PROJECT SUMMARY
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) three health systems – Virginia Commonwealth University (VCU) Health, Inova Health
System, and Sentara Healthcare; 2) two medical schools – VCU and the Eastern Virginia Medical School;
3) two cancer centers – the Massey Comprehensive Cancer Center at VCU, an NCI-designated
comprehensive cancer center, and the Inova Health’s Schar Cancer Institute which includes a recently
launched Saville Cancer Screening and Prevention Center; 4) the NIH-funded Wright Regional Center for
Clinical and Translational Science; and 5) a state-wide, primary care practice-based research network (Virginia
Ambulatory Care Outcomes Research Network – ACORN). These entities have an established track record of
working together for 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 marginalized and underserved patients and communities in
trials; and national expertise in cancer prevention, informatics, community engagement, and dissemination and
implementation science. The Virginia CSRN ACCESS Hub will initially recruit and retain at least 1,600
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 success by equitable
and inclusive 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 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, an equity lens, and dissemination and implementation expertise to the broader CSRN effort.