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Comparative Effectiveness Research on Cancer in Texas (CERCIT) is a statewide resource for outcomes and comparative effectiveness research funded by The Cancer Prevention Research Institute of Texas (CPRIT), RP101207


CERCIT News
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Do you really need that colonoscopy?
AARP, April 25, 2013
A recent study published in JAMA Internal Medicine suggests that almost a quarter of colonoscopies are either performed too often or given to patients who are too old to benefit. "It looks like some patients are getting screened inappropriately," says UTMB’s Kristin Sheffield who led the study. The study didn't fault colonoscopies doctors performed because a patient had a problem or worrisome symptom, such as blood in the stool or abdominal pain. Nor does it address colonoscopies to check patients who previously have had colorectal cancer or precancerous growths.

PMCH Symposium Awards
April 3, 2013
 UTMB PMCH held its third annual Public Health Symposium on April 3 - Public Health is Return on Investment: Save Lives, Save Money. The following awards were presented: The Laura Ray Scholarship - Lawrence Panas. The Sigma Xi Overall Poster Award for Public Health Research - Amol Karmarkar for "Diabetes Comorbidity On Health Outcomes In Patients Undergoing Medical Rehabilitation After Lower Extremity Joint Arthroplasty".Preventive Medicine and Community Health Poster Awards - Amit Kumar for "Body Mass Index versus Waist Circumference as Predictors of Disability Incidence in Mexicans Aged 50 Years and Older", Gabriela Vargas for "Physician Follow-up and Guideline Adherence in Post-Treatment Surveillance of Colorectal Cancer" and Abhishek Parmar for "Quality of Post-Treatment Surveillance of Early Stage Breast Cancer in Texas". (pictured, l to r: Abishek Parmar, Gabriela Vargas, Christine Arcari, Lawrence Panas, Amit Kumar and Amol Karmarkar).

Colonoscopy may be overused in older adults creating health risk
The Washington Post, March 12, 2013
Older U.S. adults may get too many colonoscopies, costing Medicare an estimated $500 million a year and putting patients at an increased risk of side effects such as bleeding, UTMB researchers found. About one-quarter of colonoscopies in Medicare recipients ages 70 and older may be inappropriate based on screening guidelines, according to analysis of insurance claims data released yesterday in the journal JAMA Internal Medicine. “Inappropriate colonoscopies involve an unnecessary risk with no added benefit for the older patient,” said Kristin Sheffield, the study’s lead author. “The harms are greater than the expected benefit.” The news appears widely throughout the world, appearing in such outlets as The New York Times, MSN, the Fort Worth Star-Telegram, Yahoo! News, Houston Business Journal, Businessweek, U.S. News & World Report, Chicago Tribune and Lifescript.

Cancer in Texas: Analyzing the Links
Me and My Doctor blog 09 Mar 2013 08:44 AM PST By Vivian Ho, PhDCancer in Texas
Researchers have documented dramatic differences in cancer care and cancer survival rates across the country. Texas is no different, with analysis of Texas Cancer Registry data showing substantial variation in cancer treatment and mortality in different areas of the state. Recent studies by the Comparative Effectiveness Research on Cancer in Texas (CERCIT) consortium suggest that differences in the local availability of specialists who treat cancer may affect treatment variation across the state. One study found that greater availability of colonoscopists and primary care physicians led to higher rates of colon cancer screening by colonoscopy for whites but not for blacks and Hispanics. Another study found that billings for intensity-modulated radiation therapy (IMRT) for breast cancer patients were higher in areas with a greater density of radiation oncologists. This advanced form of radiation therapy manipulates beams of radiation to conform to the shape of a tumor. Read the full article.

Overuse of surveillance colonoscopy after resection
Medical Xpress, Feb. 1, 2013
Approximately one-third of patients with normal results on their first and second colonoscopies after undergoing curative resection for colorectal cancer undergo subsequent surveillance colonoscopies within two years, which is earlier than recommended by current guidelines, according to research published in the January issue of Clinical Gastroenterology and Hepatology. CERCIT investigator, Dr. Amanpal Singh and colleagues used data from the Surveillance, Epidemiology, and End Results-Medicare linked database for 1992 to 2005 to analyze the timing for the first three colonoscopies after patients underwent curative surgery for colorectal cancer.

