RESOURCE GUIDE FOR NORTH CAROLINA CANCER REGISTRARS - 2021 h ps://unclineberger.orgrapid case ascertainment/ - UNC ...
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a collabora on between the Central Cancer Registry and UNC Lineberger Comprehensive Cancer Center RESOURCE GUIDE FOR NORTH CAROLINA CANCER REGISTRARS 2021 h ps://unclineberger.org/rapid‐case‐ascertainment/
NC CENTRAL CANCER REGISTRY UNC LINEBERGER CANCER CENTER ClarLynda Williams‐DeVane, PhD Andrew F. Olshan, PhD Director RCA Faculty Director State Center for Health Sta s cs Barbara S. Hulka Dis nguished Professor Email: ClarLynda.Williams‐DeVane@dhhs.nc.gov Dept. of Epidemiology, UNC Office: 919‐792‐5741 Email: andy_olshan@unc.edu Office: 919‐966‐7424 Chandrika Rao, PhD Heather Tipaldos, MS, CRA Director RCA Facility Director NC Central Cancer Registry UNCCH Lineberger Comp. Cancer Ctr. ‐ North Email: Chandrika.Rao@dhhs.nc.gov Email: heather_ paldos@unc.edu Office: 919‐792‐5946 Office: 919‐966‐9438 RAPID CASE ASCERTAINMENT State Center for Health Sta s cs Rapid Case Ascertainment 222 N. Dawson Street 1908 Mail Service Center Raleigh, NC 27699‐1908 JoElla Mar ng, BSN, RN, MIS, CTR, RCA Coordinator Email: joella.mar ng@dhhs.nc.gov Office: 919‐792‐5925 Fax: 919‐792‐5927 Induma Tirupatur, MA, M.Phil, Data Assistant Email: induma . rupatur@dhhs.nc.gov Office: 919‐792‐5924 Fax: 919‐792‐5927 2
TABLE OF CONTENTS Rapid Case Ascertainment (RCA) Page No. NC Cancer Registry / UNC Team 2 RCA Team 2 RCA Core 4 (who we are, what we do, why par cipate in RCA) RCA Research Process 5 Data Needed for RCA Submissions 5 NC Statute, Rule, Research Publica ons 6 Ac ve Research Studies Carolina Mammography Registry 8 Medullary Thyroid Study 9 Head & Neck Cancer Study 10 Liver Cancer Study (on hold) 11 Endometrial Cancer Study 12 Closed Research Studies Lung Study 14 Prostate Study 15 RCA Studies 1993—Present Historical Timeline 16 3
Rapid Case Ascertainment Who we are… Rapid Case Ascertainment (RCA) is a Shared Resource at UNC Lineberger Comprehensive Cancer Center, under the leadership of Faculty Director Andrew Olshan, PhD. RCA facilitates cancer preven on and control research that requires early contact with pa ents. The RCA program is a collabora on between UNC Lineberger Comprehensive Cancer Center, the North Carolina Central Cancer Registry (CCR) & par cipa ng hospitals in North Carolina. It has been in opera on since 1993. The CCR and its ability to provide the RCA system has made North Carolina a na onal leader in popula on‐based cancer research. We are among the few in the na on to provide RCA. Without this program, research involving mely pa ent contact would not be possible, and peer reviewers/funding agencies may not fund the studies. Our Primary Funding comes from the Na onal Cancer Ins tute Cancer Center Support Grant to the Lineberger Comprehensive Cancer Center. What we do…. Rapid Case Ascertainment (RCA) supports popula on‐based Epidemiologic, behavioral, clinical, health services and other cancer research. RCA facilitates research to advance knowledge of causes, treatment and preven on of cancer. The program is an invaluable resource that is making con nued research possible in North Carolina and other states. RCA provides support to studies by leveraging the north Carolina Central Cancer Registry and local hospitals for rapid ascertainment of cases and iden fying poten al cases. This allows for researchers to contact pa ents in a mely manner for interviewing purposes and for biologic specimen collec on. Why par cipate in RCA…. CONTRIBUTING TO RESEARCH – Registrars who par cipate in RCA are contribu ng to important cancer research studies. Their hard work is reflected in the research being done to help find causes & cures for cancer. COMPENSATION – Hospitals are compensated for each eligible pathology report submi ed. It is recommended that this money be used for educa onal purposes, supplies, etc. Current rate is $15 per eligible pathology report. REPORTING – Registrars receive annual enrollment reports from all studies u lizing RCA, including number of cases reported and enrolled from each facility. Reports to their hospital’s cancer commi ee demonstrate a registrar’s ac ve par cipa on and coopera on with the CCR. The inclusion of enrolled cases in annual reports may support a hospital’s accredita on. 4
