Welcome Comparative Effectiveness Research on Cancer in Texas (CERCIT)

CERCIT is a multidisciplinary consortium of investigators at the University of Texas Medical Branch (UTMB), MD Anderson Cancer Center, Rice University and the Texas Department of State Health Services Texas Cancer Registry. CERCIT is funded by the Cancer Prevention Research Institute of Texas (CPRIT).


Demographic Variations in Texas

by UTMB CERCIT, November 2016

Cancer themed typographical graphicThe size and diversity of Texas present substantial challenges to the delivery of cancer care throughout the state. The CERCIT Knowledge Translation Core produced the following report and online resources that map population, economic and health care characteristics of diverse geographic areas in Texas that are relevant to the delivery of cancer care.

Read More: Demographic Variations in Texas

UTMB-led group wins additional 5-year funding from Cancer Prevention Research Institute of Texas

by UTMB CERCIT, September 2016

A multi-institutional group, led by James S. Goodwin, MD, has been awarded a second five years of funding for "Comparative Effectiveness Research on Cancer in Texas" (CERCIT). The $6 million grant is from the Cancer Prevention Research Institute of Texas. The CERCIT renewal will build on our analyses of administrative data but expand our methods to better measure individual patient characteristics and include information on patient preferences and patient reported outcomes. Our goal is to generate evidence that will help patients and their physicians make individualized decisions about the best cancer care options for each patient. These choices include screening, treatment and end of life care in cancer.

Read More: CERCIT Renewal

Rice U. study: Texans are no better off in one city versus another for cancer treatment

by Rice University Press Release

photo of medical professional reading a tablet

HOUSTON – (July 25, 2016) – Regions in Texas differ widely in adherence to recommended cancer treatment for elderly patients, according to a study by researchers at Rice University and the University of Texas MD Anderson Cancer Center.

These differences are not due to the availability of treatment specialists or the presence of teaching hospitals, the study found. The absence of consistent explanations for these treatment differences suggests that variations like these are likely to occur elsewhere nationwide.

"Texans are no better off in one city versus another in terms of treatment across a broad range of cancers," said Vivian Ho, the chair in health economics at Rice's Baker Institute for Public Policy and director of the institute's Center for Health and Biosciences, who co-authored the study. "One might have expected Houston residents to receive better treatment because of MD Anderson's presence, but any beneficial effects could be offset by a large number of elderly in Houston not being treated there." The research findings were published in the journal BMC Health Services Research.

Cervical Health Awareness

UTMB's Dr. Ana Rodriguez was interviewed on Univision, January 2016

January was Cervical Health Awareness Month. UTMB's Dr. Ana Rodriguez was interviewed on Houston Spanish-language television station Univision about the need for women to get screened for cervical cancer and for boys and girls to get vaccinated against the human papillomavirus (HPV) in order to prevent cervical cancer.

Preventing cervical cancer – vaccinations and screenings work

by Ana M. Rodriguez, MD, Jan 2016

Ana M. Rodriguez, MD

January is Cervical Health Awareness Month – a time to focus public attention on the need for women across the country to get screened for cervical cancer and for boys and girls to get vaccinated against the human papillomavirus when they are eligible.

Read More: Cervical Cancer Prevention

Survival rates not improving for women under 50 with endometrial cancer

TMC News, Jan 2016

Despite improvements in diagnoses and treatments, survival rates for women younger than 50 with primary, invasive endometrial cancer are not improving according to a study available online in the Journal of Cancer Research and Clinical Oncology.

