Currently Funded Projects:
Connect for Cancer Prevention Study
Cancer is the second leading cause of death in the United States and has substantial negative impact on human health and well-being. Yet much remains to be learned regarding the factors that influence a person's risk of developing or dying from cancer. Marshfield Clinic Research Institute (MCRI) and two other midwestern US health care systems, HealthPartners (Minneapolis) and Henry Ford Health System (Detroit), have been funded collectively by the U.S. National Cancer Institute to conduct a large cancer prevention cohort study in US adults age 30-70. At these 3 sites and 7 other integrated health systems across the U.S., 200,000+ participants will be enrolled and followed over a decade or more to generate new knowledge on cancer causes and strategies to improve survival and quality of life. The MCRI research team developed and refined study recruitment and follow-up procedures during planning/preparation/pilot phases and is launching full-scale recruitment and biospecimen collection at eight MCHS centers in order to recruit ~12,000 participants by fall 2027.
Funding Source: National Cancer Institute
Consortium PI: Ben Rybicki, PhD, Henry Ford Health System
Site PI: Robert Greenlee, PhD, MPH
More Information: https://marshfieldresearch.org/connect
Central Data Collection Center (CDCC) - Continued Follow-up of PLCO (Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial) Participants
This project involves ongoing follow-up of a randomized cancer screening trial of nearly 30 years duration involving 74,000 females and 74,000 males aged 55-74 at entry at 10 sites around the country. Individuals in the control group received usual medical care. Individuals in the group randomized to screening received screening examinations for lung, and colorectal cancers and, depending on sex, either prostate or ovarian cancer. The screening trial was designed to determine whether: 1) screening with flexible sigmoidoscopy can reduce mortality from colorectal cancer; 2) screening with chest x-ray can reduce mortality from lung cancer; 3) screening men with digital rectal examination plus serum prostate-specific antigen can reduce mortality from prostate cancer; and, 4) screening women with CA 125 and transvaginal ultrasound can reduce mortality from ovarian cancer. Secondary objectives included: 1) to assess screening variables other than mortality for each of the interventions including sensitivity, specificity, and positive predictive values. 2) To assess incidence, stage, and survival experience of cancer cases. 3) To investigate the mortality predictive value of biologic and/or prognostic characterizations of tumor tissue as intermediate endpoints. To view publications and results, click here.
Funding Source: Westat/National Cancer Institute
PI: Robert Greenlee, PhD, MPH
Center for Research to Optimize Precision Lung Cancer Screening in Diverse Populations (PROSPR II)
The long-term goal of this multi-site center grant, which created the Lung Cancer Screening Optimization in the US (LOTUS) consortium, is to identify critical gaps in the lung cancer screening process and to design innovative, multi-level interventions to reduce lung cancer mortality, with additional attention to underserved populations. Please click on the links below to view publications that have come from this study:
Funding Source: Kaiser Permanente Colorado/National Cancer Institute
PI: Deb Ritzwoller, Kaiser Permanente Colorado
Site PI: Robert Greenlee, PhD, MPH
Molecular Profiling of Ductal Carcinoma in Situ (DCIS) and Risk of Subsequent Invasive Breast
The goal of this multi-site study is to identify tumor markers for risk of progression from having DCIS to developing subsequent invasive breast cancer. This work follows extensive collaborative pilot work with Einstein College of Medicine and several other sites in the Cancer Research Network. Please click on the links below to view publications that have come from this study:
Funding Source: Moore Foundation
PI: Kate Rendle, University of Pennsylvania
Site PI/Co-Investigator: Robert Greenlee, PhD, MPH
Identifying colorectal cancer screening strategies in rural communities
The goal is to understand and characterize factors that distinguish high performing rural health clinics and identify successful CRC screening practices.
Funding Source: American Cancer Society
PI: Jennifer Weiss, University of Wisconsin
Site PI/Co-Investigator: Robert Greenlee, PhD, MPH
Comparative-Effectiveness of Pretreatment Lung Cancer Nodal Staging
Our overall goal is to improve patient selection for pretreatment nodal biopsy in order to reduce diagnostic and treatment errors, improve long-term survival rates, and increase the value of care. The project takes place at Marshfield Clinic, Kaiser Permanente Northern California, and the University of Washington.
Funding Source: National Cancer Institute
PI: Farhood Farjah, University of Washington
Site PI/Co-Investigator: Robert Greenlee, PhD, MPH
Recently Completed Projects:
Comparison of successful colorectal cancer screening strategies in Wisconsin rural and urban settings: Achieving 80% in every community
Colorectal cancer (CRC), the second leading cause of Wisconsin (WI) cancer deaths, is the most preventable, yet least prevented cancer due to low uptake of CRC screening. One in four eligible WI adults are unscreened. There is wide variation in CRC screening among WI primary care clinics (31-90%) with screening rates at top rural clinics 5% lower than urban clinics. To achieve the National Colorectal Cancer Roundtable goal of 80% screened in every community, WI must address gaps in rural, low-income, and racial minority communities. The overall objective of this proposal was to characterize the multi-level (patient, provider, clinic, system) factors that distinguish high-performing rural and urban clinics and identify successful screening strategies across geographic regions and for subpopulations with historically low screening (Medicaid/uninsured, racial minorities).
Funding Source: University of Wisconsin/Wisconsin Partnership Program
PI: Jennifer Weiss, University of Wisconsin
Co-PI: Robert Greenlee, PhD, MPH
RIC: Risk of Pediatric and Adolescent Cancer Associated with Medical Imaging
The Radiation Induced Cancer (RIC) evaluated patterns of medical imaging in pregnancy and pediatric patients, cumulative exposure to radiation, and subsequent risk of childhood cancer with a retrospective, nested case-control study of patients enrolled in 8 integrated health care systems. Click on link to view each publication that came from the study.
Funding Source: University of California - San Francisco/National Cancer Institute
PI: Rebecca Smith-Bindman, UCSF
Site PI/Co-Investigator: Robert Greenlee, PhD, MPH
The Effectiveness, Safety, and Costs of Guideline-Concordant Lung Nodule Care
The aims of this 2-site observational study in the Cancer Research Network were to evaluate individuals who receive varying intensities of diagnostic evaluation for an incidentally detected lung nodule and compare rates of early stage lung cancer, harms, and costs of care. Click on link to view each publication that came from the study.
Funding Source: University of Washington/National Cancer Institute
PI: Farhood Farjah, University of Washington
Site PI/Co-Investigator: Robert Greenlee, PhD, MPH
CRN4: Cancer Research Resources and Collaboration in Integrated Health Care Systems
The Cancer Research Network (CRN) is a consortium of research organizations within several non-profit health care delivery systems. The uniqueness of CRN as a cancer research resource stems from: (1) the integrated access to clinical data for large, stable, and diverse patient populations that are available through the "parent" HMOs; and (2) the expertise of CRN researchers in conducting clinical cancer research involving large sets of clinical data. Through this, NCI intends to promote further technical and methodological enhancements of CRN informatics infrastructure as well as efforts to facilitate access of non-CRN-affiliated investigators to CRN data and expertise. The goal was to increase the number and scope of research projects that are based on CRN data and the participation of CRN investigators on such projects. In addition to collaborations on projects funded outside of CRN, CRN directly supports pilot projects that may be initiated either by non-CRN-affiliated investigators or by CRN investigators. Click on link to view each publication that came from the study.
Funding Source: Kaiser Foundation Research Institute/National Cancer Institute
PI: Larry Kushi, KPNC
Site PI: Robert Greenlee, PhD, MPH
