Welcome Comparative Effectiveness Research on Cancer in Texas (CERCIT)

The goal of CERCIT is to find evidence that will help patients and their physicians make individualized decisions about the best cancer care options, including screening, treatment and end of life care in cancer.

CERCIT is a multidisciplinary consortium of investigators at the University of Texas Medical Branch (UTMB), MD Anderson Cancer Center (MDACC), UT Health Science Center at Houston (UTHealth), UT Southwestern Medical Center in Dallas (UTSW), and the Texas Department of State Health Services Texas Cancer Registry. CERCIT is funded by the Cancer Prevention Research Institute of Texas (CPRIT).


Video: Comparative Effectiveness Research (and Patient-Centered Outcomes Research)

video screenshotA Geriatric Medicine Conference lecture on Comparative Effectiveness Research (and Patient-Centered Outcomes Research) was presented by James S. Goodwin, MD, George and Cynthia Mitchell Distinguished Chair of Geriatric Medicine, Department of Internal Medicine, Division of Geriatrics on November 28, 2018 at UTMB. Dr Goodwin is the PI of the CERCIT as well as the Patient-Centered Outcomes Research in the Elderly program at UTMB.




Video: Exercise Guidance After a Cancer Diagnosis: Evidence and Logistics

screenshotA special lecture sponsored by Center for Recovery, Physical Activity, and Nutrition (CeRPAN) with the Department of Nutrition & Metabolism as part of the UTMB School of Health Professions 50th Anniversary lecture series on July 25, 2018.

Presented by Kathryn Schmitz, PhD, MPH, Professor of Epidemiology, Penn State College of Medicine, Department of Public Health Sciences; Associate Director of Population Sciences, Penn State Cancer Institute.


Demographic Variations in Texas

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

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.


2018 CERCIT Publications

Fang P, He W, Gomez D, Hoffman KE, Smith BD, Giordano SH, Jagsi R, Smith GL. Racial disparities in guideline-concordant cancer care and mortality in the United States. Adv Radiat Oncol. 2018 May 4; 3(3):221-229.

PMID:  30202793

Goodwin, J. S., Li, S., Middleton, A., Ottenbacher, K., & Kuo, Y. F. (2018). Differences between skilled nursing facilities in risk of subsequent long-term care placement. J Am Geriatr Soc, 2019.  doi:10.1111/jgs.15377

PMID:  29656399

Henry ML, Niu J, Zhang N, Giordano SH, Chavez-MacGregor M. Cardiotoxicity and cardiac monitoring among chemotherapy-treated breast cancer patients. JACC Cardiovasc Imaging 2018 Aug; 11(8):1084-1093.

PMID:  30092967

Hirth JM, Hatch SS, Lin YL, Giordano SH, Silva HC, Kuo YF.  Development and validation of algorithms to differentiate ductal carcinoma in situ from invasive breast cancer within administrative claims data.  Cancer 2018 July 1; 124(3):2815-2823.

PMID:  29669162

Hoover DS, Pappadis MR, Housten AJ, Krishnan S, Weller SC, Giordano SH, Bevers TB, Goodwin JS, Volk RJ.  Preferences for communicating about breast cancer screening among racially/ethnically diverse older women. Health Commun, 2018; 1-5. doi:10.1080/10410236.2018.1431026

PMID:  29373069

Karuturi MS, Holms HM, Lei X, Johnson M, Barcenas CH, Cantor SB, Gallick GE, Bast RC Jr, Giordano SH. Potentially inappropriate medication use in older patients with breast and colorectal cancer. Cancer 2018 July 15; 124(14):3000-3007.

PMID: 29689595 

Kehl KL, Niu J. Chavez-MacGregor M, Giordano SH.  Hospitalization by cytotoxic chemotherapy regimen among older women with stage IV breast cancer. Cancer 2018 Sept 28. Doi:  10.1002/cncr.31760 [Epub ahead of print]

PMID:  30264853

Manzano JM, Yang M, Zhao H, Elting LS, George MC, Luo R, Suarez-Almazor ME. Readmission patterns after GI cancer hospitalizations: The medical versus surgical patient. J Oncol Pract, 2018; 14(3), e137-e148. doi:10.1200/JOP.2017.026310.