Read more: Endometrial Cancer in Women Under 50


2016 CERCIT Publications
Chavez-MacGregor, M., Clarke, C. A., Lichtensztajn, D. Y., & Giordano, S. H. (2016). Delayed Initiation of Adjuvant Chemotherapy Among Patients With Breast Cancer. JAMA Oncol, 2(3), 322-329. doi:10.1001/jamaoncol.2015.3856 PMID26659132
Dimou, F., Sineshaw, H., Parmar, A. D., Tamirisa, N. P., Jemal, A., & Riall, T. S. (2016). Trends in Receipt and Timing of Multimodality Therapy in Early-Stage Pancreatic Cancer. J Gastrointest Surg, 20(1), 93-103; discussion 103. doi:10.1007/s11605-015-2952-7 PMID26503262
Elting LS, Xu Y, Chavez-MacGregor M, Giordano SH. Granulocyte growth factor use in elderly patients with non-Hodgkin's lymphoma in the United States: adherence to guidelines and comparative effectiveness. J Supp. Care Cancer, 2016 Jan 3 24(6), 2695-2706. PMID26797253
Esselen, K. M., Cronin, A. M., Bixel, K., Bookman, M. A., Burger, R. A., Cohn, D. E., . . . Wright, A. A. (2016). Use of CA-125 Tests and Computed Tomographic Scans for Surveillance in Ovarian Cancer. JAMA Oncol, 2(11), 1427-1433. doi:10.1001/jamaoncol.2016.1842 PMID27442965
Goodwin, J. S., Sheffield, K., Li, S., & Tan, A. (2016). Receipt of Cancer Screening Is a Predictor of Life Expectancy. J Gen Intern Med, 31(11), 1308-1314. doi:10.1007/s11606-016-3787-y PMID27364834
Ho V, Ku-Goto MH, Zhao H, Hoffman E, Smith B, Giordano S. Regional differences in recommended cancer treatment for the elderly. BMC Health Services Research, 2016 16:262 DOI 10.1186/s12913-016-1534-z Download PDF
Huo, J., Giordano, S. H., Smith, B. D., Shaitelman, S. F., & Smith, G. L. (2016). Contemporary Toxicity Profile of Breast Brachytherapy Versus External Beam Radiation After Lumpectomy for Breast Cancer. Int J Radiat Oncol Biol Phys, 94(4), 709-718. doi:10.1016/j.ijrobp.2015.12.013 PMID26972643
Huo, J., Smith, B. D., Giordano, S. H., Reece, G. P., & Tina Shih, Y. C. (2016). A comparison of patient-centered economic and clinical outcomes of post-mastectomy breast reconstruction between obese and non-obese patients. Breast, 30, 118-124. doi:10.1016/j.breast.2016.09.004 PMID27697676
Kehl, K. L., Shen, C., Litton, J. K., Arun, B., & Giordano, S. H. (2016). Rates of BRCA1/2 mutation testing among young survivors of breast cancer. Breast Cancer Res Treat, 155(1), 165-173. doi:10.1007/s10549-015-3658-y PMID26706041
Lewis, Z. H., Ottenbacher, K. J., Fisher, S. R., Jennings, K., Brown, A. F., Swartz, M. C., & Lyons, E. J. (2016). Testing Activity Monitors' Effect on Health: Study Protocol for a Randomized Controlled Trial Among Older Primary Care Patients. JMIR Res Protoc, 5(2), e59. doi:10.2196/resprot.5454 PMID27129602
Lewis, Z. H., Swartz, M. C., & Lyons, E. J. (2016). What's the Point?: A Review of Reward Systems Implemented in Gamification Interventions. Games Health J, 5(2), 93-99. doi:10.1089/g4h.2015.0078 PMID26812253
Lin, S. H., Zhang, N., Godby, J., Wang, J., Marsh, G. D., Liao, Z., . . . Giordano, S. H. (2016). Radiation modality use and cardiopulmonary mortality risk in elderly patients with esophageal cancer. Cancer, 122(6), 917-928. doi:10.1002/cncr.29857 PMID26716915
Lowenstein, L. M., Richards, V. F., Leal, V. B., Housten, A. J., Bevers, T. B., Cantor, S. B., . . . Volk, R. J. (2016). A brief measure of Smokers' knowledge of lung cancer screening with low-dose computed tomography. Prev Med Rep, 4, 351-356. doi:10.1016/j.pmedr.2016.07.008 PMID27512650
Lyons, E. J., Baranowski, T., Basen-Engquist, K. M., Lewis, Z. H., Swartz, M. C., Jennings, K., & Volpi, E. (2016). Testing the effects of narrative and play on physical activity among breast cancer survivors using mobile apps: study protocol for a randomized controlled trial. BMC Cancer, 16, 202. doi:10.1186/s12885-016-2244-y PMID26960972
Mehta, H. B., Parmar, A. D., Adhikari, D., Tamirisa, N. P., Dimou, F., Jupiter, D., & Riall, T. S. (2016). Relative impact of surgeon and hospital volume on operative mortality and complications following pancreatic resection in Medicare patients. J Surg Res, 204(2), 326-334. doi:10.1016/j.jss.2016.05.008 PMID27565068
Meyer, L. A., Cronin, A. M., Sun, C. C., Bixel, K., Bookman, M. A., Cristea, M. C., . . . Wright, A. A. (2016). Use and Effectiveness of Neoadjuvant Chemotherapy for Treatment of Ovarian Cancer. J Clin Oncol. doi:10.1200/JCO.2016.68.1239 PMID27601552
