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Special Issue: Cancer Control in North
Carolina
We Want You to Know About Us! The North Carolina Cancer
Control Plan 2001-2006
by Joseph S. Pagano, MD
The
Chairman gives an overview of the origins, structure, accomplishments, and
plans of the NC Advisory Committee on Cancer Coordination and Control.
The North Carolina Cancer
Control Program: Caring for Uninsured and Low-Income Patients with
Cancer
by Brenda Stone-Wiggins, MPH, and Deborah Porterfield, MD,
MPH
The state’s Cancer Control Program is undertaking a comparison
of its utilization data with data from the NC Central Cancer Registry. The
results of this evaluation will support the development of outreach
interventions and policy changes aimed at providing better cancer care to
indigent North Carolinians
Cancer Control Legislation and
Policy Milestones in North Carolina
by Judith C. Wright, BSN, MPH,
Lisa Poovey Greene, BS, and Tim E. Aldrich, PhD, MPH
As the state’s
second Cancer Control Plan is inaugurated, the authors look back to the
formation of the NC Committee on Cancer in 1933 and recollect some early,
related activities. They give particular attention to the pivotal legislative
events leading up to the adoption of the first Cancer Control Plan in 1996.
Results from the 1999 North
Carolina Youth Tobacco Survey
by Elizabeth Conlisk, PhD, and
Sally Herndon Malek, MPH
A survey of over 12,000 middle- and high-school
students yielded some disturbing figures about the high rate of current tobacco
use among the state’s young people, especially middle-schoolers, as
compared to national rates. The data underscore the need for vigorous smoking
prevention, control, and cessation programs in our schools and communities.
Teen Empowerment Movement to
Prevent Tobacco Use by North Carolina’s Youth
by Jim D.
Martin, MS, Kurt M. Ribisl, PhD, Delmonte Jefferson, and Ann Houston,
CH-ES
Traditional curriculum- and classroom-based smoking prevention
programs have not been very effective, so the Tobacco Prevention and Control
Branch of NC-DHHS is examining new approaches. Empowerment programs actively
engage the state’s young people as collaborators in devising and
evaluating effective solutions to the tobacco problem. Efforts are focused at
three Youth Empowerment Centers across the state.
Labored Breathing: Policies to
Eliminate Environmental Tobacco Smoke Exposure in North
Carolina
by Adam O. Goldstein, MD, Sally Herndon Malek, MPH, and
Anne Y. Butzen
There are currently no statewide laws protecting North
Carolinians from environmental tobacco smoke (ETS), which causes 65,000 deaths
per year in the US, and 1500 in this state. In 1993 NC legislators passed a law
stating their intent to “address the needs and concerns of both smokers
and nonsmokers in public places,” but in its attempts to accommodate both
these constituencies, as well as business owners, tobacco companies, and
building owners, the law creates more problems than it solves. The author
reviews available options and the future of ETS policies for the state.
What Do They Know About It? How
the North Carolina Public Views Cancer Clinical Trials: Implications for
Primary Care Doctors
by Betsy Randall-David, RN, PhD, Nancy
Stark, RN, PhD, Jennifer Gierisch, MPH, and Frank Torti, MD
Few eligible
cancer patients join prevention trials. The NC Cancer Program’s Care
Subcommittee convened a series of focus groups to identify personal and
cultural barriers to participation among both urban and rural North
Carolinians. Their findings confirm the need for innovative, efficient outreach
strategies to encourage participation in cancer clinical trials. Of special
importance is the role of primary care providers in educating their patients
and correcting common misconceptions about the process.
Prostate Cancer as a Public
Health Issue in North Carolina
by Nancy Stark, RN, PhD, Electra
Paskett, PhD, Wendy Demark-Wahnefried, PhD, Elena Carbone, DrPH, RD, and Paul
Godley, MD
Black men in North Carolina have one of the highest mortality
rates of prostate cancer in the nation, and more than twice as many black men
as white have distant metastases at diagnosis. This disparity may relate in
part to behavior regarding prostate cancer screening and treatment. The authors
examine the controversy surrounding routine PSA screening, giving the cases for
and against, and outline recommendations.
Colorectal Cancer Screening in
North Carolina
by Michael S. O'Malley, PhD, Nicholas J. Shaheen,
MD, MPH, Melissa A. Crosby, MD, Sharon C. Murray, PhD, Jennifer S. Klenzak, MD,
Joseph A. Galanko, PhD, Aneesh Singla, MD, David F. Ransohoff, MD, MPH, Robert
S. Sandler, MD, MPH, James Gaither, MD, Electra D. Paskett, PhD
The
authors surveyed 1582 primary care doctors in North Carolina to determine their
training for, attitudes towards, and current practices of screening for
colorectal cancer with FOBT and flexible sigmoidoscopy. Data from this survey
have been used to develop strategies to help primary care doctors increase
colorectal cancer screening.
Colorectal Cancer in North
Carolina: Risk Factors, Screening Behaviors, Incidence, Stage at Diagnosis, and
Mortality
by Elizabeth Conlisk, PhD
The authors compared
data from the NC Behavioral Risk Factor Surveillance System, Central Cancer
Registry, and the national Surveillance, Epidemiology, and End Result Program
to assess the state of colorectal cancer in NC. They found large racial
disparities in the incidence of this cancer among women, and even larger
disparities in mortality.
Better Pap Tests Using
Liquid-Based Technology
by Nancy Gardner, MT
(ASCP)
Despite its acceptance and success as the standard screening test
for cervical cancer, the Pap smear is susceptible to errors in sampling,
preparation, and errors. In 1999, the NC State Laboratory of Public Health
adopted a new liquid-based technology, ThinPrep, which gives more clearly
defined cellular detail, with less nondiagnostic debris. This new testing
method results in fewer repeat smears, increased detection of abnormalities,
and greater confidence that a “negative” result means no cancer is
present.
Cancer Control and the Central
Cancer Registry of North Carolina
by M. Robert Cooper, MD, Dale
Herman, MSPH, and Tim E. Aldrich, PhD, MPH
Standardization of data
collection and reporting in Central Cancer Registries across the country have
created a valuable tool for epidemiologic and public health approaches to
cancer control. The authors discuss five justifications for the NC registry:
disease prevention, treatment, research, environmental issues, and public
education.
RUNNING THE
NUMBERS
Coronary Heart Disease and Stroke
in North Carolina
by Paul A. Buescher, PhD
In 1999 the
NC-DHHS began to include questions on heart disease and stroke in its ongoing
Behavioral Risk Factor Surveillance System, an ongoing telephone survey of
health risk factors and conditions among adults, designed by the Centers for
Disease Control and Prevention. The data obtained provide an important
supplement to hospital data, giving a more complete picture of the epidemiology
of these diseases.
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