Theme 1: Reduce tobacco use in vulnerable populations and provide evidence to guide tobacco policy. 

Theme 2: Develop and evaluate cancer screening strategies that maximize benefits while minimizing harms.

Theme 3: Develop interventions to improve the health and quality of life of cancer survivors and their caregivers.

A cross-cutting area of focus is rural cancer control, as 75% of residents in our catchment area live in rural areas. Rural residents have higher risk for cancer incidence and mortality due to socio-demographic factors more common in rural areas, such as older age, lower Socio Economic Status (SES), and limited health literacy. Geographical distance can also limit access to cancer screening, diagnosis, and treatment services. Efforts to deliver high-quality cancer prevention, detection, treatment, and survivorship care in rural settings face specific challenges, including the geographic distance to medical facilities and shortages of primary care and specialist providers. Our program members focus on addressing key challenges in rural populations, seeking to better characterize the socio-demographic factors that place rural residents at higher risk, assessing the availability and quality of cancer care, and developing novel healthcare delivery approaches, including remote interventions for health promotion that can inform care in both rural and urban settings.

Program members lead observational studies of real-world tobacco use patterns and conduct intervention studies of innovative tobacco cessation approaches. Lung cancer is the leading cause of cancer mortality in our catchment area and smoking remains elevated, as in many rural areas. Our members generate evidence used by regulatory bodies, public health organizations, and healthcare providers to reduce tobacco use. 

Program members identify effective approaches for delivering high quality cancer screening, with a particular focus on the evaluation of new technologies in clinical practice and risk-based screening strategies that seek to maximize the benefits of early detection while minimizing harms such as false positive tests. Our members have particular impact in informing national breast cancer screening recommendations, but our multi-center breast imaging registry ensures that our work has particular relevance to our catchment area.

Program members identify key behaviors associated with health promotion, symptom management, and well-being at all stages of the cancer care continuum and implement interventions at the individual, dyadic, institutional, community, or policy level. Particular attention is paid to adapting these interventions—including exercise and caregiver support--to those living in rural areas and innovating virtual delivery approaches to improve and extend care.