PMID:  29443648

Mehta HB, Sura SD, Adhikari D, Andersen CR, Williams SB, Senagore AJ, Kuo YF, Goodwin JS.  Adapting the Elixhauser comorbidity index for cancer patients. Cancer, 2018; 124(9), 2018-2025. doi:10.1002/cncr.31269.

PMID:  29390174

Meyer LA, He W, Sun CC, Zhao H, Wright AA, Suidan RS, Dottino J, Alejandro Rauh-Hain J, Lu KH, Giordano SH.  Neoadjuvant chemotherapy in elderly women with ovarian cancer:  Rates of use and effectiveness.  Gynecol Oncol. 2018 Sept; 150(3):451-459.

PMID:  29961559

Ost DE, Niu J, Zhao H, Grosu HB Giordano SH. Quality gaps and comparative effectiveness of management strategies for recurrent malignant pleural effusions. Chest, 153(2), 438-452. doi:10.1016/j.chest.2017.08.026.

PMID:  28864054

Pan HY, Jiang J, Hoffman KE, Tang C, Choi SL, Nguyen QN, Frank SJ, Anscher MS, Shih YT, Smith BD.  Comparative toxicities and cost of intensity-modulated radiotherapy, proton radiation, and stereotactic body radiotherapy among younger men with prostate cancer. J Clin Oncol, 2018; JCO2017755371. doi:10.1200/JCO.2017.75.5371.

PMID:  29561693

Pappadis MR, Volk RJ, Krishnan S, Weller SC, Jaramillo E, Hoover DS, Giordano SH, Tan A, Sheffield KM, Housten AJ, Goodwin JS. Perceptions of Overdetection of Breast Cancer among Women 70 Years of Age and Older in the USA: A Mixed-methods Analysis. BMJ Open. 2018;8:e022138. doi:10.1136/bmjopen-2018-022138

BMJ e022138

Rosenstock AS, Niu J, Giordano SH, Zhao H, Wolff AC, Chavez-MacGregor M.  Acute myeloid leukemia and myelodysplastic syndrome after adjuvant chemotherapy: A population-based study among older breast cancer patients. Cancer, 2018; 124(5), 899-906. doi:10.1002/cncr.31144.

PMID:  29236294

Swanick CW, Lei X, Iu Y, Shen Y, Goodwin NA, Smith GL, Giordano SH, Hunt KK, Jagsi R, Shaitelman SF, Peterson SK, Smith BD.  Long-term patient-reported outcomes in older breast cancer survivors: A population-based survey study. Int J Radiat Oncol Biol Phys, 2018; 100(4), 882-890. doi:10.1016/j.ijrobp.2017.11.047.

PMID:  29485067

Tamirisa NP, Goodwin JS, Kandalam A, Linder SK, Weller S, Turrubiate S, Silva C, Riall TS.   Patient and physician views of shared decision making in cancer. Health Expect 2018;, 20(6), 1248-1253. doi:10.1111/hex.12564


Taylor JS, He W, Harrison R, Zhao H, Sun CC, Lu KH, Giordano SH, Meyer LA. Disparities in treatment and survival among elderly ovarian cancer patients. Gynecol Oncol. 2018 22. Pii: S0090-8258(18)31175-5.

PMID:  30253875

van la Parra RFD, Liao K, Smith BD, Yang WT, Leung JWT, Giordano SH, Kuerer HM. Incidence and outcome of breast biopsy procedures during follow-up after treatment for breast cancer. JAMA Surg., 2018. doi:10.1001/jamasurg.2017.5572.

PMID:  29387884

Weiss A, Chavez-MacGregor M, Lichtensztajn DY, Yi M, Tadros A, Hortobagyi GN, Giordano SH, Hunt KK, Mittendorf EA.  Validation study of the American Joint Committee on Cancer Eighth Edition Prognostic Stage Compared with the anatomic stage in breast cancer. JAMA Oncol, 2018; 4(2), 203-209.doi:10.1001/jamaoncol.2017.4298

PMID:  29222540

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 2016; 16:17. doi:10.1186/s12913-016-1265-1.

PMID:  26772175

Past Videos

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

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

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

The Use of Surgery in the Elderly for Management of Metastatic Epidural Spinal Cord Compression
A CERCIT Workshop presented by Justin E. Bird, MD, June 2014

Population-Based Assessment of Breast Reconstruction
A CERCIT Workshop presented by Ben Smith, MD, June 2014

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.