Nayak, P., Luo, R., Elting, L., Zhao, H., & Suarez-Almazor, M. E. (2016). Impact of Rheumatoid Arthritis on the Mortality of Elderly Patients who Develop Cancer: A Population-Based Study. Arthritis Care Res (Hoboken). doi:10.1002/acr.22997 PMID27483088
Nayak, P., Vernon, S. W., Savas, L. S., Basen-Engquist, K., Morgan, R. O., & Elting, L. S. (2016). Functional Impairment and Physical Activity Adherence Among Gynecologic Cancer Survivors: A Population-Based Study. Int J Gynecol Cancer, 26(2), 381-388. doi:10.1097/IGC.0000000000000620 PMID26807568
Raber, M., Swartz, M. C., Santa Maria, D., O'Connor, T., Baranowski, T., Li, R., & Chandra, J. (2016). Parental involvement in exercise and diet interventions for childhood cancer survivors: a systematic review. Pediatr Res, 80(3), 338-346. doi:10.1038/pr.2016.84 PMID27064243
Sharma, G., Nishi, S. P., Lin, Y. L., Kuo, Y. F., Goodwin, J. S., & Riall, T. S. (2016). Pattern of Imaging after Lung Cancer Resection. 1992-2005. Ann Am Thorac Soc, 13(9), 1559-1567. doi:10.1513/AnnalsATS.201511-768OC PMID27243464
Shirvani, S. M., Jiang, J., Likhacheva, A., Hoffman, K. E., Shaitelman, S. F., Caudle, A., . . . Smith, B. D. (2016). Trends in Local Therapy Utilization and Cost for Early-Stage Breast Cancer in Older Women: Implications for Payment and Policy Reform. Int J Radiat Oncol Biol Phys, 95(2), 605-616. doi:10.1016/j.ijrobp.2016.01.059 PMID27034179
Smith, B. D., Jiang, J., Shih, Y. C., Giordano, S. H., Huo, J., Jagsi, R., . . . Shirvani, S. M. (2017). Cost and Complications of Local Therapies for Early-Stage Breast Cancer. J Natl Cancer Inst, 109(1). doi:10.1093/jnci/djw178 PMID27678203
Smith, G. L. (2016). Toward Minimizing Overtreatment and Undertreatment of Ductal Carcinoma In Situ in the United States. J Clin Oncol, 34(11), 1172-1174. doi:10.1200/JCO.2015.66.2064 PMID26884563
Swartz, M. C., Basen-Engquist, K. M., Markham, C., Lyons, E. J., Cox, M., Chandra, J., . . . Swank, P. R. (2016). Psychometric Analysis of the Three-Factor Eating Questionnaire-R18V2 in Adolescent and Young Adult-Aged Central Nervous System Tumor Survivors. J Adolesc Young Adult Oncol, 5(3), 278-285. doi:10.1089/jayao.2015.0058 PMID27042872
Volk, R. J., Linder, S. K., Lopez-Olivo, M. A., Kamath, G. R., Reuland, D. S., Saraykar, S. S., . . . Pignone, M. P. (2016). Patient Decision Aids for Colorectal Cancer Screening: A Systematic Review and Meta-analysis. Am J Prev Med. doi:10.1016/j.amepre.2016.06.022 PMID27593418
Williams, S. B., Duan, Z., Chamie, K., Hoffman, K. E., Smith, B. D., Hu, J. C., . . . Giordano, S. H. (2016). Risk of hospitalisation after primary treatment for prostate cancer. BJU Int. doi:10.1111/bju.13647 PMID27561186
Zanwar, P., Lin, Y. L., Kuo, Y. F., & Goodwin, J. S. (2016). Downstream tests, treatments, and annual direct payments in older men cared for by primary care providers with high or low prostate-specific antigen screening rates using 100 percent Texas U.S. Medicare public insurance claims data: a retrospective cohort study. BMC Health Serv Res, 16, 17. doi:10.1186/s12913-016-1265-1 PMID26772175
2015 CERCIT Publications
Austin MT, Nguyen H, Eberth JM, Chang Y, Heczey A, Hughes DP, Lally KP, & Elting LS. Health disparities are important determinants of outcome for children with solid tumor malignancies. J Pediatr Surg, 2015 Jan  50(1), 161-166. PMID25598116
Chavez-MacGregor M, Niu J, Zhang N, Elting LS, Smith BD, Banchs J, Hortobagyi GN, & Giordano SH. Cardiac Monitoring During Adjuvant Trastuzumab-Based Chemotherapy Among Older Patients With Breast Cancer. J Clin Oncol, 2015 Jul 1  33(19), 2176-2183. PMID25964256
Cooper AB, Parmar AD, Riall TS, Hall BL, Katz MH, Aloia TA, & Pitt HA. Does the use of neoadjuvant therapy for pancreatic adenocarcinoma increase postoperative morbidity and mortality rates? J Gastrointest Surg, 2015 Jan  19(1), 80-86; discussion 86-87. PMID25091851
Gomez DR, Liao KP, Swisher SG, Blumenschein GR, Erasmus JJ, Jr., Buchholz TA, Giordano SH, & Smith BD. Time to treatment as a quality metric in lung cancer: Staging studies, time to treatment, and patient survival. Radiother Oncol, 2015 May  115(2), 257-263.


