Virginia Cancer Screening Research Network Access Hub (Virginia CSRN Hub)

New cancer screening technologies with great promise for reducing cancer death are emerging. These technologies require large-scale, controlled clinical trials to evaluate their effectiveness and assess the feasibility of adopting and implementing them into routine practice if effective. Furthermore, the National Academy of Medicine and US Preventive Services Task Force have identified dozens of evidence gaps in current cancer screening approaches that will need similar large scale randomized controlled trials and longitudinal studies.1-3 To address this, the National Cancer Institute (NCI) is creating a Cancer Screening Research Network (CSRN) with a network of Accrual, Enrollment, and Screening Site (ACCESS) Hubs capable of conducting clinical trials and longitudinal studies, a central Statistics and Data Management Center, and a central Coordinating and Communication Center. We propose to create the Virginia CSRN ACCESS Hub from long-standing, inter-institutional partnerships to assist in this important national effort. These partnerships include 1) three health systems – Virginia Commonwealth University (VCU) Health, Inova Health System, and Sentara Healthcare; 2) two medical schools – VCU and the Eastern Virginia Medical School; 3) two cancer centers – the Massey Comprehensive Cancer Center at VCU, an NCI-designated comprehensive cancer center, and the Inova Health’s Schar Cancer Institute which includes a recently launched Saville Cancer Screening and Prevention Center; 4) the NIH-funded Wright Regional Center for Clinical and Translational Science; and 5) a state-wide, primary care practice-based research network (Virginia Ambulatory Care Outcomes Research Network – ACORN). These entities have an established track record of working together for decades; collectively care for a sizable proportion of state residents including the largest safety net health system providing both urban and rural services to a majority of Virginia’s communities; demonstrated expertise in recruiting and retaining marginalized and underserved patients and communities in trials; and national expertise in cancer prevention, informatics, community engagement, and dissemination and implementation science. The Virginia CSRN ACCESS Hub will initially recruit and retain at least 1,600 participants in the NCI-coordinated, three-arm randomized controlled Vanguard study to test two novel multicancer detection (MCD) tests compared to usual cancer screening care. We will measure success by equitable and inclusive recruitment, timeliness and adherence to the diagnostic workup and treatment protocols, and participation in all national CSRN efforts. Additionally, we will conduct a novel, mixed methods analysis of our work using a consolidated framework for implementation research constructures to demonstrate our hub’s feasibility and sustainability for future CSRN trials and to assess factors necessary for widespread adoption of MCD tests, if proven effective. Our hub will meaningfully contribute to the Vanguard study and will bring unique partnerships, an equity lens, and dissemination and implementation expertise to the broader CSRN effort.