Strategic approaches to cancer control research in NCI-funded research bases

Although the Community Clinical Oncology Program (CCOP) of the National Cancer Institute (NCI) has always encouraged research on cancer prevention and control issues, the clinical cooperative groups and cancer centers that serve as CCOP "research bases" were not required to conduct cancer control research until June 1987. This article draws upon case studies of six cooperative groups and two cancer centers to examine how CCOP research bases have defined cancer control research to be compatible with their missions, restructured roles and relationships to facilitate protocol development and implementation, and routine cancer control research to make prevention and control studies an accepted component of their scientific programs. Three "deliberate" or "emergent" strategies are found to be associated with the earlier resolution of problems and more rapid assimilation of cancer control studies into research base agendas. These strategies include (1) proactive planning, such as the early formation of a Cancer Control Research Committee (CCRC) and the identification of "idea champions" to promote cancer prevention and control research; (2) a staged approach to defining and introducing cancer control research; and (3) the creation of multiple "bridging" mechanisms to link cancer prevention and control studies with ongoing research activities. Research bases were most successful in building investigator commitment to cancer control research when they framed research questions within an accepted scientific paradigm, sought out and supported investigators with an interest in cancer prevention and control questions, created CCRCs with broadly representative memberships, and widely publicized ideas for prevention and control studies.