Over the past two decades, the number of cancer survivors has significantly increased and led to increased interest in the field of cancer survivorship research. An estimated 15.5 million cancer survivors now live in the United States and that number is expected to grow to over 20 million by 2026, largely due to better cancer care and an aging populations. Cancer survivorship has been a key theme of our CPC program since 2004 and in 2008 we successfully competed for the first training grant that focused specifically on cancer survivorship (R25 CA122061). In 2014 this training grant was renewed for an additional 5 years. The issues involved in cancer survivorship are inherently interdisciplinary and involve knowledge of cancer biology and genetics, clinical oncology, epidemiology, health services research, and social and behavioral sciences thus making our training program an ideal mechanism to train survivorship researchers. Survivorship remains one of the themes of our CPC program. We currently have several funded mentors conducting research related to survivorship (Avis, Danhauer, Rapp, Salsman, Sandberg, Wagner. Weaver). 

An estimated 40-60% of cancer in Western countries is attributable to lifestyle and environmental factors. Tobacco smoking is the leading modifiable risk factor, responsible for 20-30% of cancer incidence and mortality, followed by obesity (3-10%), alcohol consumption (3-7%), and deficiencies in healthy food intake (~5%). Poor lifestyles post-diagnosis also contribute to excess morbidity and mortality among cancer survivors. Given Wake Forest’s strengths in addiction research, the CPC program is expanding its focus on the etiologic risks of addiction and cancer, as well as the potential deleterious effects of tobacco, alcohol, and food consumption on cancer treatment efficacy. Researchers at Wake Forest have considerable experience conducting lifestyle interventions in community-based and clinical settings focusing on cancer prevention as well as improving treatment and survivorship outcomes. Thus, CAPACiTy fellows have an excellent opportunity for to engage in applied behavioral research experience with support from highly qualified mentors (Donny, Foley, Gesell, Moore, Tooze, Vitolins).

Cancer care delivery research focuses on how patient and clinician behavior, health care systems, health information technology, and financing/payment models affect the quality, cost, and outcomes of cancer care (NCI: https://healthcaredelivery.cancer.gov/ccdr/). Wake Forest has the only NCI Community Oncology Research Program (NCORP) Research Base located within a Comprehensive Cancer Center which supports community-based cancer care delivery research. Faculty mentors at Wake Forest are leaders within the NCORP RB (Dr. Weaver-Co-PI) and members of the T32 leadership and faculty mentor team have successfully taken advantage of the NCORP infrastructure for cancer care delivery research (e.g., Foley, MPI). In addition, Dr. Wagner (faculty mentor) is MPI of the ECOG-ACRIN NCORP Research Base and the Deputy Director of the ECOG-ACRIN Cancer Control and Outcomes Program. Dr. Salsman (faculty mentor) is Chair of the ECOG-ACRIN Adolescent and Young Adult (AYA) Oncology Subcommittee providing excellent connection to the research base for AYA research. Our faculty have considerable experience using these infrastructures, including engaging previous R25 post-doctoral fellows in cooperative group studies. For trainees committed to community-based cancer care delivery, these in-house resources at Wake Forest provide and unique opportunity.