Eligible community practices that participate in NCTN clinical trials have been supported with 3-year grants, but NCORP recently proposed extending those grants to 5 years in recognition of the difficulty the sites had in activating the initial grants and the challenge of preparing for another competitive renewal after only 3 years, said McCaskill-Stevens.

NCORP instituted a number of changes aimed at boosting patient accruals from community practices. In addition to transitioning to the use of the new, 24/7, Web-based oncology patient enrollment information technology of the NCTN, NCORP is developing a single portal of entry for institutions rostering with the NCTN that should improve the efficiency of the current system, which requires rostering with multiple networks. There are also ongoing discussions about how investigators can use the NCI’s Central IRB for primary review of cancer control and prevention studies run by NCORP.

NCORP has also been promoting the participation of underserved populations and incorporating disparities research questions into clinical trials and cancer care delivery research. Grubbs noted the diversity of different underserved communities, from rural populations and Native Americans to African Americans and Hispanics. “Every community has a different underserved community to deal with. There’s not one program that can encompass them all, and plenty of opportunities,” he said. But there is a lack of research on how best to enhance research participation and improve health care for underserved communities. Grubbs said he supports cancer care delivery research, but is concerned about inadequate infrastructure and resources to do such research in the community setting. Centralized databases, such as those of the Centers for Medicare & Medicaid Services and state databases for Medicaid claims, might aid in such research, he suggested.

Robin Zon, principal investigator of the Northern Indiana Cancer Research Consortium CCOP and vice president at Michiana Hematology-Oncology, PC, said that some physicians in competitive practices may not be willing to share their data unless they are de-identified and confidential. These physicians are already so time-crunched that “we don’t want to stress them by asking for more data or other information about their health care practices,” Zon said. She noted that clinical research in community practices is optional, so burdening physicians with these requests may lead them to opt out of participating in it. “We need to make things easy for them,” she concluded.

Grubbs noted that in order to take advantage of the improved IT com-

The National Academies of Sciences, Engineering, and Medicine
500 Fifth St. N.W. | Washington, D.C. 20001

Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement