The National Cancer Institute (NCI) recently launched a new program to reduce cancer deaths among minority and underserved populations through $95 million in grants that will fund community-based projects in geographically and culturally diverse areas of the country.

The new initiative, the Community Networks Program (CNP), was announced on May 6 by Health and Human Services (HHS) Secretary Michael Leavitt. It is part of NCI's ongoing efforts to understand why some population groups - often minorities and the poor - have higher cancer rates than others, and to eliminate disparities by involving local communities in education, research, and training.

"To win the war against cancer we need to better understand the areas where we know that people are dying at higher rates, and we need to find ways to target these communities with culturally relevant approaches," said Dr. Harold Freeman, director of NCI's Center to Reduce Cancer Health Disparities (CRCHD), which oversees CNP.

CNP will include up to 25 projects that reach African Americans, American Indians and Alaska Natives, Hawaiian Natives and other Pacific Islanders, Asians, Hispanics/Latinos, and the rural poor. Twelve grantees will concentrate in local areas, seven in regional ones, and six in national programs.

"It's clear that strategies for preventing cancer are most effective when tailored to a particular community," commented Dr. Freeman. "We have to find ways to apply what we've discovered about reducing cancer deaths on a local level."

Each CNP project will form an advisory group that will serve as the "voice of the community" to seek information from the community and deliver results back to it. Grantees will also work closely with policy makers and nongovernmental funding sources. CNP grantees and NCI will train investigators, identify potential research opportunities, and ensure that research findings are disseminated broadly.

Considerable research has been done on cancer disparities over the last 5 years through the Special Populations Networks program, also overseen by CRCHD. That program, which ends this year, focused on raising awareness about disparities and forging partnerships between research institutions and communities.

The CNP initiative requires grantees to apply the research and show progress toward the goal. "With this program, we are having grantees actually reduce cancer disparities in their communities," said Dr. Kenneth Chu, CNP program director. "Efforts like CNP are vital to ensuring that those who are closest to the problem are closest to the solution."

The aim is to find ways to stimulate people in these communities to adopt proven strategies or interventions for reducing cancer deaths. These include programs to eliminate smoking and increase healthy lifestyles, as well as to screen for the early detection of breast, cervical, and colorectal cancers.

Each CNP project will have three phases. The first phase will focus on developing infrastructure for reducing cancer disparities; the second will include pilot research projects in which local investigators can develop and test interventions. The third phase will focus on ways to sustain interventions once the CNP funds expire.

While cancer is the focus of the program, researchers are optimistic that what they learn can be applied to reducing health disparities in general. "We are building an infrastructure and the skills communities need to address a broad range of health disparities," said Dr. Chu.

By Edward R. Winstead