Challenges and Opportunities to Conduct Cancer Care Research in China: Experience from a Pilot Project.

Background: Cancer has become the leading cause of death in China. Effective cancer control and population science research programs are desperately needed in China. China Medical Board (CMB) funding has provided us with an opportunity to build a research team specializing in cancer care utilization and access research and demonstrate the usefulness of the accrued data. Their CMB project will describe patterns of cancer screening, incidence, and treatment in Shandong Province in China and enable the researchers to understand possible causes of disparities in cancer control in China. Yao initiated his research of cancer care in China as a PhD student when he was at The Pennsylvania State University but could not find any cancer related public data.

Findings: Although CMB projects do not provide salary support for American faculty, they do provide Chinese scholars in the US an excellent opportunity to help improve health care in China. There are many challenges and opportunities in health care service and utilization research. For example, public data for this type of research does not exist. They had to acquire secondary data from several governmental organizations. They have reconciled regional variations in data management. Once they acquired all the data, They could create the most comprehensive cancer access, utilization, and outcomes research database to date in China and possibly expand this research in Shandong and other provinces. Students and analysts need to be trained to ensure the confidentiality of data linked to personal identifiers of patients and providers. They have also discovered holes in the data. Students and analysts will need to learn to manipulate and analyze large scale, messy, secondary data.

Discussion: They hope that their key findings will identify innovative scientific opportunities to improve cancer control and reduce inequities in communities. They intend to write Chinese articles and reports to disseminate findings to communities, policy makers, and health care providers and to the scientific community. From the policy perspective, this study is a demonstration project drawing policy makers' attention to the importance of comprehensive cancer prevention and control data collection, both for accurate assessment and informed decision making with a high likelihood to effect desired change.