Program in Cancer Health Services and Quality of Care Research

This program co-led by Drs. Roger Anderson and Rajesh Balkrishnan is focused on evaluating issues surrounding access and quality to cancer care services and technologies in the United States and globally. Of particular interest to this group are issues such as quality of care issues in poor and underserved cancer populations including racial/ethnic minorities, rurally residing patients and patients with limited means and resources for cancer care.

Our research has been focusing on cancer care issues in the Appalachian region of the United States and has examined a variety of issues including access/utilization of cancer screening, use of adjuvant cancer treatments and the role of comorbidity/coexisting medical conditions in cancer outcomes in this population. We also have extensively studied cancer care in the elderly using the Medicare-SEER database across a variety of cancers. In addition, we examine issues such as patient reported quality of cancer care and treatment satisfaction using a variety of measures we have developed as a part of our research.

We are in the process of setting up tumor registries collecting patient-centered cancer outcomes information globally in low to middle income countries as well as conducting comparative effectiveness evaluations of cancer treatments and technologies using a population-based framework. Our work has been funded by agencies such as the National Institute of Health, American Cancer Society and the World Health Organization.


Select recent publications

  1. Tan X, Marshall VD, Donohoe J, Camacho F, Anderson RT, Balkrishnan R. Medication use outcomes associated with adjuvant endocrine therapy among  Appalachian breast cancer survivors. Medicine – 94(26):e1071-80, 2015.
  2. Donohoe J, Marshall V, Tan X, Camacho FT, Anderson R, Balkrishnan R. Predicting Late-stageBreast Cancer Diagnosis and Receipt of Adjuvant Therapy: Applying Current Spatial Access to Care Methods in Appalachia.  Medical Care – 53(11):980-8, 2015.
  3. Donohoe J, Marshall V, Tan X, Camacho FT, Anderson R, Balkrishnan R. Evaluating and comparing methods for measuring spatial access to  mammography centers in Appalachia. Health Services and Outcomes  Research Methodology  –  16(1):22-40, 2016.
  4. Donohoe J, Marshall V, Tan X, Camacho FT, Anderson R, Balkrishnan R. Spatial Access to Primary Care Providers in Appalachia: Evaluating Current Methodology. Journal of Primary Care and Community Health – 7(3): 149-158, 2016.
  5. Showalter TN, Camacho F, Cantrell LA, Anderson RT. Determinants of Quality Care and Mortality for Patients With Locally Advanced Cervical Cancer in Virginia. Medicine 95(8):e2913, 2016.
  6. Tan X, Camacho FT, Marshall VD, Donohoe J, Anderson RT, Balkrishnan R. Geographic disparities in adherence to adjuvant endocrine therapy in  Appalachian women with breast cancer. Research in Social and Administrative Pharmacy 13(4):796-810, 2017.
  7. Camacho FT, Tan X, Alcalá HE, Shah S, Anderson RT, Balkrishnan R. Impact of Patient Race and Geographical Factors on Initiation and Adherence to Adjuvant Endocrine Therapy in Medicare Breast Cancer Survivors. Medicine 96(24):e7147-55, 2017.
  8. Garcia C, Yao A, Camacho F, Balkrishnan R, Cantrell LA. A SEER-Medicare analysis of the impact of metformin on overall survival in ovarian cancer. Gynecol Oncol. 146(2):346-350, 2017.
  9. Tan X, Camacho TF, LeBaron VT, Blackhall LJ, Balkrishnan R. Opioid use among female breast cancer patients using different adjuvant endocrine therapy regimens. Breast Cancer Res Treat.PMID: 28639031  (In press, 2017).
  10. Yao N, Alcalá HE, Anderson R, Balkrishnan R. Cancer Disparities in Rural Appalachia: Incidence, Early Detection, and Survivorship. Journal of Rural Health. PMID: 27602545 (In press, 2017).