Kentucky has the highest rates of cancer and cancer deaths in the nation, but it doesn’t have to be that way. Half of new cancers every year could be prevented by using existing tools better. The UK Markey Cancer Center is focusing on developing programs and services to make a difference for the people of the Commonwealth.
“We need to focus on areas where we can have a big impact,” said Dr. Pamela Hull, who recently joined Markey as the associate director of population science and community impact.
Hull leads Markey’s newly formed Community Impact Office, where she oversees the cancer center’s community outreach and engagement efforts. She also oversees Markey’s population science research through the Cancer Prevention and Control Research Program and other resources. She and her team will build upon ongoing work to develop programs that reduce cancer risk and mortality. This includes increasing access to effective, evidence-based cancer screenings and treatments and promoting research and outreach that responds to community needs. In Kentucky, that means targeting several key areas identified by communities as priorities:
- Continued colorectal screenings
- Tobacco treatment and cessation
- Cancer survivorship
“It’s our responsibility to serve the entire Commonwealth of Kentucky – not only our patients but the whole population,” Hull said. “It’s a big responsibility, but it’s something we take seriously. As the only NCI-designated center in the state, we have a commitment to ensure our efforts address and respond to the needs of Kentuckians.”
Community engagement at Markey is buoyed by a network of local and statewide public health partners, including:
- Kentucky Cancer Consortium (KCC): Markey is the home of this statewide comprehensive cancer coalition. The consortium’s more than 70 member organizations develop the state’s cancer action plan.
- Kentucky Cancer Program (KCP): This statewide cancer control program is divided into two areas: KCP-East at Markey and KCP-West at the University of Louisville. The program includes regional cancer control specialists who build and coordinate partnerships and programs through district cancer councils to meet the unique needs of each area.
- Markey outreach programs: Outreach staff provide health education events to promote cancer prevention and early detection. They also organize special cancer screenings for people who do not have health insurance or can’t come in during regular business hours.
All these programs are now a part of the Community Impact Office. The office also works closely with the Kentucky Cancer Registry. Markey leads this statewide registry for Kentucky, which records and shares data on every cancer case in the Commonwealth. This allows for the coordination of data and resources. It also facilitates the sharing of community perspectives and priorities.
More attention needs to be paid to creating tools and information that cancer centers can use to engage partners and prioritize programs that make a difference, Hull said.
When engagement and research respond to community needs, they can make a powerful impact. Previously, Markey collaborated with community partners through the Kentucky Cancer Consortium and the Kentucky Cancer Program to raise awareness about the need for colorectal cancer screening. Because of these efforts, screening rates doubled from about 35 percent in 2001 to nearly 70 percent in 2014, and mortality declined 30 percent. “We were able to help catalyze coordinated efforts to make that happen,” Hull said.
Another priority identified by KCC members and KCP district cancer councils is tobacco treatment. The Community Impact Office will collaborate with these stakeholders using a community-engaged process to select and implement evidence-based tobacco treatments.
Jerod Stapleton and Dr. Krystle A. Kuhs are co-leaders of Markey’s Cancer Prevention and Control Research Program. They mentor faculty, facilitate new collaborations, plan grant submissions and make sure researchers are connected to the data and resources they need. Stapleton and other researchers are applying for a grant that would fund a study of Kentuckians between ages 15 and 39 who have been diagnosed with cancer.
In collaboration with Markey’s Dr. Ty Borders, director of the Rural Underserved Health Research Center at UK, researchers want to document follow-up care, mental health outcomes and differences in rural and urban populations so they can better understand the survivorship experience for these adolescents and young adults. This study developed after researchers used Kentucky Cancer Registry data to find that young adults diagnosed with cancer in Kentucky fare worse than their counterparts nationwide. “We want to understand the needs of these survivors to inform the type of clinical care that is needed throughout the state to address them,” Stapleton said.
Any plan to curtail cancer rates in Kentucky should aim to reduce inequities in access to care and resources, Hull said. The Commonwealth as a whole has higher poverty levels and lower education rates compared with other states. Appalachian Kentucky is among the most economically distressed regions in the country. Efforts also need to focus on African Americans and Hispanics, who experience higher rates of cancer in Kentucky, and the unique needs and screening barriers of the LGBTQ community.
A strong community outreach and engagement program is a crucial part of Markey’s goal to become a comprehensive cancer center as designated by the National Cancer Institute. “We have to show we are having an impact and measuring that impact,” Hull said, “and that we’re listening to and learning from the community.”
For community outreach to be truly successful, trust needs to be built and maintained with the people of Kentucky. Hull wants to make sure research findings are shared. “We don’t want researchers to come to a community, collect data, then leave and the community never hears from them again,” Hull said. “We focus on lasting partnerships to fight cancer together.” Hull plans to hire a health communications expert who can share findings with the public via social media, digital products and other methods. “We want to connect the research back to people so they know what they can do to prevent cancer and find it early in their community,” she said.
Hull and her team follow in the footsteps of leaders who grew and guided Markey’s cancer control and prevention program. Dr. Thomas C. Tucker served as the associate director for cancer prevention and control and associate director of the Kentucky Cancer Registry, while Dr. Robin Vanderpool served as the associate director of community outreach and engagement. Debra Armstrong, who recently retired from UK, was director of the Kentucky Cancer Program. The Markey Cancer Foundation and its board members were also instrumental in recruiting Hull and providing funding for her position and other needs for community outreach and engagement.
Stapleton says prioritizing the health of Kentuckians is a way of life at Markey, in large part because of the work of its director, Dr. Mark Evers. “It’s inspiring to contribute to cancer prevention efforts at Markey and see the real
“It’s inspiring to contribute to cancer prevention efforts at Markey and see the real commitment and buy-in that our investigators have to the state and the residents and to understanding the concerns and community needs. I think that’s very refreshing, and it starts with the leadership.”
Dr. Jerod Stapleton
commitment and buy-in that our investigators have to the state and the residents and to understanding the concerns and community needs,” he said. “I think that’s very refreshing, and it starts with the leadership.”
The new Community Impact Office and new Cancer Prevention and Control Research Program leaders will help further grow the reach and impact of collaborative efforts with partners. “We want to reduce the cancer burden and prevent people from getting cancer,” Hull said. “And if they get cancer, we want to catch it early so they have the best chance of beating it. We have the highest cancer mortality in the whole country. We’ve got a lot of work to do, and the only way we’ll pull those numbers down is if we work together with community partners across the Commonwealth. We can only improve. There’s only one way to go.”