CCSG Supplement: Dr. Hull's Markey Funded Portion - University of Kentucky Markey Cancer Center - Cancer Center Support Grant

The overarching mission of the University of Kentucky (UK) Markey Cancer Center (MCC) is to reduce mortality in Kentucky through a comprehensive program of cancer research, treatment, education, and community engagement. As the only NCI]designated cancer center in the state, the MCC embraces the entire Commonwealth of Kentucky (population over 4.4 million) as its catchment area. Kentucky is a predominantly rural state, one that persistently ranks among the most socioeconomically and educationally disadvantaged in the country. Despite advances over the last several decades, the cancer burden in Kentucky remains severe. The state has the unfortunate distinction of leading the nation in both the incidence rate for all cancer sites and the highest rate of cancer deaths per 100,000 population. Cancers with high incidence rates in Kentucky include: lung and bronchus (#1), colon and rectum (#1), and the two most common cancers associated with human papillomavirus (HPV) infections.oropharyngeal (#1) and cervical (#4). While Kentucky cancer statistics lead the nation, cancer rates in the 54 Appalachian counties in eastern Kentucky exceed those of Kentucky and point to extraordinary regional disparities. In addition to socioeconomic disadvantages and geographic barriers to healthcare access, pervasive lifestyle challenges have also been implicated in serious statewide health disparities, including cancer. For example, Kentucky ranks the 2nd highest among US stages for adult smoking prevalence, 7th highest for adult obesity prevalence, and 8th lowest for HPV vaccinations, thus contributing to the higher incidence of tobacco]related, obesity]related, and HPV]related cancers. In this supplement application, we propose two P01 concepts.1) Novel mechanisms contributing to obesity]associated colorectal cancers, and 2) Facilitating the implementation of evidence]based clinical guidelines for cancer prevention screening.that were selected for inclusion based on their strong scientific merit and because they directly address MCCfs catchment area needs and communityidentified priorities. Multidisciplinary teams will be formed with attention to gathering more preliminary data in support of competitive P01 submissions.