Cary Gross, MD
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Research Summary
As Director of Yale's Cancer Outcomes Public Policy & Effectiveness Research (COPPER; http://copper.yale.edu/).Center, the over-arching theme of my work is the disconnect between evidence generated from clinical research and the needs of members of patients in the "real-world" setting, outside of clinical trials. Ongoing investigations focus on the comparative effectiveness of different approaches to cancer screening and treatment, the complex interplay of factors affecting the value of cancer care, and the abandonment of low-value approaches to cancer care. Bioethics and research integrity are also a major interest; my work has focused on the scope and impact of financial conflicts, as well as identifying and overcoming barriers to sharing research data as part of the YODA project at Yale (http://yoda.yale.edu/ )
Specialized Terms: Cancer policy; Health policy; Comparative effectiveness; Cancer outcomes; Research ethics and integrity
Extensive Research Description
I am the Director of the COPPER Center at Yale, which aims to improve cancer care and to decrease the burden of cancer on individual patients and society, and to increase equity and patient-centeredness in cancer care. The Center is comprised of researchers and clinicians from across the Yale Schools of Medicine (General Medicine, Geriatrics, Oncology, Radiation Oncology, Dermatology, and Pediatrics), Public Health, and Nursing. We also provide training and mentorship to the next generation of cancer policy and outcomes researchers. Please see the COPPER website for a full description of the team and our work (http://copper.yale.edu/).
I have received NIH-funding from 2002 through the present time, with grants supporting the investigation of barriers to clinical trial enrollment, the impact of non-cancer illnesses on older persons with cancer, and the dissemination of new approaches to cancer screening and treatment into clinical practice.Currently, my collaborators and I are recipients of an NCI Provocative Questions grant, which aims to apply the concept of “social contagion” to cancer practice, shedding new light on the role of physicians and physician patient-sharing networks in the adoption of unproven technologies and the abandonment of proven ineffective treatments in cancer care.
Our recent grant through the American Cancer Society explores trends in breast cancer screening from both a clinical and policy perspective. Partnering with the Blue Cross Blue Shield Alliance for Health Research, we are assessing the association between state breast density legislation and the adoption of new breast imaging modalities, as well as evaluating the effectiveness of these newer approaches to breast cancer screening.
I am particularly interested in cancer in older persons. Cancer is an aging-related disease, and elderly cancer patients tend to have worse outcomes than their younger counterparts. This is likely due, at least in part, to the myriad of non–cancer problems that tend to accrue with age. To provide greater clarity for patient and provider decision-making, we are exploring the manner in which non–cancer chronic illnesses and geriatric syndromes affect the care and outcomes of older patients with colorectal cancer. We are using a large population-based cohort of patients with cancer derived from administrative data, and in a separate study, COPPER is participating in a prospective cohort study of older patients with cancer as part of the Cancer in Aging Research Group (CARG: http://www.mycarg.org/home).
Coauthors
Research Interests
Chronic Disease; Epidemiology; Health Policy; Internal Medicine; Ethics, Research
Selected Publications
- The relationship between clinical benefit and receipt of curative therapy for prostate cancer.Raldow AC, Presley CJ, Yu JB, Sharma R, Cramer LD, Soulos PR, Long JB, Makarov DV, Gross CP. The relationship between clinical benefit and receipt of curative therapy for prostate cancer. Archives Of Internal Medicine 2012, 172:362-3.
- Assessing the impact of a cooperative group trial on breast cancer care in the medicare population.Soulos PR, Yu JB, Roberts KB, Raldow AC, Herrin J, Long JB, Gross CP. Assessing the impact of a cooperative group trial on breast cancer care in the medicare population. Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology 2012, 30:1601-7.
- The cost of breast cancer screening in the Medicare population.Gross CP, Long JB, Ross JS, Abu-Khalaf MM, Wang R, Killelea BK, Gold HT, Chagpar AB, Ma X. The cost of breast cancer screening in the Medicare population. JAMA Internal Medicine 2013, 173:220-6.
- Proton versus intensity-modulated radiotherapy for prostate cancer: patterns of care and early toxicity.Yu JB, Soulos PR, Herrin J, Cramer LD, Potosky AL, Roberts KB, Gross CP. Proton versus intensity-modulated radiotherapy for prostate cancer: patterns of care and early toxicity. Journal Of The National Cancer Institute 2013, 105:25-32.
- Use of hospital-based acute care among patients recently discharged from the hospital.Vashi AA, Fox JP, Carr BG, D'Onofrio G, Pines JM, Ross JS, Gross CP. Use of hospital-based acute care among patients recently discharged from the hospital. JAMA 2013, 309:364-71.
- Online professionalism investigations by state medical boards: first, do no harm.Greysen SR, Johnson D, Kind T, Chretien KC, Gross CP, Young A, Chaudhry HJ. Online professionalism investigations by state medical boards: first, do no harm. Annals Of Internal Medicine 2013, 158:124-30.
