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Moving Cancer Research from the Lab to the Population: The Final Step in Translational Research

Moving Cancer Research from the Lab to the Population: The Final Step in Translational Research. Presented by: Thomas C. Tucker, PhD, MPH Associate Director for Cancer Control Markey Cancer Center University of Kentucky CCAF Meeting San Diego, CA April 15, 2014. Markey Cancer Center.

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Moving Cancer Research from the Lab to the Population: The Final Step in Translational Research

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  1. Moving Cancer Research from the Lab to the Population: The Final Step in Translational Research Presented by: Thomas C. Tucker, PhD, MPH Associate Director for Cancer Control Markey Cancer Center University of Kentucky CCAF Meeting San Diego, CA April 15, 2014 Markey Cancer Center

  2. Topics to be covered • The final step in translational cancer research • Why this step is so important • The concepts of Internal and External validity • How these concepts relate to translational research • The Markey Cancer Center Model for moving evidence-based research into the population • An example of the potential impact of implementing evidence-based research findings in the population

  3. The final step in translational research is the broad based implementation of cancer research findings in the population.

  4. Two important concepts • Internal validity • External validity

  5. Animal Studies Relative Risk = (A/A+B)/(C/C+D)

  6. Randomized Clinical Trial Random Allocation Relative Risk = (A/A+B)/(C/C+D)

  7. Internal Validity • When differences between the experimental (exposed) group and the control group are completely accounted for, the study is said to have internal validity and causal inferences can be made. • In other words, it is possible to determine whether the exposure causes some outcome (disease, etc.). • Many have argued that “randomization” was the most important scientific advance of the 20th century. • Why is it that the findings from randomized clinical trials with internal validity almost never have the same effect when they are applied to general populations?

  8. External Validity • When the findings from a research project or study can be generalized to some defined population, they are said to have external validity. • Epidemiology (population science) provides the tools to explore external validity and many argue that moving from studies with strong internal validity to studies with strong external validity is the next step in advancing our scientific understanding. • The continuum from research with strong internal validity to studies with strong external validity is also part of “Translational Research”.

  9. From the Laboratory to the Population Genes Cells Animals Humans Populations Basic Science Clinical Science Epidemiology Translational Research

  10. EXAMPLE Quercitrin, a natural product from apple peel, is tested in an animal model to determine if it prevents UV exposure induced skin cancer Broad application of the findings to the general population Randomized trials in human populations

  11. From the Laboratory to the Population And back again Genes Cells Animals Humans Populations Basic Science Clinical Science Epidemiology Translational Research

  12. The ultimate goal of translational cancer research is the adoption and wide-spread use of evidence-based research findings that significantly reduce the cancer burden in the population. This includes the wide-spread implementation of evidence-based cancer control interventions.

  13. Markey Cancer Center Model for Moving Evidence-based Cancer Research Findings into to the Population Kentucky Cancer Consortium (KCC) Kentucky Cancer Program (KCP) Kentucky Cancer Registry (KCR)

  14. Combining Data from Multiple Sources Demographic Characteristics Contribute to Risk Factors Contribute to Incidence and Late Stage DX Contribute to Cancer Mortality Logic Model

  15. What are the common sources of data that can be used for defining the cancer burden? • Demographic data (Census U.S) • Risk factor data (BRFSS) • Incidence data (KCR) • Mortality data (State Vital Records)

  16. An Example In 2001, Kentucky had the highest colorectal cancer incidence rate in the U.S. compared to all of the other states

  17. In 2001, it was also noted that Kentucky was ranked 49th in colorectal cancer screening compared to all other states with the second to the lowest rate (34.7% of the age eligible population).

  18. Using the process previously described, data about the burden of colorectal cancer was assembled and presented to each of the 15 District Cancer Councils. Following these presentations, all 15 of the District Cancer Councils implemented evidence based cancer control intervention programs aimed at increasing colorectal cancer screening for age eligible people living in their District.What happened following the implementation of these colorectal cancer screening programs?

  19. Colorectal Cancer Screening in Kentucky 70% 63.7% 63.7% 58.6% 60% 47.2% 50% 43.9% 40% 34.7% 49th in the U.S. 20th in the U.S. 30% 1999 2002 2004 2006 2008 2010

  20. P<.05 Source: http://cancer-rates.info/ky, Accessed January 2014

  21. P<.05 Source: http://cancer-rates.info/ky, Accessed January 2014

  22. A 24% reduction in colorectal cancer incidence and a 28% reduction in colorectal cancer mortality is a significant public health success. This provides evidence that the wide spread application of proven cancer research findings (the last step in translational research) can make a real difference in peoples lives.

  23. Thank You! Markey Cancer Center Questions Contact Information: Thomas C. Tucker, PhD, MPH tct@kcr.uky.edu TheEnd

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