CERCIT Workshop Presentations

In the first five years of CERCIT, we offered clinician-scientist training in Comparative Effectiveness Research on Cancer in Texas.
Trainees attended monthly workshops. A selection of those workshop presentations are now available as resources linked below:

Presenter Presentation
Mary Austin, MD, MPH Identifying Geographic & Socioeconomic Disparities in Access to Care for Pediatric Cancer Patients in Texas
Carlos Barcenas, MD, MSc Breast Imaging Surveillance in Breast Cancer Survivors
  Comparative analysis of chemotherapy-related toxicities in breast cancer regimens using population-based databases
  Toxicities of Chemotherapy Regimens used in Early Breast Cancer
Jaime Bennarch-Gampel, MD Surveillance of Pancreatic Cancer Patients Following Surgical Resection
  Colonoscopist and Primary Care Physician Supply and Disparities in Colorectal Cancer Screening
Justin Bird, MD The use of surgery in the elderly for management of metastatic epidural spinal cord compression
Casey Boyd, MD CERCIT Scholar Presentation- The Survivorship Experience in Pancreatic Cancer
Cheryl Bowcock, MPH (TCR) Overview of Texas Medicaid Data
Mariana Chavez-MacGregor, MD, MSc Cardiac monitoring among trastuzumab- treated patients: A population-based study in older patients with breast cancer
  Trastuzumab-related cardiotoxicity: a population based study in older patients with breast cancer
Catherine Cooksley, DrPH Model of a Proposed Query Tool
  Case Study Using Linked Cancer Registry & Claims Data
Amanda Cooper, MD The Use of PET and PET/CT in the Management of Metastatic Colorectal Cancer
Justin Dimick, MD Advances in the Science of Quality Measurement
Francesca Dimou, MD Trends in Receipt and Timing of Multimodality Therapy in Early Stage Pancreatic Cancer
Xianglin L. Du, PhD Exploring Medicaid Data for Research: Potentials and Pitfalls
Casey B. Duncan et. al. The Effect of Depression on Diagnosis, Treatment, and Survival in Pancreatic Cancer
  Hospital and Medical Care Days in Pancreatic Cancer
Linda Elting, DrPH Comparative Effectiveness of Granulocyte Growth Factors Among Elderly Patients with Non-Hodgkin's Lymphoma
  Screening Mammography Capacity
  Medicaid Coverage Analyses
  Security, Privacy and Ethical Issues in Database Research
Karl Eschbach, PhD Spatial Distribution of Cancer in Texas
  Geography, Geographic Information Systems and Cancer Comparative Effectiveness Research
Jean Freeman, PhD and James S. Goodwin, MD Cancer Effectiveness Research and the Texas Cancer Registry
Sharon Giordano, MD, MPH Clinical trial enrollment among older cancer patients
  CERCIT Project 2: Assessing the Quality of Cancer Treatment in Texas
Daniel Gomez, PhD CERCIT Scholar Presentation - An Estimation of Guideline Adherence to Nausea and Vomiting Prophylaxis in Patients Receiving Concurrent Chemoradiation for Lung Cancer, and the Implications of Chemoradiation for Lung Cancer, and the Implications of Adherence to these Guidelines: A State-wide, Population-based Study
James S. Goodwin, MD Fun with Medicare Part D Data
  Provider Level Analyses of Receipt of Colorectal Cancer Screening (mostly colonoscopy)
  Provider Level Analyses of Screening Mammography Use in Women with Limited Life Expectancy
  Writing a NIH proposal under the new guidelines
  What is Comparative Effectiveness Research?
  Colonoscopist and Primary Care Physician Supply and Disparities in Colorectal Cancer Screening
B. Ashleigh Guadagnolo, MD, MPH Using claims data to investigate RT use at the end of life
Vivian Ho PhD Explaining the Volume-Cost Relationship for Cancer Surgery
  Health Economics and Cancer Effectiveness Research
Karen Hoffman, MD, MHSc, MPH Influence of Diagnosing Urologist on Management of Favorable Prostate Cancer
  Prostate Cancer Treatment of Older Men in Texas: Population-based Practices and Quality of Care
Holly Holmes, MD Using Medicare Part D Data
