The National Cancer Institute Community Cancer Centers Program (NCCCP) is working to 

bring the latest scientific advances and evidence-based care within easy reach of cancer 

patients in underserved rural, suburban and inner-city locations across the United States. 

Nearly 85 percent of U.S. cancer patients receive treatment in their local communities, 

where cancer care is often fragmented. The NCCCP is addressing ways to offer state-ofthe-art coordinated care and to support a wide range of basic, clinical, and populationbased cancer research. 

The NCCCP network of 30 hospitals spans 22 states, sees 53,000 new cancer patients a 

year, and serves a population of 23 million Americans. Partnerships among the 30 

NCCCP hospitals and with other NCI programs and national cancer research organizations 

have been instrumental in the network’s success. NCCCP sites co-invest at least one 

dollar for every NCI dollar and share best practices to accelerate progress. 

The commitment of funds, engagement by sites, and creation of NCCCP’s strategic 

partnerships have facilitated many of the 

accomplishments described in this report. 

The NCCCP

The network sites are working to achieve 

the program’s goals of:

• Enhancing access to care 

• Improving the quality of care

• Expanding research

This report highlights the progress of the 16 

pilot NCCCP sites and describes the 

increased network activities with 

the addition of 14 new sites in 2010. 

A comprehensive evaluation of the original 

16 pilot sites will be completed by RTI 

International later in 2011.

Reducing Cancer Healthcare Disparities

A major focus of the NCCCP is to reduce healthcare disparities and ensure that patients 

from underserved populations have the same access to quality cancer care and research 

studies provided to cancer patients with similar disease burdens. With 40 percent of total 

funding dedicated to disparities, this is a cross-cutting theme for all sites. Each cancer 

center has identified at least one underserved population from a racial or ethnic minority 

group or from a rural population and improved outreach activities tailored for those 

populations. Initiatives are also underway to reach the uninsured. 

Enhancing Access. Improving Quality. Expanding Research. 

Partnerships Drive Progress

Introduction

Enhancing 

Access

30 Hospitals in 22 States

NCI launched the NCCCP pilot program in 2007 

as a public-private partnership with 16 community 

hospitals. In 2010, NCI expanded the network 

with stimulus funding from the American 

Recovery and Reinvestment Act (ARRA) and 

added 14 sites.
2

In addition, the network sites have:

• Implemented standardized tracking of race and ethnicity data

• Increased community and research partnerships focused on 

 ways to address healthcare inequities for underserved 

 populations 

• Increased community outreach activities and screening events

• Increased patient navigation services to improve the 

 coordination of cancer care, especially for underserved 

 populations 

• Increased the utilization of policies that incorporate 

 cultural considerations related to donation of tissue and 

 other biospecimens

Prioritizing Underserved Accrual to Clinical Trials

The network is working to increase clinical trial accrual rates for 

underserved populations. Sites are using tools to assess barriers to 

clinical trial participation by elderly, rurally-located, racial and ethnic 

minority patients. These groups, typically underrepresented, have 

disproportionately high cancer rates and historically low participation 

in clinical trials. 

The sites’ efforts to improve accrual 

rates include:

• Increasing the engagement of 

 patient navigators who educate 

 patients about clinical trials and serve as 

 liaisons between patients and 

 research teams

• Providing continued cultural awareness 

 training programs, such as educational 

 webinars, for hospital and cancer 

 program staff 

• Sharing best practices among the 

 network sites and using resources from 

 external experts in underserved accrual 

 to promote the expansion of the clinical

 trials infrastructure

• Identifying specific underserved populations in local communities and developing program 

 resources to reach patients from those populations

“We love our wide open spaces and 

the outdoors. That’s why we live here. 

But when you get cancer, the 

distance to your doctor’s door 

becomes a real problem.”