RCA Research Process Researchers contact Heather Tipaldos, RCA Facility Director, to discuss their upcoming project or grant. Every project must receive IRB, CCR and the NC Advisory Commi ee on Cancer Coordina on and Control (ACCCC) approvals. These approvals ensure that the informa on released to studies will be protected and that the results will benefit the public. Upon receiving all approvals, the RCA Coordinator contacts hospital cancer registrars or cancer data professionals to formally request data for newly diagnosed cancer pa ents that meet the study’s eligibility criteria. Pathology reports and demographic informa on: Registrars and HIM professionals from par cipa ng hospitals provide pathology reports and demographic informa on of poten ally eligible pa ents within one to six months of diagnosis. Pathology reports may be sent from hospitals to RCA as quickly as within 30 days of diagnosis; however, RCA will not release the pa ent informa on to the study un l the diagnos c procedure is at least 15 days old. RCA enters eligible pa ents’ data in it’s MS ACCESS database which is then uploaded to a secure MS Study Team weekly. Studies may receive data via .csv file (Excel spreadsheet) &/or ACCESS database file. The studies are required to no fy physicians and obtain their permission to contact eligible pa ents. If no physician contact is made by the study, they must wait 3 weeks (i.e. passive physician consent) before a emp ng pa ent enrollment. Invita on le ers are mailed out to eligible pa ents by studies explaining their purpose and to seek their informed consent. The NC CCR's annual brochure is included in the invita onal informa on package outlining CCR's role in cancer research and preven on. The pa ents are assured of confiden ality and also that their par cipa on is voluntary. The studies administer their protocol of in‐home/telephone interviews and specimen collec on etc. Studies may explore risk factors and/or possible causes of cancer, including diet, medica on use, family history as well as knowledge, a tudes, beliefs, and prac ces about screening and treatment. Some studies compare data between cases and controls. Some studies may choose not to enroll pa ents, but to collect data only from the path report & pa ent demographics. No studies offer treatments. Please note: Submissions to RCA do not subs tute for regular case repor ng to the Central Cancer Registry. Data Needed for RCA Submissions I. The pathology report for the cancer being studied: Path report # (ex: S19‐012345); date collected; authorizing provider; ordering loca on; pathologist; final diagnosis; comments; clinical history; gross descrip on; microscopic descrip on. II. EMR face‐sheet/demographic data: Pa ent’s complete Name; MRN; DOB; gender; current address; race; marital status; phone #s; SSN (op onal); Email (op onal). 5
RCA functions under the guidelines set by North Carolina statute and administra ve rule as men oned below: NC General Assembly Statute Article 7 Chronic Disease Part 1. Cancer Section 130A‐208 through 130A‐215, that established the Central Cancer Registry, requires all health care facilities and health care providers that detect, diagnose, or treat cancer or benign brain or central nervous system tumors to submit by electronic transmission a report to the central cancer registry each diagnosis of cancer or benign brain or central nervous system tumors in any person who is screened, diagnosed, or treated by the facility or provider, within six months of diagnosis. The law requires the Central Cancer Registry to compile, tabulate and preserve