June 30, 2003

8:30 – 9:00
The Lecture Room
Continental Breakfast

9:00 – 9:05
Introduction of Symposium and Secretary Thompson
Harvey Fineberg, M.D., Ph.D., President, Institute of Medicine

9:05 – 9:25
"Cancer Prevention Opportunities in America"
Tommy Thompson, Secretary, Department of Health and Human Services (Invited)

9:25 – 9:45
"View from the ACS: Fulfillment of the Potential of Cancer Prevention"
John Seffrin, CEO, American Cancer Society, President, UICC

9:45 – 9:55
"How Many Lives Can Be Saved?"
Tim Byers, M.D., M.P.H., IOM report co-editor
Professor of Epidemiology & Program Leader
University of Colorado, Health Sciences Center

9:55 – 10:05
"Five Ways to Harness the Power of Cancer Prevention and Early Detection"
Susan Curry, Ph.D., IOM report co-editor
Director, Health Research and Policy Centers
Professor, University of Illinois, Chicago

10:05 – 10:45
Q&A

10:45 – 11:00
BREAK

11:00 – 11:20
"Reducing Disparities in Cancer"
Harold Freeman, M.D., Department of Surgery, North General Hospital, New York
Director, Center to Reduce Cancer Health Disparities
National Cancer Institute

11:20 – 11:40
"Delivering Quality Cancer Prevention"
Hugh Straley, M.D., Associate Medical Director for Quality and Research
Group Health Cooperative

11:40 – 12:00
"Private Sector Perspectives on Cancer Prevention and Early Detection"
Lew Sandy, M.D., Executive Vice President for Clinical Strategies and Policy
UnitedHealthCare

12:00 – 12:30
Q&A

12:30 – 1:15
LUNCH
Speakers and Attendees

1:15 – 2:30
Simultaneous group discussions with invited speakers – Part I
Facilitators - Sue Curry, Ph.D., University of Illinois, Len Lichtenfeld, M.D., American Cancer Society

Policy in Tobacco and Obesity (Lecture Room)

Tobacco use and obesity are major contributors to the cancer burden. Initiatives to increase the adoption, reach, and impact of evidence-based cancer prevention interventions need to occur at multiple levels across multiple behavioral targets. The policy recommendations in the IOM National Cancer Policy Board report reflect similarities and differences in the state of the science for tobacco compared to obesity interventions. Progress in both areas will be enhanced when all states have comprehensive cancer control plans that include public and private partnerships for community-based programs (Recommendation #3). There is sufficient evidence to recommend enactment and enforcement of federal and state initiatives that reduce tobacco use (e.g., increased excise taxes, clean indoor air acts - Recommendation #1). Still needed is a coordinated, national strategy to address obesity, unhealthy diet, and physical inactivity (Recommendation #2). In light of these similarities and differences, group discussion topics include:

• What opportunities are there to link and create synergies between policy initiatives for tobacco and obesity? Particularly important is avoiding competition between the two targets, as would happen if we concluded that we've fixed tobacco and need now to turn to obesity.
• Where and how can tobacco policy successes pave the way for timelier implementation of obesity-related policies as new evidence emerges?
• What policy initiatives have the greatest potential to address and help eliminate health disparities related to tobacco and obesity?

Harvey Fineberg, M.D., Ph.D., President Institute of Medicine
Bob Croyle, Ph.D., Acting Director Division of Cancer Control and Population Sciences, National Cancer Institute
Tom Glynn, Ph.D., Director, Science and Trends, American Cancer Society
Bill Dietz, M.D., Ph.D., Director, Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention

Payer/Provider/Managed Care Issues (Board Room)

A vital role of the health care system in filling the gap between what we know and what we do for cancer prevention and early detection is to ensure universal access to evidence-based prevention interventions. The IOM National Cancer Policy Board recommends: that public and private insurers consider such evidence-based services as essential benefits (Recommendation #4); that support by increased for programs that provide primary care to uninsured and low income people (Recommendation #5); that existing national programs such as CDC's National Breast and Cervical Cancer Early Detection Program receive adequate support and be expanded for colorectal cancer screening (Recommendation #6); and that the USDHHS conduct a comprehensive review to assess whether evidence-based preventive services are being offered and successfully delivered in federal health programs (Recommendation #7). Jumping off from these recommendations, group discussion topics include:

• What are the optimal leverage points for improving access to proven prevention interventions? Of the recommendations noted by the IOM, what opportunities are there for timely and early successes in their implementation?
• What types of decision making strategies and benefit policies may be needed with regard to access to, and coverage for, cancer prevention interventions that generate high demand, but have uncertain or even unproven evidence to support them?
• What policy initiatives have the greatest potential to address and help eliminate cancer-related health disparities?

• Are there changes in current research publication and reporting policies and practices that are needed to ensure inclusion of research findings in evidence reviews such as those conducted by the USPSTF and USTFCPS?
• Are changes needed to the required sections of NIH and private foundation grant applications to ensure that investigators focus on dissemination from the inception of their prevention intervention research?
• What new research funding initiatives are needed to increase the number of studies that apply rigorous scientific methods to evaluate dissemination strategies, and what opportunities are there for shared funding of such research across NIH and other federal agencies, as well as through government-private funding partnerships?

• Who is accountable for ensuring that graduate curricula and continuing education programs include adequate coverage of cancer prevention and early detection? How can professional organizations and academic medical centers be encouraged to have this as an educational priority?
• What leverage points are there for monitoring the performance not only of health care providers but also of the systems of health care delivery, to ensure infrastructure and accountabilities for delivering evidence-based prevention interventions?
• How can state health departments and federal agencies such as CMS advance this priority?