Combating Cancer Through Public Health Practice in the United States: An In-Depth Look at the National Comprehensive Cancer Control Program

Cancer is the second leading cause of the death in the United States (U.S.). The National Comprehensive Cancer Control Program (NCCCP) is a national, public health practice program funded by the U.S. Centers for Disease Control and Prevention. The NCCCP has been planning and implementing interventions to reduce the burden of cancer since 1998. Interventions are implemented across three areas primary prevention, early detection, and survivorship using health systems and environmental changes to promote sustainable cancer control. The aim of this chapter is to provide a summary of the NCCCP, and highlight specific examples of interventions and successes to aid cancer planning in other countries. Cancer plan analyses show that all NCCCP participant cancer plans address reducing tobacco use for cancer prevention and 98% contain activities to increase colorectal cancer screening. The vast majority implement activities to improve the quality of life following a cancer diagnosis (94%). Relatively fewer cancer plans contain activities to reduce radon exposure (42%), promote human papilloma virus vaccination (62%), and incorporate the use of genomics in cancer control (56%). The examples of NCCCP activities demonstrate success in controlling cancer and other non-communicable diseases through public health practice

Preventing Chronic Disease

ESSAY Suggested citation for this article: Abstract Colorectal cancer is the second leading cause of cancerrelated mortality among U.S. adults. In 2004, treatment costs for colorectal cancer were $8.4 billion. There is substantial evidence that colorectal cancer incidence and mortality are reduced with regular screening. The natural history of this disease is also well described: most colorectal cancers develop slowly from preexisting polyps. This slow development provides an opportunity to intervene with screening tests, which can either prevent colorectal cancer through the removal of polyps or detect it at an early stage. However, much less is known about how best to implement an effective colorectal cancer screening program. Screening rates are low, and uninsured persons, low-income persons, and persons who have not visited a physician within a year are least likely to be screened. This article describes briefly this demonstration program and the process CDC used to design it and to select program sites. The multiple-methods evaluation now under way to assess the program's feasibility and describe key outcomes is also detailed. Evaluation results will be used to inform future activities related to organized screening for colorectal cancer