Cancer Prevention Study-3 (CPS-3) Research today for a cancer-free tomorrow.

1. Cancer Prevention Study-3 (CPS-3)Research today for a cancer-free tomorrow. Alpa Patel, PhD Strategic Director, CPS-3 Epidemiology & Surveillance Research

2. Outline • History of Cancer Prevention Studies • CPS-3: Overview and the need for a new study • Addressing disparities through CPS-3 • CPS-3 enrollment and promotion

3. Analytic Epidemiology Mission Statement: “To conduct and publish high-quality epidemiologic research to advance our understanding of cancer etiology and thereby contribute to the prevention of cancer and death from cancer.”

4. History of Our Follow-up Studies • Partnership • ACS researchers and volunteers • Began in early 1950’s • Results • 1st to show link between smoking and lung cancer • 1st to show impact of obesity on cancer deaths • 1st to show link between aspirin and colon cancer

5. Annual Number of Publications

6. Participants Sex Volunteers States Years Research Emphasis CPS-I 1,000,000 Both 68,000 25 1959-72 Smoking, obesity CPS-II 1,200,000 Both 77,000 50 1982- Multiple Hammond-Horn 188,000 Men 22,000 9 1952-55 Smoking, cohort model Previous Society Follow-up Studies

7. CPS-3: Planning for the Future

8. Purpose • Better understand the factors (lifestyle, environmental, genetic) that cause or prevent cancer • Ultimately, to help eliminate cancer as a major health concern for future generations

9. Study Objectives • Enroll a diverse group of 500,000 men and women • 30-65 years of age • Never been diagnosed with cancer • Willing to make a long-term commitment to the study (by completing questionnaires every few years) • Recruitment goals • At least 25% minority (racial/ethnic) participation • Geographic diversity • Blood sample on all study participants at enrollment

10. The need for a new study… • Why do we need it? • CPS-II is aging (median age=77 years) • Changes in environment and lifestyles lead to new research directives • Ex: Assessing how the rise in obesity impacts cancer risk • New scientific technologies also lead to new research directives • Why is it important? • Most large studies have moved overseas • Blood specimens on 500,000 individuals will be an entirely unique resource in the US • Brings CPS studies into the 21st century • Positions the Society to answer new and important questions in the future

11. US Follow-up Studies with Diverse Populations • Previous long-term follow-up studies have been predominantly Caucasian populations (ex. CPS-I and CPS-II >90%)

12. CPS-3 and Cancer Risk in Diverse Populations • Racial/ethnic differences in cancer risk not well understood • Need comprehensive studies with lifestyle and genetic information • Differences in incidence and mortality by race/ethnicity may be due to: • Access to care, SES, education • Cultural differences • Risk factors • Genetic susceptibility • Ex. prostate cancer risk

13. Cancer Death Rates, by Race and Ethnicity, 1998-2002 • Rate per 100,000 persons Rate per 100,000 persons

14. Liver Cancer Mortality Rates, by Race/Ethnicity, 1998-2002

15. Female Breast Cancer Death Rates, US,1975-2002 African Americans Whites Rate per 100,000 persons Year of Death

16. Current Cigarette Use, Adults (>18 yrs) by Race and Sex, United States, 1965-2001 p Source: National Health Interview Survey, 1965-2001. National Center for Chronic Disease Prevention and Health Promotion, CDC.

17. % Obese by Race/Ethnicity, 1999-2001 Obese* % Men % Women Race/Ethnicity White (Non-Hispanic) 21.7 19.8 African American (Non-Hispanic) 24.9 34.9 Hispanic 22.2 25.5 American Indian and Alaska Native 38.6 29.7 Asian American 6.0 6.2 *BMI >30 kg/m2 Source: NHIS, 1999-2001, Vital Health Statistics, Series 10, No. 219, 2/2004

18. CPS-3: Enrolling a diverse population

19. Enrollment Venues • Main enrollment venue -- Relay For Life • Partnership with Society volunteers • Efficient for large-scale enrollment • Committed, diverse population • 2006-2011 • Enrollment at Celebration on the Hill 2006 • Show research in action • Engage very committed volunteers from across the country

21. Study Participation • Initial enrollment at RFL • Complete a brief survey and sign informed consent • Provide a waist measurement • Provide a small blood sample • Within 2 months after enrollment at RFL, mailed baseline survey • To collect complete, detailed environmental and lifestyle information • Follow-up into the future • Repeat surveys every few years to update exposure information

27. 2006/2007 Pilot Work • Spring 2006 (CA, TX, GA)-6 events total • Goal: Assess efficiency and effectiveness of enrollment protocol (through Relay with volunteers, and Quest Diagnostics) • Results: • Enrolled 1,374 participants • 27% men • At diverse Relays, up to 46% NHW • Sept. 2006-Celebration on the Hill • Results: Enrolled 1,018 participants • 2007-64 events across 7 divisions • Goal: Identify successful promotional tactics, general and targeted

28. Targeted Promotion • Integrated approach throughout the Society • Proof point of commitment to addressing disparities in cancer prevention • Engage more diverse groups in Relay For Life • Ex.: Chief Diversity Officer, Employer Initiatives, Coaches vs. Cancer • Partnerships in Communities • Faith-based organizations • Service/fraternal organizations • Leadership Volunteers

29. CPS-3 Enrollment Timeline

30. CPS-3 Enrollment States Puerto Rico

31. “My mom is a two-time cancer survivor and I’m doing everything I can to make sure my children don’t ever have to say that…I really, really believe this is part of the answer.” • -CPS-3 participant

32. For more information… • Website: www.cancer.org/cps3 • Toll-free number: 1-888-604-5888 • Email: cps3@cancer.org

33. Thank you