The Nation's Investment in Cancer Research
A Plan and Budget Proposal for Fiscal Year 2008
Prepared by the Director, National Cancer Institute as mandated by The National Cancer Act (P.L. 92-218)
Overcoming Cancer Health Disparities
We will study and identify factors contributing to disparities, develop culturally appropriate approaches, and disseminate interventions to overcome those disparities across the cancer control continuum from disease prevention to end-of-life care.
Today's Research
It is well known that many population groups across the United States and around the world suffer more severely from cancer and its sequelae (after-effects). Overcoming cancer health disparities is one of the best opportunities we have for lessening the burden of cancer. NCI's investments are speeding the development and use of interventions to combat disparities across the cancer control continuum and among all underserved populations. Examples of NCI research include:
- Supporting health disparities research through NCI's biology, etiology, prevention, detection, and treatment research portfolios
- Addressing economic, social, cultural, psychological, behavioral, and biologic factors that contribute to cancer health disparities
- Developing and supporting resources and infrastructure for health disparities research
- Informatics
- Specimens, drug, and reagent resources
- Clinical trials groups
- Statistical methodology
- Centers and consortia
- Supporting education and training for careers in cancer health disparities research
Tomorrow's Strategies
Addressing the needs of the medically underserved by applying emerging evidence-based findings and research resources is a critical component of NCI's strategies to reduce cancer health disparities. Specifically, we will:
- Build on our understanding of the factors that cause cancer health disparities.
- Work with communities to develop interventions targeted to the specific needs of under-served populations.
- Provide the knowledge base for and develop interventions to better coordinate and integrate cancer services for underserved populations.
- Develop innovative, educationally- and culturally-appropriate approaches for disseminating information on research results to underserved populations. Work with others to put these approaches into practice.
- Examine the role of health policy in reducing and eliminating cancer health disparities.
- Work with others to develop a workforce of researchers and clinicians who will address cancer health disparities.
Moving Research Forward
…by Addressing the Causes of Cancer Health Disparities
With support from NCI, scientists are learning more about why some population groups have higher cancer incidence and mortality rates than others. For example, we know that many evidenced-based interventions, including cancer screening, are not adequately reaching all populations. Other research shows that, in addition to uneven access to cancer care interventions, there may be a genetic component to some cancer health disparities.
…and Progress in Pursuit of our Goal
- Interventions to Improve Cancer Screening. An NCI study found that centralized telephone care management increases screening rates for breast, cervical, and colorectal cancer in women. The study included more than 1,400 women who obtained care at community and migrant health centers in New York City. Women who were overdue for cancer screening were randomly assigned to one of two groups. Women in the usual care group received one telephone call to answer questions and review their status. Women in the intervention group received a series of telephone calls that provided information about screening, scheduled appointments, and motivational support. Screening rates in the intervention group increased by 10 percent for Pap testing for cervical cancer, 17 percent for mammography, and 60 percent for colorectal cancer screening. The findings show how a modest intervention can increase screening rates in largely minority populations.
- Differences in Smoking-related Lung Cancer Risk. In one of the largest prospective studies of its kind, NCI researchers found significant racial and ethnic differences in smoking-related lung cancer risk, after ruling out differences in diet, occupation, and education level. Analyzing data from almost 200,000 study participants, researchers found that among individuals who smoked 10 cigarettes or less a day, Whites had a 55 percent lower risk of lung cancer than Blacks, and among those who smoked 11 to 20 cigarettes daily, the risk was 43 percent lower. Among Hispanics and Japanese Americans, the percentages were lower still. However, the risk difference was minimal among people who smoked 30 cigarettes or more a day. While research into the environmental factors that influence lung cancer risk across populations is still vital, the investigators suggest that genomic research may eventually pinpoint genes that increase susceptibility to smoking-related lung cancer and may help explain these racial and ethnic differences.
