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

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 multimillion 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.