Cancer survivor Daryl Sather 

NCCCP Billings Clinic Cancer Center

Billings, Montana

“When I was first diagnosed, my 

doctor gave me a few choices of 

where I could get treated. One of 

the big cancer centers was just too 

far away. I had a family and work to 

consider. I chose to get treated here 

because the doctors were highly 

recommended and because I wanted 

to be close to home.” 

Cancer survivor Daniel Cheeseman

NCCCP Helen F. Graham Cancer 

Center at Christiana Care

Newark, Delaware

 
3

Promoting Evidence-based Cancer Care

The sites are committed to improving the quality of 

cancer care they deliver by following evidence-based 

practice guidelines developed by national 

cancer organizations. 

Significant accomplishments include:

• The NCCCP network of 30 cancer centers and 

 their affiliated oncology practices have more 

 than doubled their participation in the American 

 Society of Clinical Oncology’s (ASCO) Quality 

 Oncology Practice Initiative (QOPI®) – a program 

 that collects data and reports on measures from 

 evidence-based guidelines, such as conducting 

 pain assessments, providing smoking cessation 

 support, tracking timeliness of chemotherapy 

 administration, and providing psychosocial 

 support. With each collection cycle, the network now selects the two disease-

 specific modules to be monitored. As of fall 2010, 25 NCCCP sites have oncology 

 practices participating in QOPI® and five sites have achieved QOPI® certification 

 through ASCO’s national certification program. 

• The 16 pilot sites continued to participate in the beta-testing of the Commission on 

 Cancer’s (CoC) Rapid Quality Reporting System (RQRS). RQRS allows real-time 

 reporting using existing cancer registry operations to measure concordance with 

 breast and colorectal cancer measures and supports ongoing quality assurance 

 programs. A comparative analysis of NCCCP sites’ performance with non-NCCCP 

 sites is currently underway. 

“The NCCCP’s commitment 

to quality of care will lead to 

fundamental changes in the clinical 

practice of oncology. The NCCCP 

sites and their affiliated oncology 

practices have assumed a 

leadership role to enhance the care 

of cancer patients using a model of 

quality measurement and feedback 

and participating with their fellow 

community cancer centers around 

steps leading to possible Quality 

Oncology Practice Initiative (QOPI®) 

Certification. They are optimizing 

cancer care and, one step at a time, 

making a lasting imprint on the 

quality of care they deliver.”

Terry Gilmore, RN and Pam 

Kadlubek, MPH 

QOPI® & QOPI® Certification 

Program American Society of 

Clinical Oncology

Improving

Quality

Compared to other cancer programs involved in the RQRS initiative, NCCCP sites show higher 

concordance with the quality of care hormone therapy breast cancer measure. NCCCP (n = 16 hospitals), 

Control (n = 45 hospitals)
4

• The pilot sites added 27 new disease-specific multidisciplinary care (MDC) conferences, 

 where oncologists, surgeons, radiologists and support staff meet to discuss individual cases to 

 determine personalized, optimal treatment plans. All NCCCP sites are working to increase 

 prospective case reviews and sites are using a network-developed assessment tool to evaluate 

 and improve their current MDC programs.

• All network sites are promoting the use of evidence-based approaches for the integration of 

 genetic and molecular testing into the model of cancer care in their centers and they are using 

 the NCCCP-Cancer Genetic Counseling Assessment Tool to evaluate their cancer genetic 

 programs, set improvement goals, and exchange information with other NCCCP sites. 

Read more about the sites’ efforts to expand multidisciplinary care in the January/February 2011 issue of 

Oncology Issues. The publication contains the first few articles in the journal’s series about the NCCCP. 

The published articles are available on the NCCCP website [http://ncccp.cancer.gov].

Expanding Cancer Survivorship and Palliative Care Programs

To improve cancer treatment and follow-up care, the NCCCP network is expanding survivorship, 

palliative care and psychosocial programs and services for all cancer patients. Sites are increasing the 

use of patient treatment summaries to facilitate communication among the cancer treatment team, the 

patient, and the patient’s other healthcare providers. In 2007, only 25 percent of the original pilot sites 

had considered use of patient treatment summaries; now, more than 60 percent of the original 16 sites 

generate these forms for patients and providers. The summaries also guide the development of posttreatment survivorship care plans.

