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.
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO mcopur@sfmc-gi.org.
Mehmet Sitki
MS
Copur
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Ryan
R
Ramaekers
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Mithat
M
Gönen
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Mary
M
Gulzow
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Rebecca
R
Hadenfeldt
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Courtney
C
Fuller
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Jenifer
J
Scott
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Sarah
S
Einspahr
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Heather
H
Benzel
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Mary
M
Mickey
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Max
M
Norvell
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Douglas
D
Clark
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Dron
D
Gauchan
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Dax
D
Kurbegov
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO mcopur@sfmc-gi.org.
Mehmet Sitki
MS
Copur
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Ryan
R
Ramaekers
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Mithat
M
Gönen
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Mary
M
Gulzow
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Rebecca
R
Hadenfeldt
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Courtney
C
Fuller
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Jenifer
J
Scott
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Sarah
S
Einspahr
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Heather
H
Benzel
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Mary
M
Mickey
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Max
M
Norvell
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Douglas
D
Clark
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Dron
D
Gauchan
Saint Francis Cancer Treatment Center, Grand Island, NE; Memorial Sloan Kettering Cancer Center, New York, NY; and Catholic Health Initiatives, Denver, CO.
Dax
D
Kurbegov
D002173:Cancer Care Facilities; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data*; D003151:Community Health Centers; D003153:Community Health Services; D005260:Female; D006078:Government Programs; D006801:Humans; D008297:Male; D054547:National Cancer Institute (U.S.); D009329:Nebraska; D019035:Rural Health Services; D014481:United States