Implement Cancer prevention and control programs to reduce morbidity, mortality, and related health disparities. - Project Abstract Summary The Delaware Division of Public Health Cancer Prevention and Control program respectfully submits its application for all three programs outlined in CDC-RFA-DP22-2202. Delaware will utilize Cancer Prevention and Control Programs for State, Territorial, and Tribal Organizations grant funding to expand inclusive and equitable statewide cancer control and survivorship efforts. Through the organizational structure and experience of Delaware’s Cancer Control Program, Delaware is well-positioned to carry out all proposed activities. Delaware is committed to improving the health equity of its residents through prevention, screening, and health and wellness of cancer survivors. Delaware is the second smallest state in the U.S., geographically, with a population of under one million (estimated at 977,780 in 2020). Over half (51%) of all Delawareans are aged 40 or older, placing a sizeable portion of the state’s population at age-related increased risk for cancer. From 2013-17, Delaware ranked 2nd highest among states for all-site cancer incidence and 15th highest for all-site cancer mortality. Two decades worth of coordinated and collaborative early detection and cancer control efforts have led to downward trends in all-site cancer incidence and mortality and has enhanced the livelihoods of individuals impacted by cancer. However, important health disparities remain. As examples, from 2013-17, 36% of African American women diagnosed with breast cancer were regional or distant stage compared to 28% of Caucasian women diagnosed with breast cancer. African American men in Delaware are more likely to be diagnosed with and to die from prostate cancer. From 2003-07 to 2013-17, Delaware’s all-site cancer mortality rate increased 18% among Hispanic males. Delaware proposes to facilitate collaborative planning and implementation of evidence-based cancer surveillance, prevention, and control strategies in target populations that improve the inclusive and equitable provision of cancer services among identified target populations. Delaware’s Screening for Life (SFL) Program (NBCCEDP), Comprehensive Cancer Control Program (CCCP), and Delaware Cancer Registry (DCR) Program comprise the Delaware Cancer Prevention and Control Program. In collaboration with the Delaware Cancer Consortium (DCC), the three programs work together through partnerships, leveraging resources, and coordinating efforts to achieve the objectives outlined in Delaware’s 5-Year State Cancer Control Plan. For each program, Delaware outlines specific target populations, programmatic inputs, strategies, activities, and outputs. Proposed activities target multiple short-term outcomes including increased partnerships with program stakeholders, increased use of data to inform program planning and improvement, increased EBI implementation to improve provider-level screening rates, and increased outreach to populations with demonstrated health disparities. Intermediate outcomes include an increased number of Delaware men and women who receive SFL-paid screening and follow-up services, increased number of services provided to target populations, increased proportion of cancers diagnosed in the early, most treatable stage, increased adherence to timely diagnostic follow up and referral, and decreased inequities in the delivery of cancer services among Delawareans. Anticipated long-term outcomes include decreased cancer incidence, morbidity, mortality, and reduced cancer disparities. Delaware respectfully requests robust funding to ensure Delaware can continue its critical work in reducing and eliminating cancer related disparities through actionable steps that move Delaware toward the CDC’s vision of “all people free from cancer”.