statistical, clinical and other reports and records relating to the incidence, treatment and cure of cancer to support Public Health. NC Administrative Rule 10A NCAC 47B.0106 authorizes the Central Cancer Registry to release data for medical research or education. The RCA unit within the CCR supports population‐based cancer research and with appropriate approvals, facilitates quick identification of cancer patients for epidemiological studies. Of note ... RCA has helped enroll more than 20,000 cancer pa ents in research studies. Since 1993, RCA has iden fied and reviewed over 315,000 path reports for 30 studies spanning 15 cancer sites. Most pa ents are pleased to take part in research studies about their cancer. Hospitals and registrars in all 100 N.C. coun es are par cipa ng. Currently, these studies are u lizing RCA for the following cancer sites: Head & Neck, Thyroid, Breast, and Endometrial. Research Publica ons and RCA RCA is a significant resource for researchers to gather data that leads to crea on and publica on of scholarly ar cles. RCA requests that it be informed of the publica on of any scholarly document(s) using data gener‐ ated from an RCA Study and that the following acknowledgment be placed in every publica on: This research recruited par cipants &/or obtained data with the assistance of Rapid Case Ascertainment, a collabora on between the North Carolina Central Cancer Registry and the Lineberger Comprehensive Cancer Center at the University of North Carolina at Chapel Hill. RCA is supported by a grant from the Na onal Cancer Ins tute of the Na onal Ins tutes of Health (P30CA016086). 6
ACTIVE STUDIES 7
Carolina Mammography Registry (CMR) cmr.unc.edu Cancer being studied: Breast (malignant and benign) Purpose of study: To build a mammography registry that can be linked to a breast pathology database to study performance of screening mammography as it is practiced in the community. Study Design: Primary data from mammography facilities on screening mammography and all breast imaging and biopsies are tracked/linked with breast pathology outcomes. This enables the study of pathologic correlation with mammographic assessments, characteristics of the women, recommendations of the radiologists and follow‐up patterns for positive mammograms. Research Ins tu on: Dates of Eligibility for Path Reports: UNC‐Chapel Hill 1993 – 2022 130 Mason Farm Rd Case Eligibility Criteria: All breast pathology Bioinformatics Building #3126 reports (including benign) in 36 counties in North Chapel Hill, NC 27599‐7515 Carolina : Anson, Ber e, Buncombe, Cabarrus, Caldwell, Carteret, Chatham, Chowan, Cleveland, Craven, Edgecombe, Edgefield, Gaston, Guilford, Halifax, Henderson, Her ord, Principal Inves gator: Iredell, Lee, Lincoln, Macon, Mecklenburg, Montgomery, Nash, Louise Henderson, PhD New Hanover, Onslow, Orange, Pinehurst, Pi , Polk, Richmond, Rockingham, Union, Wake, Wayne, Wilson. 919‐843‐7799 louise_henderson@med.unc.edu Females ≥ age 18 years only Some facilities send reports directly to CMR Project Manager: RCA requests reports from hospitals within close Katie Marsh, MPH proximity to a CMR participating site. 919‐966‐2865 Only cases that match with a mammographic katie_marsh@med.unc.edu record in the registry are used. Patients are NOT contacted. CMR is studying the mammographic process, not women in specific terms. What To Submit To RCA: All malignant & benign paths + Facesheet data Females only, ≥ 18 yrs. For Ques ons, Contact: JoElla Mar ng, RCA Coordinator joella.mar ng@dhhs.nc.gov 919‐792‐5925 8
