Cancer Center Support Grant

Cancer is the second leading cause of death in the state of Michigan. However, expected cancer mortality in 2020 may be underestimated due to the COVID-19 pandemic. The pandemic is a public health crisis that has dramatically altered almost every dimension of daily life in the U.S. Michigan ranks fifth among states in COVID-19 incidence and mortality, largely driven by the predominantly African American city of Detroit, which accounts for one-third of Michigan's COVID-19 cases. COVID-19-related disruptions in daily life and routines may have a broad range of adverse consequences including limited access to care, resources, and information, as well as psychological distress that undermine prevention and control efforts at the population and individual level and across the cancer care continuum. Therefore, we propose to participate in a consortium of NCI-designated cancer centers who will rapidly deploy surveys containing a standard set of core questions to populations across the U.S. The broad goal of the proposed research is to assess how differences in demographics (rural/urban, age, gender, race, educational attainment) will impact engagement in cancer preventive behaviors (e.g., tobacco cessation) and cancer management/survivorship behaviors (e.g., adherence to treatment and surveillance) in the context of COVID19-related environmental constraints (e.g., social distancing, employment, mental health, etc.). This research will be conducted among the general adult population, cancer patients, and cancer survivors within Karmanos Cancer Institute's 46-county catchment area in Michigan. Further, this work will be aligned with the efforts of a COVID-19 Population Science (CPS) Consortium that includes University of Iowa Holden Comprehensive Cancer Center, the James Comprehensive Cancer Center at the Ohio State University, University of Colorado Cancer Center, and the O'Neal Comprehensive Cancer Center at University of Alabama - Birmingham as the coordinating site. There are three specific aims. Aim 1: Develop a core set of questions to assess community and individual responses to the COVID-19 pandemic across populations, along with modules that will apply to specific sub-populations in any given catchment area. Aim 2: Administer the core set of questions and locally relevant modules to 2000 adults to determine the association between COVID-19 responses and cancer prevention and control behaviors among the general adult population, cancer patients, and cancer survivors in the KCI catchment area in Michigan, with a focus on racial and rural-urban differences. Aim 3: Develop and implement strategies to increase access to appropriate cancer resources based on survey results, in partnership with stakeholder organizations throughout the catchment area and evaluate their reach in the population. The proposed work represents an extraordinary opportunity to capture the impact of this public health crisis on cancer care and outcomes. This research will also shed new light on the social determinants that drive racial disparities in cancer specifically, and health more broadly. Data will also inform practical strategies to support vulnerable populations that disproportionately carry COVID-19 burden.