Guadagnolo BA, Liao KP, Giordano SH, Elting LS, & Shih YC. Variation in Intensity and Costs of Care by Payer and Race for Patients Dying of Cancer in Texas: An Analysis of Registry-linked Medicaid, Medicare, and Dually Eligible Claims Data. Med Care, 2015 Jul  53(7), 591-598. PMID26067883
He W, Zhao H, Chan W, Lopez D, Shroff RT, & Giordano SH. Underuse of surgical resection among elderly patients with early-stage pancreatic cancer. Surgery, 2015 Jun 29. PMID26138347
Jagsi R, Jiang J, Momoh AO, Alderman A, Giordano SH, Buchholz TA, Pierce LJ, Kronowitz SJ, & Smith BD. Complications After Mastectomy and Immediate Breast Reconstruction for Breast Cancer: A Claims-based Analysis. Ann Surg, 2015 Apr 14. PMID25876011
Nayak P, Paxton RJ, Holmes H, Thanh Nguyen H, & Elting LS. Racial and ethnic differences in health behaviors among cancer survivors. Am J Prev Med, 2015 Jun  48(6), 729-736. PMID25998923
Riall TS, Adhikari D, Parmar AD, Linder SK, Dimou FM, Crowell W, Tamirisa NP, Townsend CM, Jr., & Goodwin JS. The risk paradox: use of elective cholecystectomy in older patients is independent of their risk of developing complications. J Am Coll Surg, 2015 Apr  220(4), 682-690. PMID25660731
Smith BD. When is good enough really good enough? Defining the role of radiation in low-risk ductal carcinoma in situ. J Clin Oncol, 2015 Mar 1  33(7), 686-691. PMID25605858
Smith GL, Huo J, Giordano SH, Hunt KK, Buchholz TA, & Smith BD. Utilization and Outcomes of Breast Brachytherapy in Younger Women. Int J Radiat Oncol Biol Phys, 2015 Sep 1  93(1), 91-101. PMID26279027
Smith GL, Jiang J, Giordano SH, Meyer LA, & Eifel PJ. Trends in the quality of treatment for patients with intact cervical cancer in the United States, 1999 through 2011. Int J Radiat Oncol Biol Phys, 2015 Jun 1  92(2), 260-267. PMID25968823
Tamirisa NP, Parmar AD, Vargas GM, Mehta HB, Kilbane EM, Hall BL, Pitt HA, & Riall TS. Relative Contributions of Complications and Failure to Rescue on Mortality in Older Patients Undergoing Pancreatectomy. Ann Surg, 2015 Jan 5. PMID25563871
Tamirisa NP, Sheffield KM, Parmar AD, Zimmermann CJ, Adhikari D, Vargas GM, Kuo YF, Goodwin JS, & Riall TS. Surgeon and Facility Variation in the Use of Minimally Invasive Breast Biopsy in Texas. Ann Surg, 2015 Jul  262(1), 171-178. PMID25185475