Medullary Thyroid Carcinoma Surveillance Study: A Case‐Series Registry Cancer being studied: Medullary Thyroid Carcinoma Purpose of study: To systema cally monitor the annual incidence of Medullary Thyroid Cancer (MTC) in the U.S. through the NAACCR to iden fy any possible increase related to the introduc on of long‐ac ng GLP‐1 receptor agonist into the U.S. market; to establish a registry of incident cases of MTC in adults in the U.S. in order to characterize their medical histories and possible risk factors, including history of treatment with long‐ac ng GLP‐1 receptor agonists. Study Design: 28 state cancer registries; adult men and women; ICD‐O‐3 histology criteria; 75% of incident cases; 450 new cases per year from par cipa ng state registries. Research Ins tu on: Dates of Eligibility for Path Reports: United BioSource, LLC (UBC) 2010 — 2025 200 Pinecrest Plaza Morgantown, WV 26505‐8065 Case Eligibility Criteria: Ages: ≥ 18 yrs at Dx; Living pa ents Principal Inves gator: Race: All races Amy Miller, RPh, PharmD Diagnosis: First newly diagnosed medullary 844‐475‐8924 thyroid cancer Geographic loca on: Residence within all 100 NC Project Manager: coun es Andrea Davis United BioSource, LLC (UBC) 610‐316‐4471 Andrea.Davis@ubc.com What To Submit To RCA: MTC paths + Facesheet data Pa ents ≥ 18 yrs. For Ques ons, Contact: JoElla Mar ng, RCA Coordinator joella.mar ng@dhhs.nc.gov 919‐792‐5925 9
CHANCE‐2: The Carolina Head and Neck Cancer Study chance2.unc.edu Cancer being studied: Head and Neck (Oropharyngeal) Purpose of study: To understand how the characteris cs of a head and neck cancer pa ent and their tumor influence prognosis, treatment, and outcome. Study Design: Dates of Eligibility for Path Reports: 1,800 newly diagnosed cases. June 2018 ‐ May 2022 Telephone interview at baseline and Study started October 2018 within 2 years post‐baseline. Medical records and stored tumor ssue collec on. Case Eligibility Criteria: Ages: 20 ‐ 80 at Dx; Living pa ents Research Ins tu on: Race: All races UNC‐Chapel Hill Language: English Lineberger Cancer Center ‐ North Diagnosis: First newly‐diagnosed invasive 1700 Mar n Luther King Pkwy Rm. 332 squamous cell carcinoma of head and neck Chapel Hill, NC 27599 Note: Path reports must be submi ed within 6 months of diagnosis Principal Inves gator: Sites/Topography: Oral Cavity, Pharynx, Larynx Andy Olshan, PhD (exclude Lip, Salivary Glands, Nasopharynx, Nasal 919‐966‐7424 Cavity and Nasal Sinuses) andy_olshan@unc.edu Geographic loca on: Residence within 46 coun es in North Carolina: Alamance, Brunswick, Project Manager: Cabarrus, Caswell, Catawba, Chatham, Craven, Cumberland, Heather Tipaldos, MS Davidson, Davie, Duplin, Durham, Edgecombe, Forsyth, Franklin, 919‐966‐9438 Gaston, Granville, Greene, Guilford, Halifax, Harne , Iredell, Johnston, Lee, Lenoir, Lincoln, Mecklenburg, Montgomery, Moore, heather_ paldos@unc.edu Nash, New Hanover, Onslow, Orange, Pender, Person, Pi , Randolph, Rockingham, Rowan, Sampson, Stanley, Union, Vance, Wake, Wayne, Wilson. What To Submit to RCA: Oral cavity, Pharynx, Larynx Paths + Facesheet/demographic data No: skin, salivary gland, nasopharynx, nasal cavity, brain Paths ≤ 6 months old, Invasive SCC (no in situ) For Ques ons, Contact: JoElla Mar ng, RCA Coordinator joella.mar ng@dhhs.nc.gov 919‐792‐5925 10
HCC ACE: HepatoCellular Carcinoma And Cadmium Exposure Cancer being studied: Primary Liver HCC (Placed on hold effec ve Oct 30, 2020) Purpose of study: Popula on‐based case control study to determine if regulatory sequences of previously iden fied cadmium‐associated methyla on mediate the rela onship between cadmium exposure and liver cancer (HCC) risk. Research Ins tu on: Dates of Eligibility for Path Reports: NC State University Dept. of Biology July 2019—July 2021 850 Main Campus Dr. Study started October 2019 Raleigh, NC 27606 Case Eligibility Criteria: Principal Inves gator: Ages: 45‐75 at Dx; Living pa ents Cathrine Hoyo, PhD Race: All Races 919‐515‐0540 Diagnosis: First newly‐diagnosed HCC choyo@ncsu.edu Residence: Within 39 NC coun es ‐ Alamance, Bladen, Cabarrus, Catawba, Chatham , Project Manager: Cumberland, Davidson, Davie, Duplin, Durham Rachel Maguire Edgecombe, Forsyth, Gaston, Greene, Guilford, 919‐515‐4085 Harne , Hoke, Iredell, Johnston, Lee, Lenoir, Lincoln, rlmaguire@ncsu.edu Mecklenburg, Montgomery, Moore, Nash, Orange, Pi , Randolph, Richmond, Robeson, Rowan, Sampson, Scotland, Stanly, Union, Wake, Wayne, Wilson. What To Submit To RCA: Liver (C22.0) paths only + Facesheet/demographic data No intrahepa c bile duct Paths ≤ 3 months old HCC only For ques ons, contact: JoElla Mar ng , RCA Coordinator joella.mar ng@dhhs.nc.gov 919‐792‐5925 11
