpret this number |
Primary Investigator: |
Tiro, Jasmin |
Organization: |
Ut Southwestern Medical Center |
Project Title: |
Multi-Level Optimization of the Cervical Cancer Screening Process in Diverse Settings & Populations (METRICS) |
Fiscal Year: |
2022 |
Abstract
ABSTRACT
For more than 5 decades, the US has sought to lower cervical cancer deaths through screening; however,
disparities remain. Introduction of oncogenic human papillomavirus (HPV)-based tests and HPV vaccines have
expanded cervical cancer prevention strategies and changed screening and management guidelines. As
technology, guidelines, and policies change, our MultilEvel OpTimization of the CeRvIcal Cancer Screening
Process in Diverse Settings & Populations (METRICS) PROSPR II Research Center will elucidate multilevel
factors that hamper or facilitate the cervical cancer screening process and reduce disparities in vulnerable
populations. METRICS unites three PROSPR I Research Centers with demonstrated capability to provide
validated data for a combined cohort of ~1.2 million screened and unscreened women. Our community
settings represent 3 care delivery models—safety-net system, managed care system, and primary care
provider networks in Texas, Washington, and Massachusetts. We will collect, harmonize, and document >
10 years of high-quality, comprehensive cervical cancer screening process data at the patient, provider,
clinic, and system levels using a rich array of electronic clinical information systems and novel data sources.
Our combined cohort is socioeconomically and geographically diverse and includes vulnerable groups
such as HIV-infected and uninsured women. Our three interconnected observational projects are
designed to understand how cervical cancer screening is delivered across our spectrum of delivery models,
and how to optimize the screening process to reduce disparities. Innovative geospatial and Bayesian statistical
methods in Project 1 will better elucidate at what levels variation in screening process occurs. Project 2 will
investigate how multilevel programs and policies influence adherence to guidelines for average-risk women.
Project 3 will inform precision screening for women with altered risk. Based on our observational findings, in
years 4-5, we will design and implement pilot interventions leveraging IT-enabled tools to address key failures
in the screening process and reduce disparities. Our transdisciplinary team has epidemiologists, primary and
specialty care physicians, and intervention, implementation, and healthcare delivery experts. We are poised to
efficiently evaluate the full cervical cancer screening process and provide expertise, leadership, and resources
for cross-organ PROSPR II collaborations. Our cores and research projects will achieve our goals of
advancing understanding of screening as practiced in community settings through: (1) analysis of
multilevel observational data from our heterogeneous settings with diverse populations, (2) development and
testing of impactful interventions to optimize the screening process, and (3) application of our novel
observational projects and quality metrics to the cancer screening processes for other organs. Based on our
successful experience leading and collaborating in PROSPR I, we thoughtfully organized our four cores to
be able to launch research activities and contribute to trans-PROSPR II activities quickly and effectively.
Publications
Evaluating and Improving Cancer Screening Process Quality in a Multilevel Context: The PROSPR II Consortium Design and Research Agenda.
Authors: Beaber E.F.
, Kamineni A.
, Burnett-Hartman A.N.
, Hixon B.
, Kobrin S.C.
, Li C.I.
, Oliver M.
, Rendle K.A.
, Skinner C.S.
, Todd K.
, et al.
.
Source: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2022-08-02; 31(8), p. 1521-1531.
PMID: 35916603
Related Citations
Cost Effectiveness of Mailed Outreach Programs for Colorectal Cancer Screening: Analysis of a Pragmatic, Randomized Trial.
Authors: Kapinos K.A.
, Halm E.A.
, Murphy C.C.
, Santini N.O.
, Loewen A.C.
, Skinner C.S.
, Singal A.G.
.
Source: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2022-02-07; , .
EPub date: 2022-02-07.
PMID: 35144024
Related Citations
Variation in the receipt of human papilloma virus co-testing for cervical screening: Individual, provider, facility and healthcare system characteristics.
Authors: Haas J.S.
, Cheng D.
, Yu L.
, Atlas S.J.
, Clark C.
, Feldman S.
, Silver M.I.
, Kamineni A.
, Chubak J.
, Pocobelli G.
, et al.
.
Source: Preventive medicine, 2022 01; 154, p. 106871.
EPub date: 2021-11-08.
PMID: 34762966
Related Citations
De-implementation of cervical cancer screening before age 21.
Authors: Silver M.I.
, Anderson M.L.
, Beaber E.F.
, Haas J.S.
, Kobrin S.
, Pocobelli G.
, Skinner C.S.
, Tiro J.A.
, Kamineni A.
.
Source: Preventive medicine, 2021 12; 153, p. 106815.
EPub date: 2021-09-29.
PMID: 34599920
Related Citations
Exposure Definition in Case-Control Studies of Cervical Cancer Screening: A Systematic Literature Review.
Authors: Castanon A.
, Kamineni A.
, Elfström K.M.
, Lim A.W.W.
, Sasieni P.
.
Source: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2021 12; 30(12), p. 2154-2166.
EPub date: 2021-09-14.
PMID: 34526301
Related Citations
Early assessment of the first wave of the COVID-19 pandemic on cancer screening services: The International Cancer Screening Network COVID-19 survey.
Authors: Puricelli Perin D.M.
, Elfström K.M.
, Bulliard J.L.