Elizabeth Jaramillo, MD Variation in PSA Screening among Primary Care Physicians
  Overuse of PSA Screening for Prostate Cancer in Older Men
Yong-Fang Kuo, PhD Data Management of Linkage of Texas Cancer Registry with other Sources
Carol Lewis, MD, MPH Post-Treatment Surveillance for Head and Neck Cancer
Steven Lin, MD, PhD Population-based Analysis of Late Effects and Health Status of Survivors Treated with Radiation for Thoracic Malignancies
  The Impact of Radiation Therapy Technology Use on Cardiopulmonary Mortality in the Elderly with Esophageal Cancer
Elaine Liu, PhD Instrumental Variables Estimation: Why, What and How?
Joann-Grace M. Manzano, MD Unplanned Hospitalizations and Readmissions among Elderly Patients with Gastrointestinal Cancer
Techksell McKnight, MD, MPH The Use of MRI in the Evaluation of Breast Cancer
Sahil Mittal, MD Effectiveness of locoregional therapy before liver transplant for liver cancer
Mary Ninan, MD Hospitalization for toxicity in patients treated with Rituximab
Abhishek Parmar, MD Quality of Post-Treatment Surveillance of Early Stage Breast Cancer in Texas
  Trajectory of Care and Use of Multimodality Therapy in Locoregional Pancreatic Adenocarcinoma
Jeremy Rassen, ScD Instrumental variable methods in comparative effectiveness research
Taylor Riall, MD, PhD Social Network Analysis and Physician Practice Patterns
  Trends and Comparative Effectiveness in Treatment of Stage IV Colorectal Adenocarcinoma
Ana Rodriguez, MD Second primary cancer after radiotherapy in women with invasive cervical carcinoma
  Utilization of BRCA Testing in Older Women with Breast and Ovarian Cancer in Texas
Amanda Scarbrough, PhD, MHSA and Carol Trono, MA Texas AHEC East, CERCIT and Knowledge Translation
Jay Shah, MD The Road Less Traveled: Does Bladder Cancer Care Differ Between Rural and Urban Texas?
Gulshan Sharma MD, MPH Overuse of care, considered aggressive at end of life
Ben Smith, MD Local Therapy for Early Breast Cancer: Trends, Complications, and Patient-Centered Outcomes
  Moving from patient to physician to networks: Old and new approaches to evaluating quality and disparities in breast cancer care
  Population-based assessment of breast reconstruction: Care Patterns, Disparities, and Outcomes
Grace Smith, MD, PhD, MPH Utilization and Outcomes of Breast Brachytherapy in Younger Women
  Patterns of Care in Patients with Cervical Cancer
  Using Claims to Study Cancer Survivors
Maria Suarez-Almazor, MD, PhD Use of DXA in Patients with Prostate Cancer and Breast Cancer Initiating Hormonal Therapy
Nina Tamirisa, MD Shared Decision Making In Cancer Care
  Underuse of Minimally Invasive Breast Biopsy in Texas: The Role of the Surgeon
Gabriela Vargas, MD Physician Follow-Up and Guideline Adherence in Post-Treatment Surveillance of Colorectal Cancer
  Timing of Chemotherapy and Primary Tumor Resection in Older Patients with Stage IV Colorectal Cancer
Melanie Williams, PhD (TCR) The Texas Cancer Registry: Who, What, When, How, etc.
  Linking Texas Cancer Registry Data
Leonard Zwelling, MD, MBA Conflict of Interest in Academia-Straining the Public's Trust
  RED KOOL-AID,BLUE KOOL-AID Health Care Reform-The Key Is the 4 P's
Site managed by Sealy Center on Aging • Last Updated: September 2019
UTMB MDACC UT Health Science Center Houston UTSW TCR DSHS CPRIT

CERCIT is a multidisciplinary consortium of investigators at the University of Texas Medical Branch (UTMB), MD Anderson Cancer Center (MDACC), UT Health Science Center at Houston (UTHealth), UT Southwestern Medical Center in Dallas (UTSW), and the Texas Department of State Health Services Texas Cancer Registry. CERCIT is funded by the Cancer Prevention Research Institute of Texas (CPRIT). Manuscript Acknowledgement: This work was supported [in part] by the Comparative Effectiveness Research on Cancer in Texas (CERCIT) Grant #RP160674, funded by The Cancer Prevention Research Institute of Texas (CPRIT).