Carolina Endometrial Cancer Study (CECS) cecs.unc.edu Cancer being studied: Endometrial Purpose of study: To understand how the characteris cs of an endometrial cancer pa ent and their tumor influence prognosis, treatment and outcome. Study design: ~1,800 newly diagnosed cases. Telephone/Mail‐In/Online interview at baseline with yearly follow‐up for 5 years. Saliva Self‐Collec on Kits, Medical Records and Tumor Tissue Collec on. Research Ins tu on: Dates of Eligibility for Path Reports: UNC Lineberger Comp. Cancer Center North January 2020—Ongoing 1700 MLK Jr. Blvd., Room 323 Study started Sept 2020 Campus Box #7294 Chapel Hill, NC 27599‐7294 Case Eligibility Criteria: Ages: 20‐80 at Dx; Living pa ents Principal Inves gators: Race: All Races Andrew F. Olshan, PhD, Professor Language: English 919‐966‐7424 Diagnosis: *First newly‐diagnosed Invasive andy_olshan@unc.edu Endometrial cancer or Serous Endometrial Intraepithelial cancer Hazel B. Nichols, PhD, Associate Professor *Prior H/O other cancers accepted 919‐966‐7456 *Metasta c site with an Endometrial primary hazel.nichols@unc.edu accepted Sites: Corpus Uteri (body of uterus) Project Manager: *Lower uterine segment, endometrium, Heather J. Tipaldos, MS myometrium, uterine fundus, overlapping 919‐966‐9438 lesion of corpus uteri, & Uterus, NOS heather_ paldos@unc.edu Geographic loca on: Residence within all 100 NC coun es What To Submit To RCA: Endometrial paths + Facesheet/demographic data Invasive Endometrial Cancers & Serous Endometrial Intraepithelial Cancers Exclude paths with only endometrial hyperplasia Paths ≤ 6 mos old For ques ons, contact: JoElla Mar ng , RCA Coordinator joella.mar ng@dhhs.nc.gov 919‐792‐5925 12
CLOSED STUDIES 13
A Mul disciplinary Collabora on to Assess Use of Guideline Recommended Molecular Biomarker Tes ng in Rural vs. Urban Lung Cancer Pa ents (Pilot ‐ Star ng 11/2018) Cancer being studied: Non‐Small Cell Lung Cancer (NSCLC) (Study officially closed January 02, 2020) Purpose of Study: The long‐term goal of this research is to improve the use of bio‐marker tes ng for all pa ents with advanced NCSLC. The object of this pilot is to explore rural—urban dispari es with biomarker tes ng. Study Design: We will u lize the pathology reports to extract lab‐sequencing test results from 1,000 NSCLC pa ents diagnosed in North Carolina in 2018. We will link the Pathology reports with access and contextual factors from U.S. Census data to evaluate the impact of recent molecular advances in lung cancer treatment on health dispari es. There will be no pa ent contact. Research Ins tu on: Dates of eligibility for path reports : UNC‐Chapel Hill January 2018—December 2018 130 Mason Farm Rd Bioinforma cs Building # 3126 Case Eligibility Criteria: Chapel Hill, NC 27599‐7515 Ages: 18 or older Race: African American/Black OR Principal Inves gator: Caucasian/White Louise Henderson, PhD Diagnosis: First newly diagnosed 919‐843‐7799 NSCLC; Stage IV; No prior cancers louise_henderson@med.unc.edu Geographic loca on: Residence within 25 coun es in North Carolina (Bladen, Buncombe, Project Manager: Burke, Caldwell, Columbus, Cumberland, Davidson, Davie, Ka e Marsh, MPH Haywood, Henderson, Iredell, Jackson, Macon, McDowell, 919‐966‐2865 Mitchell, Montgomery, Randolph, Richmond, Robeson, kate_marsh@med.unc.edu Rowan, Rutherford, Sampson, Scotland, Transylvania, Watauga) 14
