Virginia Cancer Screening Research Network Access Hub (Virginia CSRN Hub) - New cancer screening technologies with great promise for reducing cancer death are emerging. These technologies require large-scale controlled clinical trials to evaluate their effectiveness and assess the feasibility of adopting and implementing them into routine practice if effective. Furthermore, the National Academy of Medicine and US Preventive Services Task Force have identified dozens of evidence gaps in current cancer screening approaches that will need similar large scale randomized controlled trials and longitudinal studies.1-3 To address this, the National Cancer Institute (NCI) is creating a Cancer Screening Research Network (CSRN) with a network of Accrual, Enrollment, and Screening Site (ACCESS) Hubs capable of conducting clinical trials and longitudinal studies, a central Statistics and Data Management Center, and a central Coordinating and Communication Center. We propose to create the Virginia CSRN ACCESS Hub from long-standing, inter-institutional partnerships to assist in this important national effort. These partnerships include 1) two cancer centers – Massey Comprehensive Cancer Center at Virginia Commonwealth University (VCU), an NCI-designated cancer center, and Inova’s Schar Cancer Institute which includes a novel Saville Cancer Screening and Prevention Center; 2) two medical schools – VCU and the Eastern Virginia Medical School; 3) the NIH-funded Wright Regional Center for Clinical and Translational Science; 4) three health systems – VCU, Inova, and Sentara Healthcare; and 5) a state-wide primary care practice-based research network with over 500 member practices (Virginia Ambulatory Care Outcomes Research Network, ACORN). These entities have an established track record of working together for several decades; collectively care for a sizable proportion of state residents including the largest safety net health system providing both urban and rural services to a majority of Virginia’s communities; demonstrated expertise in recruiting and retaining a broad range of patients and communities in trials; and national expertise in cancer prevention, informatics, recruitment across communities, and dissemination and implementation science. The Virginia CSRN ACCESS Hub will initially recruit and retain at least 2,000 participants in the NCI-coordinated, three-arm randomized controlled Vanguard study to test two novel multi-cancer detection (MCD) tests compared to usual cancer screening care. We will measure our hub’s success by generalizable recruitment, timeliness and adherence to the diagnostic workup and treatment protocols, and participation in all national CSRN efforts. Additionally, we will conduct a novel mixed methods analysis of our work using a consolidated framework for implementation research (CFIR) constructures to demonstrate our hub’s feasibility and sustainability for future CSRN trials and to assess factors necessary for widespread adoption of MCD tests, if proven effective. Our hub will meaningfully contribute to the Vanguard study and will bring unique partnerships, a generalizability lens, and dissemination and implementation expertise to the broader CSRN effort.
