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Cary Gross, MD

Professor of Medicine (General Medicine) and of Epidemiology (Chronic Diseases); Founder and Director, Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale School of Medicine; Director, Adult Primary Care Center, Quality Improvement; Chair, National Clinician Scholars Program; Director, National Clinician Scholars Program

Contact Information

Cary Gross, MD

Office Location

Mailing Address

  • General Internal Medicine

    PO Box 208056, 333 Cedar Street

    New Haven, CT 06520-8056

    United States

COPPER Center

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Yale Medicine

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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 relation between funding by the National Institutes of Health and the burden of disease.Gross CP, Anderson GF, Powe NR. The relation between funding by the National Institutes of Health and the burden of disease. The New England Journal Of Medicine 1999, 340: 1881-7. PMID: 10369852, DOI: 10.1056/NEJM199906173402406.
  • 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. PMID: 12533125, DOI: 10.1001/jama.289.4.454.
  • 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 PMID: 28922780, DOI: 10.1093/jnci/djx145.
  • 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. PMID: 22393088, PMCID: PMC3383112, DOI: 10.1200/JCO.2011.39.4890.
  • 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. PMID: 23303200, PMCID: PMC3638736, DOI: 10.1001/jamainternmed.2013.1397.
  • 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. PMID: 23243199, PMCID: PMC3536640, DOI: 10.1093/jnci/djs463.
  • 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. PMID: 23340638, PMCID: PMC3598620, DOI: 10.1001/jama.2012.216219.
  • 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 PMID: 25031307, PMCID: PMC4155428, DOI: 10.1093/jnci/dju159.
  • 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, 179: 1292-1295. PMID: 31233086, PMCID: PMC6593646, DOI: 10.1001/jamainternmed.2019.1058.
  • 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 PMID: 28376191, PMCID: PMC6059114, DOI: 10.1093/jnci/djw330.
  • 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. PMID: 26181021, PMCID: PMC4707944, DOI: 10.1001/jamaoncol.2015.37.
  • 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. PMID: 17088577, DOI: 10.7326/0003-4819-145-9-200611070-00006.
  • 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. PMID: 28275035, DOI: 10.6004/jnccn.2017.0034.
  • 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. PMID: 30646225, PMCID: PMC6324449, DOI: 10.1001/jamanetworkopen.2018.3146.
  • 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. PMID: 15187053, DOI: 10.1001/jama.291.22.2720.
  • Are racial and ethnic minorities less willing to participate in health research?Wendler D, Kington R, Madans J, Van Wye G, Christ-Schmidt H, Pratt LA, Brawley OW, Gross CP, Emanuel E. Are racial and ethnic minorities less willing to participate in health research? PLoS Medicine 2006, 3: e19. PMID: 16318411, PMCID: PMC1298944, DOI: 10.1371/journal.pmed.0030019.
  • 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. PMID: 32091540, PMCID: PMC7042809, DOI: 10.1001/jamainternmed.2020.0030.
  • Association Between Sexual Orientation, Mistreatment, and Burnout Among US Medical Students.Samuels EA, Boatright DH, Wong AH, Cramer LD, Desai MM, Solotke MT, Latimore D, Gross CP. Association Between Sexual Orientation, Mistreatment, and Burnout Among US Medical Students. JAMA Network Open 2021, 4: e2036136. PMID: 33528552, PMCID: PMC7856540, DOI: 10.1001/jamanetworkopen.2020.36136.
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