STATE-OF-THE-ART CANCER MANAGEMENT IN RURAL AREAS

东南癌症控制联盟（S3C）和北卡罗来纳

The Southeast Cancer Control Consortium (S3C) and the North Carolina Rural Health Research Program of the University of North Carolina at Chapel Hill and its health services research center have formed a coalition to strengthen the transfer of state-of-the-art cancer diagnosis and management practices between regional cancer specialists (CCOP communities) and rural health care providers. The long-term objectives are to improve staging, increase the proportion of patients entering clinical trials, and enable the treatment of these patients in their community, whenever appropriate. The design of this intervention allows the rapid transfer of new information to the fourteen communities composing the S3C. A rapid tumor reporting system will be developed utilizing the Central Cancer Registry of North Carolina and community tumor logs. A nurse facilitator system will be implemented to scan the logs, track patients, and provide the primary care physicians in the intervention group with community resources available for oncological care. Further, the nurse facilitator will coordinate the patient's treatment with the chemotherapy team or other treatment facilities at the community hospital. A Community Advocates Cancer Control Program will be utilized to inform both primary care physicians and the populations they serve as to the use of community resources. The Comprehensive Cancer Control Center at Wake Forest University will provide training for both nurse facilitators and chemotherapy nurses. Accession to clinical protocols will be administratively managed by the chemotherapy coordinators of the Cancer Center, the nurse facilitators, and the chemotherapy nurses of the regional oncology centers. Protocols from the Cancer Center, CALGB, NSABP and RTOG are available for community participation. The intervention will be conducted regionally by the S3C community of Goldsboro, located in Wayne County, NC. The surrounding rural counties of Duplin, Lenoir, Greene, Johnston and Sampson will be the participants in this process. The control county will be the S3C community of Greenwood, SC with its surrounding counties of Saluda, Newberry, Laurens, Abbenville and McCormick. The North Carolina Rural Health Research Program of the University of North Carolina at Chapel Hill and the Health Services Research Center will manage data collection and evaluate changes in patterns of care resulting from this community intervention.