Workshop: Multi-PI Grants
Presented by James S. Goodwin, MD and others at UTMB

CERCIT Workshop August 2014
Fun with Medicare Part D Data presented by James S. Goodwin, MD

CERCIT Workshop August 2014
Shared Decision Making in Cancer Care presented by Nina Tamirisa, MD

CERCIT Workshop June 2014
The use of surgery in the elderly for management of metastatic epidural spinal cord compression
presented by Justin E. Bird, MD

CERCIT Workshop June 2014
Population-based assessment of breast reconstruction
presented by Ben Smith, MD

Data & Reports

Fact Sheets

Prostate Cancer [PDF]: Prostate Specific Antigen (PSA) Testing in Men Aged 65 & Older

Mammography [PDF]: Mammography in Women Aged 65 & Older

Colonoscopy [PDF]: Colonoscopy in Adults Aged 65 & Older

Reports and Special Publications

Surveillance Patterns Following Lung Cancer Resection [PDF]: This report describes the current population-based trends in surveillance practices and the use of these modalities in patients with non-small cell lung cancer (NSCLC) following curative resection.

Comparative Effectiveness of MRI vs. Mammography Alone in Patients Undergoing Breast-Conserving Therapy for Breast Cancer [PDF]: This report compares the effectiveness of MRI vs. mammography alone in patients undergoing breast-conserving therapy for breast cancer

Hispanic Cancer Report [PDF]: From A quarterly publication of the Texas Public Health Association (TPHA) Supplement, Fall 2013, A Comprehensive Report on Cancer among Hispanics in Texas.

CERCIT Featured in the Texas Public Health Journal Summer 2013
Using research to keep Texans informed about cancer care – that is at the heart of CERCIT (Comparative Effectiveness Research on Cancer in Texas). A description of this project and selected articles from its four research areas are featured in the Spring 2013 issue of the Texas Public Health Journal, a quarterly publication of the Texas Public Health Association (pages 22-55):

Just how much does cancer cost in Texas? [PDF] Texas Public Health Journal, Vol 63, Issue 4, Fall 2011. Findings are reported in the Cost of Cancer in Texas, 2005 [PDF] published by the Texas Cancer Council.

Site managed by Sealy Center on Aging • Last Updated: Nov 2016

Manuscript Acknowledgement: This work was supported [in part] by the Comparative Effectiveness Research on Cancer in Texas (CERCIT) Grant #RP140020, funded by The Cancer Prevention Research Institute of Texas (CPRIT).