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  The Health Record Review
by Frank Irving


EMR will be an integral part of new NCI site for colorectal cancer screening

Posted on Mon, Oct 10, 2011 - 12:26 pm

A five-year, $6.3 million grant from the National Cancer Institute (NCI) establishes UT Southwestern Medical Center and Parkland Health & Hospital System as part of a three-site network for colorectal cancer screening. The Parkland-UT Southwestern PROSPR (Population-based Research Optimizing Screening through Personal Regimens) Center joins similar NCI PROSPR sites already operating in California and Washington state. Parkland’s EMR system and its Center for Clinical Innovation will serve as the information technology backbone of the collaboration with UT Southwestern.

In all, NCI will set up nine to 12 PROSPR sites around the country to examine and improve screening processes for colorectal, breast and cervical cancers. The UT Southwestern-Parkland partnership, which hopes to reach more than 32,000 Dallas County residents age 50 and older, will focus on people who lack insurance or are underinsured.
Two UT Southwestern investigators -- Dr. Celette Sugg Skinner, associate director of the Harold C. Simmons Cancer Center, and Dr. Ethan Halm, chief of general internal medicine and professor of internal medicine and clinical sciences -- will lead the Dallas site. Their goal is twofold: to optimize colon cancer screening among Dallas residents and to develop a model for screening that can be used by public hospitals nationwide.
“The earlier we can detect cancers, the better we are able to treat them,” said Skinner. “Late-stage cancer is harder to treat, and there is no reason why people with less insurance should bear a disproportionate burden of cancer.”
There are more than 140,000 new cases of colorectal cancer in the U.S. each year and nearly 50,000 deaths. But the disease, like breast and cervical cancer, can often be cured if caught early.
“Screening for colon cancer has the potential to virtually eliminate colon cancer mortality,” commented Dr. James K. V. Willson, director of the Simmons Cancer Center, the only NCI-designated cancer center in North Texas and a partner with UT Southwestern and Parkland on the PROSPR site. The Texas Cancer Registry and the UT School of Public Health in Dallas are also collaborating on the project.
Colorectal cancer has higher rates of occurrence and mortality among low-income patients, often because they lack access to proper screening, Skinner noted. UT Southwestern and Parkland said their “safety-net setting” is unique compared to other PROSPR sites, which serve populations that tend to have better insurance coverage.
“There is a known disparity in morbidity related to colorectal cancer that is evident along racial, ethnic and socioeconomic groups,” observed Dr. John Jay Shannon, Parkland’s executive vice president for medical affairs and chief medical officer. “The methodologies we will be exploring in the PROSPR grant are an attempt to apply innovative thinking and behavioral sciences to bridging that disparity.”
The grant will help expand and refine interlocking research projects already under way at UT Southwestern. The first involves a touch-screen computer program deployed in clinics to ask patients questions in English or Spanish about their personal risk factors and family history, using the responses to generate a personalized screening regimen for colon cancer for each patient.
A second project will compare the cost and effectiveness of various outreach strategies aimed at people in need of cancer screening. In a third project, investigators will attempt to determine best practices in the primary care clinics and across the entire Parkland network that most effectively promote screening.
Photo courtesy of UT Southwestern.