The good news: Cancer patients are living longer, per the American Cancer Society’s recently released Statistics report, with 70% of all cancer patients surviving at least five years. The bad news: People are still getting cancer far too often and some, like the folks living in rural communities and most racial/ethnic minority populations, are not surviving as long as the norm.
The factors driving these disparities are outlined in the Cancer Action Plan of Washington, or CAPOW, a five-year strategic plan to reduce cancer rates — and cancer deaths — in the state.
Shaped by the CAPOW Statewide Coalition, a big-tent team of more than 150 individuals from 60-plus groups including nonprofits, health care facilities, native and tribal leaders, early detection programs and academic research and cancer care institutions like Fred Hutch Cancer Center, it’s an ambitious document weighing in at nearly 70 pages.
Along with a slew of statistics and strategies, CAPOW provides a pragmatic structure — seven workgroups, 11 priority areas, and 36 objectives — that aligns with federal, state and the CAPOW coalition partners’ goals.
“We know that these are really lofty goals, especially considering this coalition is just getting off the ground,” said Fred Hutch community benefit manager Katie Treend, who until a few months ago worked as the coordinator for the Washington State Department of Health’s Comprehensive Cancer Control Program, which led the CAPOW initiative, supported by the Fred Hutch/University of Washington/Seattle Children’s Cancer Consortium’s Office of Community Outreach & Engagement (OCOE).
“For the first couple of years, the coalition was really focused on just identifying priorities,” she said. “We spent a lot of time working with our communities to find out what those priorities were. Now that the plan is launched and available to the public, we're shifting from a planning mindset to action.”
What action is Fred Hutch taking to drop cancer rates in our state? Read on for some highlights.
Disparities in health outcomes tops CAPOW’s list of priorities and with good reason.
“Every community faces cancer a little bit differently, especially those who are not white, upper class, college-educated individuals who live in an urban setting,” Treend said.
Data from Fred Hutch bears this out:
It’s a lot to tackle, but CAPOW’s aim is to reduce these disparities and promote health equity by marshalling resources and encouraging all kinds of collaborations. Or as Treend puts it, “we want to work smarter and not harder, in terms of leveraging resources.”
Goals include improved health literacy; better representation in cancer research; increased prevention and screening for LGBTQIA+ individuals; better utilization of community health workers and better utilization of transportation resources, completely aligning with the mission and strategic aims of the Fred Hutch Office of Community Outreach & Engagement (OCOE).
Created specifically to reduce the state’s health disparities (and the stigma of cancer), OCOE’s efforts include community partnerships, health fairs, education events, community health assessments and even podcasts. In addition to its main office at Fred Hutch in Seattle, OCOE has offices in Sunnyside and Spokane, where health educators work directly with the public to boost education, outreach and access.
OCOE’s researchers also lead interventions like the GUIDE study, designed to improve participation — and representation — in cancer clinical trials.
“Targeting the structural conditions that prevent inclusive participation in cancer research is key,” said OCOE Director Jason “Jay” Mendoza, MD, MPH, who along with OCOE staff scientist Jean McDougall, PhD, MPH, developed GUIDE to reduce the financial burdens associated with participating in cancer trials.
While cancer therapies offered in clinical trials are free, the transportation costs, parking fees, childcare, missed work and other incidentals fall to the patient.
And they can add up, creating a huge structural barrier. GUIDE is just one way Fred Hutch is busting down these barriers.
Not all, but many cancers can be prevented through behavior and lifestyle changes, which is why CAPOW’s second priority area revolves around cancer prevention efforts.
“Most people recognize how important healthy eating and active living are for general wellness, but they may forget those things can reduce certain types of cancer, as well,” Treend said. “Physical activity reduces bladder, breast, colorectal, endometrial and other cancers. And it helps reduce cancer recurrence, as well.”
Commercial tobacco use also causes many lung cancers (though certainly not all) and it’s linked to other cancers, as well.
“Commercial tobacco cessation is very important,” Treend stressed. “It can be one of the most critical things you can do for your health.”
Fred Hutch has many options for people hooked on commercial tobacco, including free apps developed by cancer prevention researcher Jonathan Bricker, PhD, and his Health and Behavioral Innovations in Technology (HABIT) lab. Bricker holds the Fred Hutch Endowed Chair in Cancer Prevention. Resources for smoking cessation include:
Being overweight or obese also bumps cancer risk, so Bricker has also tailored tools to help people pummel their cancer risk through weight loss. His WeLNES study — Weight Loss, Nutrition, Exercise Study — pairs telephone coaching with Acceptance and Commitment Therapy (ACT), a behavioral therapy that drives change by helping people notice, then move past, unhealthy cravings.
— Fred Hutch Community Benefit Manager Katie Treend, MPH
Colorectal cancer, or CRC, is another CAPOW priority and Fred Hutch researchers are already tackling it via the Fred Hutch/UW Medicine Population Health Colorectal Cancer Screening Program.
