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Wyoming Department of Health

Wyoming Department of Health. A New Generation of Cancer Control Partnerships: Integrating Public Health into Clinical Practice Brent D. Sherard, M.D., M.P.H. Director and State Health Officer Wyoming Department of Health. Burden of Cancer.

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Wyoming Department of Health

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  1. Wyoming Department of Health A New Generation of Cancer Control Partnerships: Integrating Public Health into Clinical Practice Brent D. Sherard, M.D., M.P.H. Director and State Health Officer Wyoming Department of Health

  2. Burden of Cancer • Each year, cancer claims the lives of more than half a million Americans • Costs of cancer in U.S.: • $210 billion overall in 2005, including nearly $136 billion for lost productivity and more than $70 billion for direct medical costs

  3. Leading Causes of Death in Wyoming 2004 • Heart Disease - 934 • Cancer - 863 • Chronic Respiratory Diseases - 307 • Stroke - 209 • Influenza and Pneumonia - 108 • Diabetes Mellitus - 108

  4. Cancer Deaths - Preventable? • In 2004, the American Cancer Society estimates: • 260 men and women will die of lung cancer in Wyoming • 110 men and women will die of colorectal cancer in Wyoming • 50 deaths from breast cancer • 80 men will die of prostate cancer in Wyoming

  5. Wyoming Mortality Rate Trend Data1975-2002 Rates are per 100,000 and age-adjusted to the 2000 US Std. Million (18 age groups) standard.

  6. Cancer Agenda Driven by Public Health Concerns In terms of disease, cancer is by far the leading cause of potential life lost in the United States

  7. Cancer Leads in Potential Years of Life Lost in Wyoming Wyoming Vital Statistics Report—2001

  8. Why Comprehensive Cancer Control? • Improved coordination of cancer control activities-essential to maximize resources and achieve desired cancer control outcomes • Benefits-increased efficiency for delivering both public health-related messages and services to the public

  9. Comprehensive Cancer Control(continued) • Collaborative process • Results in risk reduction, early detection, better treatment, and enhanced survivorship. • Encourage healthy lifestyles, promote recommended cancer screening guidelines and tests • Increase access to quality cancer care, and improve quality of life for cancer survivors

  10. Public Health — Clinical Medicine • Public Health • Public Education • Laws and Policies • Programs • Media • Integration of Services • Vaccines • Clinical Medicine • - Public Education • - One on One Counseling • - Personal Relationship with Patient and Family • - Integration of Services • - Vaccines

  11. Partnerships • Advantages • Pooling and improved efficiency of limited resources • Diversity of public message • Policy and funding at state and federal level • General support

  12. California: Risk Reduction • California’s skin cancer prevention program • Statewide initiative • Purpose-reduce new cases of skin cancer • Focus on child care centers, elementary and high schools • Dissemination of sun-safety packages including educational materials • Two skin cancer prevention videos for elementary school students

  13. Ohio: Early Detection • Northwest Ohio Colorectal Cancer Task Force • Rural coalition-increase colorectal cancer screening in a 6 county area • Screening colonoscopy free of charge to uninsured residents • Diagnostic and treatment services provided if necessary • March 2006-1106 screening colonoscopies • 8 colorectal cancers discovered • 20 cases of high-grade dysplasia were found and removed • Precancerous polyps were removed from 518 of those screened

  14. Public Health and Clinical Practice: What Will it take to Reduce Cancer Mortality? • A cancer health care agenda driven by both clinicians and public health officials • Emphasis on primary care • Expanded access to primary and cancer care services • Systems of care as opposed to the clinician as the solo pilot of an individual’s care • Payment mechanisms to support these systems

  15. Cancer Agenda Collaboration Between Public Health and Clinical Medicine • Cancer awareness • Cancer prevention and screening • Cancer treatment

  16. Can We Eliminate All Cancer Deaths? • Unfortunately, all people will die…of something; people and families more acceptable of death in the elderly and older age groups. • The trend is to pull out all stops for young people. • There will always be a leading cause of death (heart disease, stroke, cancer, chronic lower respiratory disease, Alzheimer’s)

  17. A Proposed Refinement in our Cancer Goals • Public Education • What is cancer • How and why people develop these diseases including risk factor reduction • Why screening is important • Where people can receive cancer screening and prevention services

  18. Ultimate Outcome • Eliminate premature cancer deaths

  19. Emphasis on Primary Care Services • Gatekeeper • Potentially lower costs through coordination of services • Personal relationship • Better understanding of individual and family wishes, desires, and outcomes • Mental Health Services • Hospice

  20. Percent of Wyoming Adults Reporting No Health Care Coverage (2005 BRFSS)

  21. Future Challenges • Reimbursement • Pay for performance • Health Care coverage for prevention services • Access to screening services • Mental health services • Cancer stigma? • State, county, and community-driven efforts to promote cancer awareness

  22. Questions? Brent D. Sherard, M.D., MPH Wyoming Department of Health Director and State Health Officer

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