Community physician and researcher partnerships deliver latest care to breast cancer patients

Cancer patients who receive care from local physicians partnering with the medical research community are as likely to receive innovative treatments compared to patients treated at medical school affiliated hospitals, according to research from the University of North Carolina at Chapel Hill.

The study examined rates of sentinel lymph node biopsy, an innovative method for detecting spread of the disease into other parts of the body in breast cancer patients using data from Surveillance Epidemiology and End Results (SEER)-Medicare and National Cancer Institute’s Community Clinical Oncology Program (CCOP).  Results showed that women who were treated in the CCOP practice-based research networks received the innovation at very high rates, even when compared to those treated at medical school affiliated hospitals. 

The research team was led by Anne-Marie Meyer, research assistant professor with the UNC Gillings School of Global Public Health and facility director for the UNC Lineberger Comprehensive Cancer Center’s Integrated Cancer Information and Surveillance System (ICISS). The study, published in Medical Care and highlighted by the Agency for Health Care and Research Quality (AHRQ), is one of the first to examine the networks’ ability to translate new medical treatment into rural and community medical practice.

“A lot of science and innovation occurs in academic research settings such as medical schools.  The newest innovative treatments and procedures often get disseminated quickly within academic settings, but can have slower adoption in community practice” said Meyer. “Cancer care, specifically, has adapted new technology and innovations rapidly over the past couple of decades.”

Practice-based research networks (PBRNs) pair community physicians with academic researchers to accelerate the adoption of treatment innovations into standard medical practice.  Supported by the National Institutes of Health (NIH), PBRNs can take many forms and encompass wide range specialties from primary care practitioners to rural oncologists.  This study specifically examined data from patients treated by physicians associated with the NCI CCOPs, an oncology-focused PBRN program that includes 47 sites nationally including two in North Carolina.

“The NCI program provides money for staffing and infrastructure to enroll patients in clinical trials. The idea being that the innovations happening in academic medical settings will diffuse out into community practice quicker, and that rural patients or patients in the community will have greater access to the latest clinical trial research and cutting edge treatment,” said Meyer.

The research team linked data from SEER-Medicare with data from the NCI CCOP program to track the treatment of women who were diagnosed with stage I or II breast cancer between 2000 and 2005 and who received breast-conserving surgery.  The data revealed that the women treated by physicians in the NCI network were significantly more likely to receive sentinel node biopsies a less invasive, less difficult procedure for patients.

 “It is clear that patients treated by CCOP-affiliated physicians were as likely to undergo this state-of-the-art therapy as patients seen in major academic centers at the time the innovation was disseminating into clinical practice – which indicates the CCOP program likely played a role in the dissemination of this innovation out into the community” said Meyer.

The research was supported in part by National Cancer Institute at NIH 5R01CA124402 and the Integrated Cancer Information and Surveillance System, UNC Lineberger Comprehensive Cancer Center, with funding from the University Cancer Research Fund.