MaineHealth Cancer Care Network (MHCCN) and NCORP Activities across the Lifespan

摘要 缅因州成人癌症发病率和死亡率分别位居第12位和第8位，儿童癌症发病率位居第三 这在全国是最高的，导致了我们州明显的癌症健康差距。据估计，2018年将有8600名新成人 缅因州确诊的癌症病例；癌症是我们州最常见的死亡原因。在这些成人病例中，6185例(72%)将 在MaineHealth癌症护理网络(MHCCN)医院或门诊设施接受他们的护理。这个病人的数量与任何 大都会癌症中心。缅因州只有130万居民，是一个小州，是最农村的州，也是历史最悠久的州 这个国家的人口。有显著的癌症危险行为和暴露，有许多社会经济和 地理上的挑战也是如此，这进一步加重了我们的癌症负担。MHCCN显然是围绕患者、健康进行组织的 提供者和医疗保健系统多层次战略和干预措施，在NCORP征集中确定优先顺序，并在 这项提议。我们的卫生系统在2014年开始了全面的肿瘤学战略规划进程，在相对较短的时间内 这段时间使我们有机会提交我们对本FOA的答复。在癌症护理模式上达成了共识，即我们 会继续追查。唯一的目标是确保“在正确的地点、尽可能靠近家的地方得到正确的护理”。 如果是这样的话。我们州的癌症患者及其家人渴望获得最先进的以患者为中心的护理。这个NCORP 对于我们的组织来说，申请来得再好不过了，恰逢该组织的显著增长和实质性的多 在过去的几年里，在MH肿瘤学上投资了100万美元。在此背景下，我们应用程序的根本目标是 在包括儿科、青少年和青壮年在内的一生中致力于并为NCORP活动做出贡献， 在我们的社区和农村护理环境中的成年人和老年癌症患者。我们召集了一个互动性很强的 我们网络中的跨学科团队参与并领导这项研究工作。我们的中心假设是发展中的 在整个MH肿瘤学中始终以患者为中心的高度互动和跨学科的癌症护理方法将具有 在预防、筛查、诊断、治疗、生存、 不仅为我们的患者及其家人，而且为我们的使命至关重要的其他方面提供临终关怀和护理-包括 教育下一代医疗保健提供者并扩大我们的研究目标，特别是在我们所关心的农村地区 网络。我们提出了四个目标：开展并积极参与1)癌症控制研究，2)癌症预防研究，3) 癌症护理提供研究；以及4)利用NCORP和我们最新推出的 获得新英格兰北部临床和翻译研究网络拨款(1U54 GM115517)。我们将追求这些目标 在整个生命周期中，儿童和成年人都参与其中。MHCNN非常期待我们将做出实质性的贡献 在NCORP研究组合的所有范围内。我们将利用我们的机构资产、患者资源和专业知识 从社区和农村环境的角度出发，在整个生命周期内增加价值，并为NCORP提供领导。我们 欢迎并珍视作为新的机构成员加入NCORP网络的机会。

Abstract Maine ranks 12th and 8th in adult cancer incidence and mortality respectively, and pediatric cancer incidence rates are the third highest in the nation, contributing to marked cancer health disparities in our state. In 2018, it is estimated there will be 8,600 new adult cancer cases diagnosed in Maine; cancer is the most common cause of death in our state. Of these adult cases, 6,185 (72%) will receive their care at a MaineHealth Cancer Care Network (MHCCN) hospital or outpatient facility. This patient volume is akin to any major metropolitan cancer center. With only 1.3 million residents, Maine is a small state, is the most rural state, and has the oldest population in the nation. There are significant cancer risk behaviors and exposures, and there are numerous socioeconomic and geographic challenges as well, further compounding our cancer burden. The MHCCN is clearly organized around patient, health provider, and healthcare system multi-tiered strategies and interventions that are prioritized in the NCORP solicitation and defended in this proposal. Our health system embarked upon a comprehensive oncology strategic planning process in 2014 that in a relatively short period has led to the opportunity to submit our response to this FOA. Consensus was reached on the model of cancer care that we would pursue. The singular goal is to ensure that "the right care, in the right location, as close to home as possible" will be provided. Cancer patients in our state and their families desire access to state-of-the-art patient-centered care. This NCORP application could not come at a more auspicious time for our organization, coinciding with significant growth and substantive multi- million dollar investment in MH Oncology over the past couple years. With this backdrop, the fundamental goal of our application is to commit and contribute to a robust slate of NCORP activities across the lifespan including pediatric, adolescent and young adults, adults, and elderly cancer patients in our communities and rural care settings. We have assembled a highly interactive and interdisciplinary team across our network to participate in and lead this research endeavor. Our central hypothesis is that developing a highly interactive and interdisciplinary approach to cancer care that is at all times patient-centered throughout MH Oncology will have salutary effects on all aspects of our cancer care across the continuum of prevention, screening, diagnosis, treatment, survivorship, end-of-life, and care delivery not only for our patients and their families but for other aspects critical to our mission – including educating the next generation of healthcare providers and expanding our research pursuits especially in rural areas within our care network. We propose 4 aims: To conduct and actively participate in 1) cancer control research, 2) cancer prevention research, and 3) cancer care delivery research studies; and 4) to capitalize upon clinical research opportunities afforded by NCORP and our newly awarded Northern New England Clinical and Translational Research Network grant (1U54 GM115517). We will pursue these aims across the lifespan engaging both children and adults. The MHCNN has every expectation that will we make substantive contributions across the spectrum of the NCORP research portfolio. We will capitalize on our institutional assets, patient resources, and expertise from the vantage point of community and rural settings to add value across the lifespan and provide leadership to the NCORP. We welcome and value the opportunity to join the NCORP network as a new institutional member.