Research Accomplishment Reports 2007

TEAM Up

D. Murray, C. Stamper
HEEL

 

Project Description

The Commonwealth of Kentucky was invited in 2003 to participate in Team UP, a national cancer control pilot program also being implemented in five other states. The program was conceived at the national level by four agencies: the National Cancer Institute (NCI), the American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), and the United States Department of Agriculture (USDA). Based on data from the Kentucky Cancer Registry, nine counties with higher rates for breast and cervical cancer mortality were chosen by a state team (including the U.K. Health Education through Extension Leadership program) to participate in the program. The selected counties were Powell, Wolfe, Breathitt, Magoffin, Floyd, Johnson, Martin, Elliott, and Lawrence. Control counties (Bell, Clay, Harlan, Jackson, Knox, Lesley, Letcher, McCreary, and Whitley) were selected for comparison measurements based on similar mortality rates and demographic and socio-economic similarities to the Team UP counties.

The Kentucky Team UP state team (state agencies, HEEL, Regional Extension Programs, and community partners (extension agents, health department staff, and others) reviewed research tested interventions and selected an intervention modeled after a North Carolina study, the Forsyth County Research Tested Intervention Project, and included clinic-based/provider interventions, community education/outreach interventions, and the use of mass media to promote cervical and breast cancer screening.

Impact

Current Kentucky Cancer Registry data is demonstrating that Team UP counties, in comparison to the control counties, show an incremental increase in the percentage of breast and cervical cancer cases detected in earlier stages. Team Up appears to illustrate the positive impact that can be made in high cancer mortality counties when evidence-based interventions and collaboration between key stakeholders is encouraged and evidence-based interventions are applied. More time is needed, however, to see if this positive trend will continue or intensify as the community education efforts and mass media has increased over time.

Team UP was clearly able to incur positive changes at the local level among the selected counties by increasing the screening rates for breast and cervical cancer among rarely or never screened women. Current data is showing that the Team UP counties, in comparison to the control counties, is demonstrating an incremental increase in the number of women screened and in the percentage of breast and cervical cancer cases detected in early stages. The majority of Team UP counties have increased their breast cancer screening rates for the Medicare population in 2005 in six of the nine counties. Team UP counties are screening on average, 4.77% more rarely or never screened women for cervical cancer than are the control counties as reported by the KY Women’s Cancer Screening Program. Team UP counties are detecting more cases of cervical cancer at early stages than are the control counties although cases are too small for valid statistical comparison.