- Evolution of breast cancer screening in the Medicare population: clinical and economic implications.Killelea BK, Long JB, Chagpar AB, Ma X, Wang R, Ross JS, Gross CP. Evolution of breast cancer screening in the Medicare population: clinical and economic implications. Journal Of The National Cancer Institute 2014, 106.
- The Impact of Social Contagion on Physician Adoption of Advanced Imaging Tests in Breast Cancer.Pollack CE, Soulos PR, Herrin J, Xu X, Christakis NA, Forman HP, Yu JB, Killelea BK, Wang SY, Gross CP. The Impact of Social Contagion on Physician Adoption of Advanced Imaging Tests in Breast Cancer. Journal Of The National Cancer Institute 2017, 109.
- Regional-Level Correlations in Inappropriate Imaging Rates for Prostate and Breast Cancers: Potential Implications for the Choosing Wisely Campaign.Makarov DV, Soulos PR, Gold HT, Yu JB, Sen S, Ross JS, Gross CP. Regional-Level Correlations in Inappropriate Imaging Rates for Prostate and Breast Cancers: Potential Implications for the Choosing Wisely Campaign. JAMA Oncology 2015, 1:185-94.
- Contrary To Conventional Wisdom, Physicians Abandoned A Breast Cancer Treatment After A Trial Concluded It Was Ineffective.Howard DH, Soulos PR, Chagpar AB, Mougalian S, Killelea B, Gross CP. Contrary To Conventional Wisdom, Physicians Abandoned A Breast Cancer Treatment After A Trial Concluded It Was Ineffective. Health Affairs (Project Hope) 2016, 35:1309-15.
- The effect of age and chronic illness on life expectancy after a diagnosis of colorectal cancer: implications for screening.Gross CP, McAvay GJ, Krumholz HM, Paltiel AD, Bhasin D, Tinetti ME. The effect of age and chronic illness on life expectancy after a diagnosis of colorectal cancer: implications for screening. Annals Of Internal Medicine 2006, 145:646-53.
- Racial and Ethnic Disparities in Oncotype DX Test Receipt in a Statewide Population-Based Study.Davis BA, Aminawung JA, Abu-Khalaf MM, Evans SB, Su K, Mehta R, Wang SY, Gross CP. Racial and Ethnic Disparities in Oncotype DX Test Receipt in a Statewide Population-Based Study. Journal Of The National Comprehensive Cancer Network : JNCCN 2017, 15:346-354.
- Low-Income Children With Chronic Conditions Face Increased Costs If Shifted From CHIP To Marketplace Plans.Peltz A, Davidoff AJ, Gross CP, Rosenthal MS. Low-Income Children With Chronic Conditions Face Increased Costs If Shifted From CHIP To Marketplace Plans. Health Affairs (Project Hope) 2017, 36:616-625.
- Use of Alternative Medicine for Cancer and Its Impact on Survival.Johnson SB, Park HS, Gross CP, Yu JB. Use of Alternative Medicine for Cancer and Its Impact on Survival. Journal Of The National Cancer Institute 2018, 110.
- Factors Associated With Cancer Disparities Among Low-, Medium-, and High-Income US Counties.O'Connor JM, Sedghi T, Dhodapkar M, Kane MJ, Gross CP. Factors Associated With Cancer Disparities Among Low-, Medium-, and High-Income US Counties. JAMA Network Open 2018, 1:e183146.
- Association of State Dense Breast Notification Laws With Supplemental Testing and Cancer Detection After Screening Mammography.Busch SH, Hoag JR, Aminawung JA, Xu X, Richman IB, Soulos PR, Kyanko KA, Gross CP. Association of State Dense Breast Notification Laws With Supplemental Testing and Cancer Detection After Screening Mammography. American Journal Of Public Health 2019, 109:762-767.
- Adoption of Digital Breast Tomosynthesis in Clinical Practice.Richman IB, Hoag JR, Xu X, Forman HP, Hooley R, Busch SH, Gross CP. Adoption of Digital Breast Tomosynthesis in Clinical Practice. JAMA Internal Medicine 2019.
- Assessment of the Prevalence of Medical Student Mistreatment by Sex, Race/Ethnicity, and Sexual Orientation.Hill KA, Samuels EA, Gross CP, Desai MM, Sitkin Zelin N, Latimore D, Huot SJ, Cramer LD, Wong AH, Boatright D. Assessment of the Prevalence of Medical Student Mistreatment by Sex, Race/Ethnicity, and Sexual Orientation. JAMA Internal Medicine 2020, 180:653-665.
- Scope and impact of financial conflicts of interest in biomedical research: a systematic review.Bekelman JE, Li Y, Gross CP. Scope and impact of financial conflicts of interest in biomedical research: a systematic review. JAMA 2003, 289:454-65.
- Participation in cancer clinical trials: race-, sex-, and age-based disparities.Murthy VH, Krumholz HM, Gross CP. Participation in cancer clinical trials: race-, sex-, and age-based disparities. JAMA 2004, 291:2720-6.