The sites developed and utilized psychosocial and palliative care assessment tools to evaluate their 

respective center’s ability to provide quality care in these areas. 

Read more about NCCCP pilot sites’ efforts to develop and deliver treatment summaries to patients and 

their physicians, and post-treatment survivorship care plans in the May/June 2011 issue of Oncology 

Issues. The articles will be available on the NCCCP website [http://ncccp.cancer.gov] after publication. 

Implementing Electronic Health Records

Oncology care most often begins in general practices and surgical domains, moving through diagnostic 

testing, and proceeding to cancer care therapies, such as radiation and chemotherapy administration. 

Cancer care providers must access complete patient records in order to support individualized care. 

Integrated Electronic Health Records (EHRs) are essential to supporting quality cancer care due to the 

longitudinal nature of the cancer continuum. At the completion of the pilot period, the original 16 NCCCP 

sites were able to access patient records through EHRs, yet these EHRs lacked oncology-specific fields 

and workflow support. Leveraging the Clinical Oncology Requirements for EHR documentation created by 

NCCCP sites in collaboration with ASCO and NCI, the expanded NCCCP network is working to improve 

platforms for oncology care.
5

Increasing Patient Participation in 

Clinical Trials

NCCCP sites are supporting cancer research 

by enhancing infrastructures to increase 

patient accrual to clinical trials, with an 

emphasis on the accrual of patients from 

underserved populations. Use of NCCCP’s 

web-based Screening and Accrual Log allows 

the network to identify barriers to clinical trial 

accrual in real time and target interventions 

to overcome those barriers. Other resources, 

including the Minority/Rural Matrix and 

Clinical Trials Best Practice Matrix, enable 

sites to document accrual challenges, 

measure program improvements, and 

collectively focus efforts on strategies to 

expand the clinical trial infrastructure. 

The NCCCP sites’ efforts to increase 

patient accrual to clinical trials include:

• Twelve sites have partnered with 

 NCI-designated Cancer Centers to 

 offer their patients access to Phase I and Phase I/II clinical trials, with 

 additional sites developing the infrastructure and partnerships to do the same.

• The sites have broadened their clinical trials portfolio, increased supportive care/

 cancer control and prevention trials, increased Cooperative Group membership, 

 and increased the number of local physicians accruing patients to clinical trials.

Read more about NCCCP initiatives to increase accrual to clinical trials in the March/April 

2011 issue of Oncology Issues. The published articles are available on the NCCCP website 

[http://ncccp.cancer.gov].

“The NCCCP network has been invaluable 

in our research program to evaluate the 

newly developed patient version of the Patient 

Reported Outcomes Version of the Common 

Terminology Criteria for Adverse Events (PROCTCAE). The five participating NCCCP sites 

in the ongoing PRO-CTCAE national validation study have provided access to patient 

participants in the community with diverse 

backgrounds and performance status levels. 

Enrollment at NCCCP sites has been brisk 

and efficient – over 150 patients in fewer than 

three months. NCCCP sites have been active 

partners during the study, with staff providing 

feedback and responding to our feedback via 

weekly, well-attended conference calls. The 

NCI staff overseeing the NCCCP component 

of this study has also been vital to its success, 

facilitating constant communication between 

sites and investigators and resolving queries 

quickly. It has been a pleasure conducting a 

study in this network, which has provided 

an ideal real-world context for testing the 

PRO-CTCAE.” 

