California's CCCP Ovarian Cancer Additional Program Proposal

Project Abstract

Ovarian cancer is the fifth most common cancer among California women and causes more deaths than any other gynecologic cancer. In 2003, California had 658 more cases (2,252 cases) of ovarian cancer diagnosed in its population than the state with the second highest number of cases, New York (1,594 cases).

Non-Hispanic white women are at the greatest risk for this cancer and Asian/Pacific Islander (API) women have the lowest risk. However, it is the fourth most common cancer in South Asian women and fifth most common in Chinese women in California.

According to national SEER data, the stage distribution indicates that 19% of ovary cancers are diagnosed while the cancer is still confined to the primary site whereas 68% are diagnosed after the cancer has already metastasized. In 1998, the economic burden of gynecologic cancers in California indicated that ovarian cancer was the most costly at an estimated $292 million, then cervical cancer at $206 million and uterine cancer at $126 million.

The California Department of Health Services’ (CDHS) Comprehensive Cancer Control Program (CCCP), in collaboration with the California Dialogue on Cancer (CDOC), requests $160,933 to develop and implement an ovarian cancer awareness program (COCAP) in California targeting women 50 years or older. The goals of the program are to promote early symptom recognition by both healthcare providers and patients, educate healthcare providers about current diagnostic recommendations for at-risk women, and disseminate ovarian cancer treatment recommendations and clinical trials information to foster wider participation by women diagnosed with ovarian cancer.

These goals should foster earlier stage of diagnosis, more rapid and accurate diagnostic procedures and development of better treatment paradigms for long term reductions in mortality from ovarian cancer. Given the evidence-based studies on presentation of early symptoms in ovarian cancer and lack of recognition of the non-gynecologic manifestations of both early and late stage disease in women 50 plus years of age, by both health care providers and patients, we will focus our efforts here.

In year one, we plan the following: 1) develop the infrastructure for COCAP, including hiring the program manager; 2) form the Core Planning Group (CPG) with DHS, American Cancer Society- California Division (ACS-CA), UC Davis Medical Center-Dept of Obstetrics & Gynecology (UCDMC-OB-Gyn), National Ovarian Cancer Coalition-Sacramento Division (NOCC-Sac) and Gilda’s Club; 3) establish the COCAP web site with the stakeholder recruitment module; 4) develop the provider training/CME module in collaboration with our CPG; and 5) launch the first regional training module in the Sacramento region in cooperation with UCDMC and NOCC-Sac; and 6) release four competitive community-based (CBO) awards to aid them in training their clinical staff in current standards of care for ovarian cancer.

During years 2-5, we plan: 1) to offer 2 regional provider trainings/CME per year; 2) develop and disseminate patient education materials throughout the state, via print and video media, special events, and the nationally recognized UCDMC telemedicine network, according to guidelines established by Community Preventive Services; 3) continue with funding 4 new CBO-provider proposals per year using the COCAP module; 4) network with AANCART (Dr. Moon Chen) to  target API groups disproportionately impacted by ovarian cancer; and 5) work with CDOC Teams to assess potential changes to ovarian cancer incidence rates and mortality.