mHealth Symptom Self‐Management Among Men with Prostate Cancer and Their Partners Cancer Being Studied: Prostate (Study Officially Closed January 29, 2021) Purpose of study: To administer an easy‐to‐use couple‐focused web‐based and tailored symptom man‐ agement program. The interven on program, Prostate Cancer Educa on & Resources for Couples (PERC), aims to help manage the nega ve effects of prostate cancer related symptoms on men and their partners and improve their wellbeing. Study Design: 250 cases and their partners Web‐based symptom management program. Research Ins tu on: Dates of Eligibility for Path Reports: UNC‐Chapel Hill School of Nursing January 2018 – January 2021 3800 Carrington Hall Study started April 2018 Chapel Hill, NC 27599 Case Eligibility Criteria: Principal Inves gator: Ages: 40‐75 Lixin Song, PhD Race: All races 919‐966‐3612 Language: English lixin_song@med.unc.edu Marital Status: Married or domes c partner/living as married Diagnosis: First newly‐diagnosed prostate cancer (non‐metasta c); no prior or concurrent cancers Geographic loca on: Residence within 36 NC counties: Alamance, Brunswick, Buncombe, Cabarrus, Ca‐ tawba, Cleveland, Columbus, Craven, Cumberland, Davidson, Duplin, Durham, Forsyth, Gaston, Guilford, Harne , Henderson, Iredell, Johnston, Lee, Lenoir, Lincoln, Mecklenburg, Nash, New Hanover, Pender, Pi , Randolph, Robeson, Rockingham, Rowan, Sampson, Union, Wake, Wayne, Wilson. What To Submit To RCA: All POS Prostate paths (Prostatectomies/BXs/TURPs) + Facesheet/demographic data Paths ≤ 3 months old Married pa ents or w/domes c partner (we need Marital Status in demographics) For Ques ons, Contact: JoElla Mar ng, RCA Coordinator joella.mar ng@dhhs.nc.gov 919‐792‐5925 15
Years RCA Studies 1993—Present 1993‐1996 Carolina Breast Cancer Study (Phase 1) 1993‐Ongoing Carolina Mammography Registry (CMR) 1996‐2006 NC Colorectal Cancer Study (NCCCS) 1999‐2008 NC Ovarian Cancer Study (NCOCS) 2000‐2003 NC Melanoma Study (GEM) 2000‐2004 Carolina Breast Cancer Study (Phase 2) 2001‐2004 Carolina Prostate Cancer Treatment Outcomes Study 2002‐2006 Carolina Head & Neck Cancer Study (CHANCE) 2002‐2007 Carolina Family Registry for Colorectal Cancer Studies 2003‐2005 Colorectal Cancer Care Outcomes Research Study (CANCORS) 2004‐2007 NC‐Louisiana Prostate Cancer Project (PCaP) 2006‐2008 Wake Forest Cancer Study (Contribu on of AMACR and Phytanic Acid to Prostate Cancer Risk among African Americans in NC) 2006‐2008 Your Story: Understanding Your Breast Cancer Experience 2006‐2012 Yale/Duke Meningioma Study 2007‐2007 The Liver Cancer Pilot Study 2008‐2009 Environmental and Gene c Risk Factors for Hepatocellular Carcinoma (HCC) 2008‐2010 Study of Outcomes in Colon Cancer Survivors (SOCCS) 2008‐2011 Shaw‐Johns Hopkins: Dispari es in Prostate Cancer Treatment Modality & Quality of Life 2008‐2013 Carolina Breast Cancer Study (Phase 3) 2009‐2013 ICCS‐Directed Physical Ac vity Enhancement for Colon Cancer Survivors: SurvivorCHESS 2010‐2012 NC Prostate Cancer Compara ve Effec veness & Survivorship Study (NC ProCESS) 2010‐2016 Duke African American Ovarian Cancer Study (AACES) 2010‐Ongoing Medullary Thyroid Carcinoma Surveillance Study: A Case‐Series Registry 2011‐2012 NC Inflammatory Breast Cancer Case‐Control Study 2013‐2015 Life Stresses, Family and Partner Support and Cancer Care for Women 2013‐2015 Compara ve Effec veness and Survivorship Health in Bladder Cancer (CEASE‐BC) 2014‐2015 Measuring Pa ent‐Centered Communica on for Colorectal Cancer Care and Research 2015‐2015 Tailored Web‐Based Prostate Cancer Educa on for Pa ents and Partners (Pilot Study) 2017‐2018 Evalua on of the Pa ent Experience Regarding Access/Quality of HCC Care in NC 2018‐2019 Mul disciplinary Collabora on to Assess Use of Guideline Recommended Molecular Biomarker Tes ng in Rural vs Urban Lung Cancer Pa ents 2018‐2021 mHealth Symptom Self‐Management Among Men with Prostate Cancer and Their Partners 2018‐Ongoing Carolina Head and Neck Cancer Study (CHANCE‐2) 2019‐ (On Hold) HCC ACE: HepatoCellular Carcinoma And Cadmium Exposure 2020‐Ongoing Carolina Endometrial Cancer Study (CECS) Thank you for your par cipa on in Rapid Case Ascertainment! 16
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