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UT Southwestern, Parkland Hospital get $6.3 million grant for colorectal screening program

The National Cancer Institute recently awarded $6.3 million to UT Southwestern Medical Center and Parkland Hospital as one of three national sites to improve screening for colorectal cancer.

The five-year grant establishes the Parkland-UT Southwestern as an NCI PROSPR (Population-based Research Optimizing Screening through Personal Regimens) Center, joining already established PROSPR sites in Washington state and California. In all, NCI is looking to establish a dozen such sites across the country aimed at improving the screening processes for colorectal, breast and cervical cancers.

Under the Texas program, lead investigators Celette Sugg Skinner, MD, associate director of the Harold C. Simmons Cancer Center, and Ethan Halm, MD, chief of general internal medicine and professor of internal medicine and clinical sciences will seek to improve colon screening for Dallas-area residents and in the process develop a model that can be employed by public hospitals across the country.

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"The earlier we can detect cancers, the better we are able to treat them," said Skinner, in an announcement detailing the grant. "Late-stage cancer is harder to treat, and there is no reason why people with less insurance should bear a disproportionate burden of cancer."

Colorectal cancer is the third leading cause of cancer deaths in the country, according to statistics from NCI. In 2010 it is estimated that more than 142,000 men and women were diagnosed with either cancer of the colon or rectum and that more than 52,000 deaths were attributed to the disease.

NCI's PROSPR centers are targeting colorectal, breast and cervical cancers for improved screening procedures because all three show very high survival rates if detected early. Colorectal cancers have a 90 percent five-year survival rate if diagnosed when the cancer is still confined to the primary site. Yet, there is a lot of room for improvement since only 39 percent of those diagnosed with the cancer are still at this early stage.

"Screening for colon cancer has the potential to virtually eliminate colon cancer mortality," said James K. V. Willson, MD, director of the Simmons Cancer Center, in a press release announcing the grant.

The Parkland-UT Southwestern program, which aims to reach as many as 32,000 Dallas County residents, is also unique as its screening efforts will focus on residents who either lack health insurance or are underinsured, whereas the other PROSPR sites serve populations with higher rates of insurance.

By focusing on those without insurance or less than adequate coverage, the Texas-based PROSPR hopes it can also address the disparity of morbidity rates among particular groups.

"There is a known disparity in morbidity related to colorectal cancer that is evident along racial, ethnic and socioeconomic groups," said John Jay Shannon, MD, Parkland's executive vice president for medical affairs and chief medical officer. "The methodologies we will be exploring in the PROSPR grant are an attempt to apply innovative thinking and behavioral sciences to bridging that disparity."

The funding will be applied to three distinct programs already under way: the use of Spanish and English language touch screens patients can use to determine risk factors; a study comparing the relative effectiveness of screening outreach programs; and a study to determine best practices at both primary care clinics and across the entire Parkland network that most effectively promote screening.

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