Yale School of Medicine

Internal Medicine

Internal Medicine, Yale School of Medicine

Internal Medicine
333 Cedar Street
Room LMP-1072
P.O. Box 208056
New Haven, CT 06520-8056

Cary P. Gross

Cary P. Gross

Associate Professor of Medicine,
Associate Director, Robert Wood Johnson Clinical Scholars Program
Section of General Internal Medicine

Research Activities

Cancer in older persons

Cancer is commonly a disease of the elderly, 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. We are exploring the manner in which non–cancer chronic illnesses affect the care and outcomes of older patients with colorectal cancer. Using a large population-based cohort of cancer patients as well as qualitative interview studies, we will identify how these conditions affect cancer outcomes as well as how physicians and patients incorporate comorbid conditions into their treatment preferences and goals.

Clinical Research: Methodologic and Ethical considerations

A common criticism of clinical trials is the enrolled patients are highly selected and may not represent patients in the general population. We have identified patient, provider, and health system factors that influence trial enrollment, and have clarified the impact of highly selective eligibility criteria on study generalizability. Our analyses of racial disparities have suggested that decreased access to healthcare is a major culprit in the persistence of disparities in trial participation. I have also studied the political and ethical issues involved in the organization and funding of biomedical research, with a particular focus on relations between industry, academia, and healthcare providers. We have analyzed the scope and impact of financial conflict of interest on clinical research, as well as the perspectives of trial participants on provider and institutional conflicts.

Clinical & Teaching Activities

  • Associate Director, Robert Wood Johnson Clinical Scholars Program
  • Director of Quality Improvement, Adult Primary Care Center, Yale-New Haven Hospital
  • Preceptor, Yale Internal Medicine Residency Longiudinal Clinic

Selected Publications

Cancer in Older Persons

  • Murthy VH, Li Y, Krumholz HM, Gross CP. Age-, race-, and gender-based disparities in cancer trial participation. JAMA. 2004; 291:2720-6.
  • Gross CP, Wong, N, Dubin JA, Mayne ST, Krumholz HM. Enrollment of older persons in cancer trials after the Medicare reimbursement policy change. Archives of Internal Medicine. 2005;165:1514-20.
  • Smith BD, Haffty BG, Buchholz TA, Smith GL, Galusha DH, Bekelman JE, Gross CP. Effectiveness of radiation therapy in older women with ductal carcinoma in situ. Journal of the National Cancer Institute 2006;98:1302-1310.
  • 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;145:646-653.
  • Gross CP, Andersen MS, Krumholz HM, McAvay GJ, Proctor D, Tinetti ME. The Relation between Medicare Screening Reimbursement and Stage at Diagnosis for Older Patients with Colon Cancer. JAMA 2006;296:2815-2822
  • Gross CP, Guo Z, McAvay GJ, Allore HG, Young M, Tinetti ME. Multimorbidity and survival among older persons with colorectal cancer. The Journal of the American Geriatric Society 2006;54(12):1898-1904.
  • Gross CP, McAvay GJ, Guo Z, Tinetti ME. The impact of chronic illnesses on the use and effectiveness of adjuvant chemotherapy for colon cancer. Cancer 2007;109:2410-2419.

Research Methods & Ethics

  • Hampson LA, Agrawal M, Joffe S, Gross CP, Verter J, Emanuel EJ. Patient’s views on financial conflicts of interest in cancer research trials. The New England Journal of Medicine 2006;335:2330-2337.
  • Ross JS, Lackner JE, Lurie P, Gross CP, Wolfe S, Krumholz H. Pharmaceutical company payments to physicians: Early experiences with disclosure laws in Vermont and Minnesota. JAMA 2007;297:1216-1223.
  • Bekelman JE, Li Y, Gross CP. Scope and impact of financial conflicts of interest in biomedical research: A Systematic Review. Journal of the American Medical Association 2003; 289: 454-65.
  • Gross CP, Heiat A, Mallory R, Krumholz. Reporting the recruitment process in published randomized controlled trials: Who are these patients and how did they get here? Annals of Internal Medicine 2002: 137:10-15.
  • Wendler D, Kington R, Madans J, Van Wye G, Pratt LA, Brawley OW, Gross CP, Emanuel E. Are racial and ethnic minorities less willing to participate in health research? Public Library of Science 2006; 3:19-28.
  • Gross CP, Krumholz H, Van Wye G, Emanuel E, Wendler D. Does random treatment assignment cause harm to research participants? Public Library of Science 2006;3(6):0001-0009.
  • UyBico SJ, Pavel S, Gross CP. Recruiting vulnerable populations into research: A systematic review of recruitment interventions. Journal of General Internal Medicine 2007; 22:852-63.
Education:
 M.D., New York University School of Medicine - New York, NY 6/93
Training:
 Residency: Memorial Sloan-Kettering Cancer Center - New York, NY Chief Resident, Department of Medicine, 7/96-6/97
Intern and Resident Internal Medicine, New York Hospital - Cornell Medical Center - New York, NY, 7/93-6/96

Contact

Campus Address
333 Cedar Street
P.O. Box 208025
New Haven, CT 06520

E-mail
ary.gross@yale.edu

Office Phone
203-688-2984
Fax 203-688-40927