Ethan Basch, MD 

Principal Investigator, PRO-CTCAE Study

Memorial Sloan-Kettering Cancer Center

Expanding

Research

“For several years, we have been partnering with several NCCCP sites, mainly in the areas of conducting 

Phase II clinical trials, and in a major approach to personalized cancer care called ‘Total Cancer Care’ 

(TCC). This latter project involves enrolling patients in a large prospective, observational study which 

includes acquiring biospecimens from patients for molecular profiling and clinical data with the goal of 

‘providing the right treatment for the right patient at the right time.’ Our colleagues at the NCCCP sites 

have proven to be outstanding contributors and have been involved in the design and implementation of 

the TCC study. Participation by our community colleagues is critical to the development and delivery of 

personalized cancer care and evidence-based medicine, and ultimately benefits patients by improving 

access to research and quality care. It is a privilege for Moffitt investigators to be able to partner with our 

colleagues at NCCCP sites.”

William Dalton, MD, PhD

President/Chief Executive Office Moffitt Cancer Center
6

Promoting High-quality Biospecimen Collection

To advance cancer research, NCCCP sites are actively participating in the collection of highquality biospecimens using standardized collection and storage procedures. This is helping to build a 

community-based research platform where patient data and high-quality blood and tissue samples are 

collected to support genomically-informed medicine.

• Eight sites follow NCI Best Practices for Biospecimen Resources for the collection 

 and storage of high-quality biospecimens. 

• Eight sites participate in biospecimen research programs: five sites are affiliated 

 with Moffitt Cancer Center’s Total Cancer Care program and three sites work with 

 The Cancer Genome Atlas, a collaboration of NCI and the National Human Genome 

 Research Institute. 

Expanding Community-based Bioinformatics Infrastructure

NCCCP sites are working with and participating in caBIG® – NCI’s nationally networked research 

information technology platform – to leverage standards-based best practices and provide insight into 

the nuances of community-based informatics programs while helping to build documentation more 

suited to the community segment. The 30 sites have gained access to a network of oncology informatics 

expertise to solve both common and unique technology issues, while also receiving guided access to the 

tools through caBIG® and other program solutions. The sites continue to work on a number of efforts to 

implement informatics tools to support improved cancer care in the community and to facilitate data 

sharing activities in support of research efforts.

A few of these include:

• Participation in a collaborative project to network with and exchange technology 

 and informatics best practices with the NCI-designated Cancer Centers through 

 the NCI caBIG® Deployment Program 

• Collaboration with NCI’s Cancer Imaging Program and the Center 

 for Biomedical Informatics and Information Technology (CBIIT) to demonstrate 

 electronic data submission for clinical trial imaging data through annotated image 

 exchange using the National Biomedical Imaging Archive

• Initiation of a project with NCI’s CBIIT to define community-based oncology 

 outcomes data elements to support data warehousing and outcomes data analysis 

 capabilities; NCCCP sites are working to create data warehouses, build longitudinal 

 patient records, and develop strategies to engage private practice oncology 

 providers in data sharing. 
7

NCCCP: Partnerships Drive Progress

The NCCCP network provides a platform for collaboration with a number of national cancer 

organizations to enhance the goals of the organizations as well as the NCCCP. 

An overview of program partnerships includes:

• American College of Surgeons - Commission on Cancer – NCCCP sites 

 participated as beta sites in the RQRS initiative to show how being part 

 of a network can accelerate progress in improving adherence to evidence-

 based guidelines. 

• American Society of Clinical Oncology – The NCCCP has developed 

 partnerships for a quality initiative (QOPI®) and for a collaboration on a white paper 

 on oncology-specific EHR requirements.

• Linkages with NCI–designated Cancer Centers – NCCCP sites have increased 

 the number of relationships with NCI-designated Cancer Centers (including 

 Cooperative Group programs). These linkages support NCCCP’s overall goal to 

 bring higher quality, state-of-the-art cancer care to patients in their communities. 

 Activities include: early drug development programs, clinical trials affiliations, and 

 communications, disparities, and biospecimen initiatives. 

