Health Disparities

The National Cancer Institute (NCI) has targeted the reduction of cancer-related health disparities as an important challenge. Health disparities are differences in the incidence, prevalence, mortality, and burden of cancer and related adverse health conditions that exist among specific population groups in the United States. These population groups may be characterized by gender, age, ethnicity, education, income, social class, disability, geographic location, or sexual orientation. The goal is to understand the causes of health disparities in cancer and develop effective interventions to reduce or eliminate them.

The Epidemiology and Genetics Research Program (EGRP) supports a variety of research addressing health disparities. Ongoing, large, investigator-initiated cohort studies have and will continue to be critical to understanding the determinants of cancer incidence and mortality in underserved populations. These studies involve collection of extensive health information and biological specimens from thousands to tens-of-thousands of persons from different population groups who are then followed over time to determine cancer occurrence or death from cancer. Examples of cohort studies funded at least in part by EGRP which are contributing to the understanding of cancer-related disparities include:

• Black Women's Cohort
• Multiethnic/Minority Cohort Study of Diet and Cancer (MEC)
• Southern Community Cohort Study

Case-control studies are another commonly used approach in epidemiologic research. In case-control studies persons with cancer and persons without cancer are compared in terms of genetic, lifestyle and other factors, such as race and ethnicity, age, gender, socioeconomic status, and geographic location. Comparisons within case-control studies, such as by ethnic group, can provide key insights into differences in cancer risk. EGRP supports many case-control studies. In addition, two large research resources sponsored by EGRP which recruit participants and collect data from a variety of population groups are:

• Breast and Colon Cancer Family Registries
• Cancer Genetics Network

EGRP also supports regional studies or tools which include research that compares populations with respect to the distribution of risk factors and cancer risk. For example, in the United States, there are several regions in which there is an unusually high incidence of breast cancer, such as Marin County near San Francisco, California, and much of the Northeast. One of the most detailed analyses was carried out on the Long Island population as part of the Long Island Breast Cancer Study Project, a multistudy effort to investigate whether environmental factors are responsible for breast cancer in Suffolk, Nassau, and Schoharie counties, N.Y., and in Tolland County, Conn.

To learn more about EGRP's health disparities research portfolio, view a list of EGRP's active health disparities grants and selected summaries of EGRP-funded research.