Minimally invasive breast biopsy lags in Texas
The Oncology Report, Jan. 25, 2013
More than a fifth of women in Texas with image-detected breast abnormalities failed to undergo minimally invasive breast biopsy as recently as 2008, according to a review of statewide Medicare data, even though in 2005 a U.S. consensus panel declared the minimally invasive approach the procedure of choice and that few patients should have excisional biopsy as their initial procedure. “Our studies identify targets for interventions to improve minimally invasive breast biopsy rates, such as the Hispanic disparity and geographic variations in practice pattern," said Dr. Taylor S. Riall, a UTMB cancer surgeon. “Our findings highlight that the strategies for intervention need to vary by geographic region and the underlying etiology of the failure to adopt this cost-effective practice.".

Avoiding over-diagnosis with PSA screenings
Galveston Daily News, Oct. 15, 2012
In this guest column, UTMB’s Dr. Elizabeth Jaramillo writes about the Prostate-Specific Antigen test and decreasing the rate of over-diagnosis, false positives and unneeded biopsies. “Prostate cancer has some aggressive forms, but usually it is a very slow-growing cancer. Especially in older men, the cancer grows so slowly that other diseases will likely cause mortality before the cancer causes symptoms or spreads.”

Surgeons Forum Discusses Proven Ways of Improving Quality and Reducing Health Care Costs The Sacramento Bee September 11, 2012
The American College of Surgeons hosted more than 80 health care leaders at the ACS Surgical Health Care Quality Forum Houston to discuss how programs focused on surgical quality and education can reduce patient complications and readmissions, resulting in lower costs and greater health care value. "When done correctly, outcomes or comparative effectiveness research using population-based data such as ACS NSQIP can play a critical role in the quality improvement process at the local, regional, and national level," said panelist Taylor S. Riall, MD, PhD, FACS, John Sealy Distinguished Chair in Clinical Research, Director, Center for Comparative Effectiveness and Cancer Outcomes, associate professor, department of surgery, and CERCIT investigator.

Screening for prostate cancer is an exception to the rule
Houston Chronicle, Sept. 7, 2012
September is Prostate Cancer Awareness Month, and the U.S. Preventive Services Task Force and the American Cancer Society no longer recommend using the PSA test to screen for prostate cancer. In this guest column, UTMB’s Dr. James S. Goodwin writes that, “For most cancers, the rule of thumb is ‘earlier is better,’ as in the earlier a cancer is caught, the better the outcome. Prostate cancer is an exception to the rule, however. With prostate cancer, looking for it has been found to cause more harm than good.” The article also appears in the Daily News.

Pancreatic cancer patients' choices easier with new study
Medical News Today, Aug. 25, 2012
Should patients with pancreatic cancer who know there time is ending soon spend a great amount of that little time undergoing aggressive and difficult treatment that will only add a brief period of additional life? UTMB's Dr. Casey Boyd and colleagues analyzed both hospital and medical care days in pancreatic cancer patients with stage, treatment and survival, which was able to give them a quantitative look at the whole experience of a patient with this disease. She hopes that this paper will help doctors give patients the information they need to make important decisions. The news also appears in Science Daily and Guidry News.

The controversy over cancer screening
Austin American-Statesman, Aug. 15, 2012
Continuing coverage: The Comparative Effectiveness Research on Cancer in Texas research group is studying cancer screening patterns in Texas and investigating associated outcomes. UTMB leads this research consortium, which includes the University of Texas MD Anderson Cancer Center, the University of Texas School of Public Health, Rice University, Baylor College of Medicine and the Texas Cancer Registry. The column also appears in The Galveston Daily News and Houston Chronicle.

