Fall 2016

George J. Weiner, MD, is director of the Holden Comprehensive Cancer Center, University of Iowa.

Commentary Overview

* To ensure that academic cancer centers thrive well into the future, we need to do a better job of explaining their unique role to a broad range of constituents.

* AACI's Academic Difference Initiative is focused on gathering, organizing and sharing already available information that provides evidence of the immense value of academic cancer centers.

* The initiative's collected examples of academic cancer centers' unique value focus on four areas—research, clinical care, education and economic impact.
About AACI Commentary

As part of AACI's efforts to feature the work and views of its member centers, AACI publishes AACI Commentary, a quarterly editorial series. Written by cancer center leaders, each edition focuses on a major issue of common interest to AACI cancer centers.

AACI's Academic Difference Initiative: Cancer Centers' Impact on Patient Care, Research, Education, and the Local Economy


Academic cancer centers play a major and unique role in enhancing cancer research, clinical care and education. This role will increase in value as our understanding of cancer's complexity grows and is applied to patient care. Academic cancer centers leverage synergies among their various missions, with the result being a positive impact on health and the economy at the local, regional and national levels. Accelerating progress in cancer medicine depends on the success of academic cancer centers and the development of new models of collaboration between these centers and community oncology.

To ensure that they thrive well into the future, we need to do a better job of explaining academic cancer centers' unique role to a broad range of constituents--patients, payers, policy makers, university leadership, community oncology partners and the general public.

As part of the first phase of its Academic Difference Initiative (ADI), the Association of American Cancer Institutes gathered and organized evidence highlighting the value of academic cancer centers. Some of this evidence is based on analyses of the value of specific projects at individual centers while other evidence points more to the national impact of such centers as a whole.

ADI's second phase involves disseminating the gathered information including providing it to individual cancer centers to enhance local support for their work. At the national level, this information will be used to advocate for academic cancer centers in general.

In the second half of 2016, an ADI Communications and Marketing Subcommittee convened three teleconferences to review more than 100 documents submitted by 25 AACI cancer centers. Part of the subcommittee's charge was to organize these documents in a way that allows AACI member centers to more clearly identify the unique attributes and value of academic cancer centers. A library of these ADI documents is housed on AACI's website and available for review by AACI members.

This initiative is not intended to be another level of peer review on the quality of information gathered by member cancer centers, nor is it designed to develop a new, comprehensive database or generate new data. Instead, it is focused on gathering, organizing and sharing information that is already available that speaks to academic cancer centers' vital role.

The collected examples of academic cancer centers' unique value focus on the following four areas.

Academic cancer centers make fundamental scientific discoveries, explore the translational potential of these discoveries, test cutting-edge approaches to cancer prevention, early detection and therapy, and monitor our success at reducing the burden of cancer in the communities we serve. This includes clinical trials and outcomes research that contribute to the development of guideline-concordant care. Academic cancer centers generate intellectual property leading to patents and start-up companies, and innovative early-phase clinical trials have led to major changes in the cancer treatment paradigm, including more effective treatments that are less toxic and sometimes less expensive than established treatments. Academic cancer centers are developing new collaborations that accelerate progress by allowing the cancer research community to work together to respond to the changing paradigm in our understanding of how cancer's molecular makeup influences therapy and care. Examples include the Oncology Research Information Exchange Network (ORIEN) and the Big Ten Cancer Research Consortium.

Clinical Care
By partnering closely with community oncologists and providing access to multidisciplinary teams of experts in specific cancer types, academic cancer centers help to ensure that patients receive quality care both at the academic cancer centers and in their communities. The ability to tap into this knowledge base will be increasingly important to community oncologists as we learn more about cancer's complexity, and there is growing evidence that access to such expertise improves patient outcomes. Academic cancer centers also provide clinical care to under-served populations, and a number offer free training to patient navigators who serve patients in the community in a culturally sensitive manner.

By and large, all U.S. oncologists have been trained at academic cancer centers. The same applies to cancer researchers who eventually work in both the public and private sectors and have been central to innovation in the biotechnology industry, a driver of the national economy. Clinical and research training programs abound at academic cancer centers, yet not all are alike. Many fill unique niches such as providing training in specific research fields, new technologies, specific cancer types, underrepresented minority populations, outcomes research and health care delivery. Beyond physicians and researchers, academic centers train nurses, pharmacists, physician assistants, and other members of the cancer care team. Academic cancer centers also educate the public through extensive outreach programs. This includes interactions and in some cases leadership roles in statewide cancer control efforts, support for education programs to reduce cancer disparities, communication about healthy life styles and unique approaches like culinary classes that focus on cancer patient nutrition.

Economic Impact
These three overlapping missions of academic cancer centers — research, clinical care and education —have a positive economic impact locally, regionally and nationally. Academic centers create intellectual property, generate jobs, invest locally, act as economic drivers by launching start-up companies and bring resources to the community through "medical tourism". There is growing evidence that such centers provide cost-efficient cancer care based on their success in following guidelines and limiting ineffective, expensive end-of-life treatments.

Looking Ahead
AACI is in the preliminary stages of exploring a collaboration with the National Comprehensive Cancer Network (NCCN), which has been conducting an initiative similar to AACI's ADI. Both organizations have agreed to appoint a small group of representatives to map how we might work together to document the value of academic cancer centers, and 13 NCCN centers have contributed documents to the Academic Difference Initiative.

In addition, I will be moderating an ADI presentation at the 2016 AACI/CCAF Annual Meeting, providing details about the initiative's progress including findings and how cancer centers can use the information that we've collected. Panelists will be: Judy Fortin, Senior Director of Communications and Media Relations, Winship Cancer Institute of Emory University; Anne L. Levine, Vice President External Affairs, Dana-Farber Cancer Institute; and, Dr. Julie Wolfson, Assistant Professor, Pediatric Hematology-Oncology, University of Alabama at Birmingham. Dr. Wolfson led a study on the impact of care at comprehensive cancer centers, published in November 2015 in the journal, Cancer.

The ADI will be an ongoing effort. AACI will continue to reach out to center directors and administrators, public and government relations staff and others to help us gather additional information, and use the collected information to convey the message we all believe – that academic cancer centers are more valuable than ever, and are vital if we are to accelerate our ability to reduce the burden of cancer for those we serve.

A version of this AACI Commentary was published in The Cancer Letter, December 11, 2015.

Representing 95 of North America's premier academic and free-standing cancer centers, the Association of American Cancer Institutes is dedicated to reducing the burden of cancer by enhancing the impact of leading cancer centers.