“Since the program launched in 2021, colorectal screening rates have risen across our health care system from 62% to 73%, closing more than half of the gap toward the national 80% screening benchmark,” said program director and Fred Hutch/UW Medicine gastroenterologist Rachel Issaka, MD, MAS, in the just-released 2025 Annual Report. Issaka holds the Kathryn Surace-Smith Endowed Chair in Health Equity Research. Other program efforts include:
Additionally, Fred Hutch’s Ulrike “Riki” Peters, PhD, MPH, and Li Hsu, PhD, recently launched a free tool to help people identify whether they have a higher risk of colorectal cancer. Peters holds the Fred Hutch 40th Anniversary Endowed Chair.
Both DNA variants and environmental and lifestyle factors can affect cancer risk. Hsu and Peters’ new free website, MyGeneRisk Colon, can tell you if your lifestyle — and/or your DNA — puts you at a higher risk.
Fred Hutch file photos
With more and more cancer patients surviving long enough to experience the late-term effects of their treatment, the need for continued care and post-treatment “surveillance,” e.g., monitoring for cancer recurrence or other health issues, has increased substantially.
Subsequently, quality of life/survivorship is another CAPOW priority area and one that Fred Hutch is already working to improve. The Survivorship Program, established in 2006 and led by Scott Baker, MD, and Eric Chow, MD, MPH, recently named medical oncologist Vidhya Nair, DO, as its new medical director of Adult Cancer Survivorship.
“We’ve made so many advances in cancer treatments that many patients are being cured and living longer,” Nair explained. “We have to find ways to care for them, not only in terms of monitoring for [cancer] recurrence but also addressing late long-term effects of treatment, including second cancers.”
Survivors have post-treatment psychosocial and sexual health needs, as well, and some may be at high risk for developing cardiovascular disease (CVD), if they received treatment known to cause cardiac effects. Nair said both the risk and the surveillance for CVD depend on the type of treatment, its duration and other risk factors.
“Cardiovascular disease is still the leading cause of death in the U.S.,” she said. “It’s an important comorbidity that can happen in our patients.”
Chow and colleagues, in fact, just published research in JAMA Network Open illustrating the importance of screening cancer survivors for CVD risk after treatment. Chow holds the Jennifer Lynn Kranz, Unravel Pediatric Cancer Endowed Chair at Fred Hutch.
Fred Hutch currently has two long-term follow-up (LTFU) programs, one for people who’ve gone through bone-marrow or stem-cell transplant and another for those who’ve gone through cellular immunotherapy. In addition, any cancer patient can be seen in the Survivorship Clinic by providers like Nair; patients can also get a Survivorship Care Plan, a document that includes their treatment summary, information on potential long-term adverse effects and individualized follow-up recommendations.
Moving forward, a tailored Survivorship program will be embedded into each disease group at Fred Hutch. In breast oncology, for instance, Nair said patients in active treatment (e.g., those going through surgeries, chemo, radiation and other medical therapies) will see their oncologist as well as an APP, or advanced practice provider.
“But once they transition out of active treatment,” Nair said, “they would mostly see an APP, hopefully the same one they were seeing during treatment.”
APPs would continue to monitor these patients for recurrence and address ongoing needs, like managing endocrine therapy side effects. Their oncologists will still be available and involved, as needed, but will mainly focus on newly diagnosed patients just going into treatment. Eventually, patients would transfer their care from survivorship to primary care.
“We’re trying to make the transition from oncology to primary care as smooth as possible,” Nair said. “We want to make sure it’s safe and that we’re addressing these important survivorship topics early on and over the course of time, instead of trying to address it all, say, at one Survivorship Clinic visit.”
Treend said CAPOW is crucial, especially as federal funding cuts and changes in policy have forced many community health centers and cancer prevention programs to tighten their belts.
“We see the cancers rates, the number of people diagnosed at late stages,” she said. “Cancer screening still needs to happen even when people are uninsured. The money can go away, but the work remains. So we have to continue to be steadfast and identify how we can do that work as the resources become sparse or as they change.”
And Fred Hutch — which along with conducting cancer care and research has a federal mandate to serve everyone in Washington state — is a big part of that.
“In times like this, Fred Hutch’s involvement and support of a coalition like CAPOW is critical,” she said. “We already provide financial assistance to patients and provide screenings and try to link people to primary care. But we also have knowledge, we have best practices, we have experience in what works and what doesn’t.”
“Fred Hutch can work with communities, share resources with them,” she said. “We want people to know they don’t have to go it alone.”
Diane Mapes is a senior editor and writer at Fred Hutch Cancer Center, who's written for NBC News, TODAY, CNN, MSN, Seattle Magazine and other publications. A breast cancer survivor and patient advocate, you can reach her at dmapes@fredhutch.org or doublewhammied.com / @double_whammied / @doublewhammied.bsky.social. Just diagnosed and need information and resources? Visit our Patient Care page.
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