• NCI Center to Reduce Cancer Health Disparities (CRCHD) Community 

 Networks Program (CNP) – NCCCP sites have relationships with nine CNP 

 organizations that conduct research projects to address healthcare disparities in 

 specific underserved populations. 

NCCCP: Expanding Research Through Federal Stimulus Funding

In addition to supporting the 2010 expansion of the NCCCP program from 16 to 30 cancer 

centers, government stimulus funds have been used to retain 42 staff positions at NCCCP 

sites and create 206 full-time equivalent positions at the 30 participating sites. 

ARRA funds have also been used to develop several research programs at network 

sites to:

• Create additional partnerships with NCI’s CRCHD-CNP to increase cancer 

 screening events in racial/ethnic minorities and other underserved populations

• Improve the coordination of care for underserved populations across the cancer 

 care continuum 

• Participate with five NCI-designated Cancer Centers in the preliminary validation of 

 the Patient Reported Outcomes – Common Terminology Criteria for Adverse Events 

 measurement tool 

• Improve the navigation of patients during the transition from cancer care 

 to survivorship

• Expand access to evidence-based smoking cessation programs for cancer 

 survivors and their family members 

• Conduct a study on the impact of multidisciplinary care on processes and 

 outcomes of cancer care

• Facilitate access to early phase trials through collaborations with the NCI Early 

 Drug Development Program

• Engage community physicians in minority communities to enhance clinical 

 trial accrual

• Research breast cancer bio-marker practice changes

• Identify strategies to enhance clinical trial participation among Native Americans 

• Partner with state cancer coalitions to implement mutual objectives in state 

 cancer plans 

Connecting

Collaborating

Contributing
8

Communications and Patient Advocacy: Connecting Patients With Care

Cancer treatment advances are limited if they are out of reach – or if patients don’t know they are available. 

Each NCCCP site is working to enhance community awareness of cancer-related issues and the role of the 

NCCCP in their communities. 

Communication efforts include:

• Supporting initiatives to increase cancer screening and early detection with a focus on 

 underserved populations

• Developing lay language educational materials and programs to promote increased accrual to 

 cancer clinical trials

• Educating local oncologists about the NCCCP to increase participation in MDC conferences, 

 clinical trials, and other program components

An integral part of the NCCCP has been its linkage to local advocacy groups through representation 

by members of the NCI Director’s Consumer Liaison Group (DCLG) on the NCCCP Program Advisory 

Committee. Resources developed by the DCLG, such as materials to promote biospecimen donation, are 

made available to the network sites. This advocacy association ensures the perspective of cancer patients 

is considered in all aspects of the NCCCP. The connections with the patient and community perspective 

continue to provide ongoing direction to the NCCCP program to support its central purpose of improving 

patient outcomes and research opportunities for patients in diverse communities across the United States. 

Promoting NCCCP Contributions to Community-based Cancer Initiatives

The NCCCP is working to develop resources and tools that are applicable to a broad range of communitybased cancer programs. During the past year, NCCCP representatives have published papers in various 

journals, posted resources on the NCCCP website, and made presentations at several national meetings, 

including: American Society of Clinical Oncology (June 2010 and June 2011), Center for Medical 

Technology Policy (November 2010), NCI-designated Cancer Centers Directors’ Retreat (February 2011), 

Association of Community Cancer Centers (March 2011), NCI Institute of Medicine National Cancer 

Clinical Trials System Workshop (March 2011), American College of Healthcare Executives (March 2011), 

and Cancer Center Administrators Forum (April 2011).

This report reflects the work and contributions of hundreds of individuals at the NCCCP sites, 

the NCI, ASCO, the Commission on Cancer, and several NCI-designated Cancer Centers. The NCCCP 

demonstrates that partnerships can drive progress toward the goals of improving the quality of cancer care 

and accelerating cancer research to improve outcomes for patients across the United States.

NIH Publication No. 11-7773

Printed April 2011