Screening for Prostate Cancer: U.S. Preventive Services Task Force Recommendation Statement
Annals of Internal Medicine, July 17, 2012
The USPSTF recommends against PSA-based screening for prostate cancer (grade D recommendation). This recommendation applies to men in the general U.S. population, regardless of age. This recommendation does not include the use of the PSA test for surveillance after diagnosis or treatment of prostate cancer; the use of the PSA test for this indication is outside the scope of the USPSTF. Read the full document.

Confusion causes rates to lag for colon-cancer screening
Houston Chronicle, March 24, 2012
March is National Colorectal Cancer Awareness Month — a good time to remind Texans of the importance of being screened for colorectal cancer, which is the second-leading cause of cancer death in the United States, writes UTMB's Dr. James S. Goodwin in this guest column. "These deaths can largely be prevented with appropriate screening. But our research shows that in Texas, the number of people getting screened varies greatly from region to region and among different age and ethnic groups." The column also appears in the Daily News.

Most older adults need colon cancer screening
MSNBC, March 6, 2012
Most adults should get regularly screened for colon cancer between age 50 and 75, according to internal medicine doctors, with the time between screenings dependent on what method is used to check for early signs of cancer. While under-screening is a problem among certain groups, so is over-screening — especially among the oldest patients, according to Dr. James Goodwin, a geriatrician who has studied colon cancer screening at UTMB and wasn't involved in the new research. "The development of colon cancer ... occurs over many, many years," said Goodwin, who told Reuters Health that polyps caught by screening take 15 to 20 years to grow into a symptomatic cancer, on average. The Reuters article appears in news outlets around the globe, including in the Chicago Tribune and Baltimore Sun.

New Cancer Research Effort to Benefit Texans
UTMB, February 6, 2012
Galveston - A research initiative that will impact clinical cancer care for Texans is underway. But unlike similar initiatives, the results of this one will be shared with a much broader audience and not just researchers and physicians. This research is exploring important questions about screening patients for certain cancers. Read the full press release.

Zwelling, Goodwin and Elting: Cancer survivors present unique new challenges
El Paso Times, Jan 29, 2012

More docs no help for racial colonoscopy gap
MedPage Today, Dec. 17, 2011
Communities that have more physicians available to perform colonoscopies actually have bigger — not smaller — disparities in screening rates between minority and white patients, according to a recent study of Texas Medicare claims data. In the study of claims for nearly 975,000 Texas Medicare beneficiaries, colonoscopy use was higher in whites (40.7 percent) than in blacks (35.0 percent) or Hispanics (28.7 percent), reported Dr. Taylor S. Riall and colleagues from UTMB

Personalized cancer care: Think big and small
Special to The Daily News, Dec 9, 2011
by CERCIT Investigators, Drs. James S. Goodwin, Leonard A. Zwelling and Linda Elting

Some facts to consider in prostate-cancer debate
Houston Chronicle, Oct 25, 2011
by CERCIT Investigators, Drs. Leonard A. Zwelling and James S. Goodwin

What's New/ Upcoming Events


CPRIT’s 3rd Annual CPRIT Innovations in Cancer Prevention and Research Conference
October 24–26, 2012, Austin, Texas

CERCIT Highlights:

Poster Presenters:

Carlos Barcenas, MD, MS;  Catherine Cooksley, DrPH & Tony DiNuzzo, PhD;  Abhishck Parmar, MD;  Gabriela Vargas, MD

Oral Presentation Slides:


CERCIT Workshop Activity Schedule

Congratulations to the first group of “graduating” CERCIT scholars! Their accomplishments were many and their contributions were great. Thank you for kicking off our CERCIT Training program and setting a high standard of excellence for our current and future scholars. For current and past scholar information, visit our training page and click on Scholars. Past Scholar presentations are available on the CERCIT Training Activities page.
Manuscript Acknowledgement: This work was supported [in part] by the Comparative Effectiveness Research on Cancer in Texas (CERCIT) Grant #RP101207, funded by The Cancer Prevention Research Institute of Texas (CPRIT).
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