, Burón A.
, Campbell C.
, Flugelman A.A.
, Giordano L.
, Kamineni A.
, Ponti A.
, Rabeneck L.
, et al.
.
Source: Preventive medicine, 2021 10; 151, p. 106642.
EPub date: 2021-06-30.
PMID: 34217420
Related Citations
The trajectory of racial/ethnic disparities in the use of cancer screening before and during the COVID-19 pandemic: A large U.S. academic center analysis.
Authors: Marcondes F.O.
, Cheng D.
, Warner E.T.
, Kamran S.C.
, Haas J.S.
.
Source: Preventive medicine, 2021 10; 151, p. 106640.
EPub date: 2021-06-30.
PMID: 34217419
Related Citations
Cancer screening in the U.S. through the COVID-19 pandemic, recovery, and beyond.
Authors: Croswell J.M.
, Corley D.A.
, Lafata J.E.
, Haas J.S.
, Inadomi J.M.
, Kamineni A.
, Ritzwoller D.P.
, Vachani A.
, Zheng Y.
, National Cancer Institute Population-based Research to Optimize the Screening Process (PROSPR) II Consortium
.
Source: Preventive medicine, 2021 10; 151, p. 106595.
EPub date: 2021-06-30.
PMID: 34217414
Related Citations
Impact of COVID-19-related care disruptions on cervical cancer screening in the United States.
Authors: Burger E.A.
, Jansen E.E.
, Killen J.
, Kok I.M.
, Smith M.A.
, Sy S.
, Dunnewind N.
, G Campos N.
, Haas J.S.
, Kobrin S.
, et al.
.
Source: Journal of medical screening, 2021 06; 28(2), p. 213-216.
EPub date: 2021-03-17.
PMID: 33730899
Related Citations
How the Coronavirus Disease-2019 May Improve Care: Rethinking Cervical Cancer Prevention.
Authors: Feldman S.
, Haas J.S.
.
Source: Journal of the National Cancer Institute, 2021-06-01; 113(6), p. 662-664.
PMID: 32609333
Related Citations
Blood-based biomarkers of human papillomavirus-associated cancers: A systematic review and meta-analysis.
Authors: Balachandra S.
, Kusin S.B.
, Lee R.
, Blackwell J.M.
, Tiro J.A.
, Cowell L.G.
, Chiang C.M.
, Wu S.Y.
, Varma S.
, Rivera E.L.
, et al.
.
Source: Cancer, 2021-03-15; 127(6), p. 850-864.
EPub date: 2020-12-03.
PMID: 33270909
Related Citations
Anal Cancer and Anal Cancer Screening Knowledge, Attitudes, and Perceived Risk Among Women Living With HIV.
Authors: Rodriguez S.A.
, Higashi R.T.
, Betts A.C.
, Ortiz C.
, Tiro J.A.
, Luque A.E.
, Barnes A.
.
Source: Journal of lower genital tract disease, 2021-01-01; 25(1), p. 43-47.
PMID: 33149011
Related Citations
Primary Care Provider Beliefs and Recommendations About Colorectal Cancer Screening in Four Healthcare Systems.
Authors: Ghai N.R.
, Jensen C.D.
, Merchant S.A.
, Schottinger J.E.
, Lee J.K.
, Chubak J.
, Kamineni A.
, Halm E.A.
, Skinner C.S.
, Haas J.S.
, et al.
.
Source: Cancer prevention research (Philadelphia, Pa.), 2020 11; 13(11), p. 947-958.
EPub date: 2020-07-15.
PMID: 32669318
Related Citations
Pathways to breast cancer screening artificial intelligence algorithm validation.
Authors: Lee C.I.
, Houssami N.
, Elmore J.G.
, Buist D.S.M.
.
Source: Breast (Edinburgh, Scotland), 2020 Aug; 52, p. 146-149.
EPub date: 2019-09-09.
PMID: 31540699
Related Citations
Cervical cancer screening research in the PROSPR I consortium: Rationale, methods and baseline findings from a US cohort.
Authors: Kamineni A.
, Tiro J.A.
, Beaber E.F.
, Silverberg M.J.
, Wheeler C.M.
, Chao C.R.
, Chubak J.
, Skinner C.S.
, Corley D.A.
, Kim J.J.
, et al.
.
Source: International journal of cancer, 2019-03-15; 144(6), p. 1460-1473.
EPub date: 2018-12-20.
PMID: 30353911
Related Citations
Cervical Cancer Burden and Opportunities for Prevention in a Safety-Net Healthcare System.
Authors: Pruitt S.L.
, Werner C.L.
, Borton E.K.
, Sanders J.M.
, Balasubramanian B.A.
, Barnes A.
, Betts A.C.
, Skinner C.S.
, Tiro J.A.
.
Source: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2018 12; 27(12), p. 1398-1406.
EPub date: 2018-09-05.
PMID: 30185535
Related Citations
Cervical Cancer Incidence Among Elderly Women in Massachusetts Compared With Younger Women.
Authors: Feldman S.
, Cook E.
, Davis M.
, Gershman S.T.
, Hanchate A.
, Haas J.S.
, Perkins R.B.
.
Source: Journal of lower genital tract disease, 2018 Oct; 22(4), p. 314-317.
PMID: 30256336
Related Citations