Office of Research & Development

Cancer Outcomes Research Program

The mission of the Cancer Outcomes Research Program is to conduct research to understand the burden of cancer among Veterans and identify modifiable factors to improve care.

For more information, contact the Cancer Outcomes Program Manager at Christina.Williams4@va.gov

Our current research portfolio includes:

Prospective Evaluation of Risk Factors for Large Colonic Adenomas in Asymptomatic Subjects (CSP #380)

The primary objective of this study is to determine the prevalence of advanced neoplasia (defined as a polyp > 1 cm, villous histology, high grade dysplasia, or colorectal cancer) and 10-year cancer outcomes in a screening cohort. Screening colonoscopies were performed in 3,121 Veterans at 13 VA medical centers between 1994 and 1997. These participants were then followed for up to 10 years. A biorepository including blood, normal tissue, polyps, and cancer was created. Results published in 2000 informed Congress about the benefits of screening colonoscopy, leading to Medicare coverage of the procedure. Subsequent publications informed the 2006 and 2012 US Multisociety Task Force Guidelines on Colorectal Cancer Screening. Interested investigators may submit requests to access the data and/or specimens through the CSPEC-Durham Data and Specimen Repository.

Study Chairs: David Lieberman, MD; Dawn Provenzale, MD, MS; Elizabeth Hauser, PhD; Ziad Gellad, MD, MPH

Genetic and Genomic Analysis of CSP #380 Tissues (CSP #380b)

The primary objectives of this study are to assess the feasibility of performing genomic analysis on polyp tissue and to compare mutations and genome-wide methylation in patients at high versus low risk for colorectal cancer. In addition, creating risk stratification algorithms for colorectal cancer screening and surveillance using the specimens collected from CSP#380 biorepository participants. Interested investigators may submit requests to access the data and/or specimens through the CSPEC-Durham Data and Specimen Repository.

Study Chairs: Elizabeth Hauser, PhD; Dawn Provenzale, MD, MS; Ziad Gellad, MD; David Lieberman, MD; Stanley Hamilton, MD; Steven Schichman, MD, PhD

Longitudinal Analysis of the CSP #380 Cohort

The primary objective of this study is to collect longitudinal data and specimens from CSP #380 participants to study the progression to colorectal cancer. Interested investigators may submit requests to access the data and/or specimens through the CSPEC-Durham Data and Specimen Repository.

Study Chairs: Dawn Provenzale, MD, MS; Elizabeth Hauser, PhD; Ziad Gellad, MD, MPH; David Lieberman, MD

Colonoscopy vs. Fecal Immunochemical Test in Reducing Mortality from Colorectal Cancer (CONFIRM) Biorepository (CSP #577)

The primary objective of this study is to create a biorepository of blood and tissue samples from up to 10,000 participants of the CONFIRM clinical trial, and to request access to participants' electronic medical records and survey data. Data and specimens collected through this biorepository may be requested by interested VA and non-VA investigators in the future.

Study Chairs: Jason Dominitz, MD, MHS; Douglas Robertson, MD, MPH; Co-I: Dawn Provenzale, MD, MS

Early-stage Lung Cancer Treatment and Survival: Impact of Race

The primary objective of this study was to analyze data from the VHA Central Cancer Registry to examine trends in receipt of surgical and nonsurgical treatment among Blacks and Whites over a decade and determine the impact of race on survival according to treatment. Results concluded the racial disparity in surgery was no longer apparent at the end of the 2001-2010 decade and previously reported racial differences in survival outcomes were not observed in this cohort.

PI: Christina Williams, PhD, MPH

Epidemiology of Cancer among Veterans (EpiCAN)

The primary objective of this study is to develop a unified data resource that will serve as a platform to evaluate the burden of cancer and quality of cancer care among veterans. The research objectives seek to comprehensively assess cancer incidence, treatment, survivorship, and associated outcomes to identify improvements in cancer care among patients treated at the VA and society at large.

PI and Investigators: Christina Williams, PhD, MPH; Dawn Provenzale, MD, MS; Michael Kelley, MD; Leah Zullig, PhD, MPH; Bradley Hintze, PhD


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