Cancer Health Disparities
Untitled Document
Key Points
- The National Cancer Institute (NCI) defines "cancer health disparities"
as adverse differences in cancer incidence (new cases), cancer prevalence
(all existing cases), cancer death (mortality), cancer survivorship, and
burden of cancer or related health conditions that exist among specific
population groups in the United States (see Question 1).
- Complex and interrelated factors contribute to the observed disparities
in cancer incidence and death among racial, ethnic, and underserved groups.
The most obvious factors are associated with a lack of health care coverage
and low socioeconomic status (see Question 2).
- Although cancer deaths have declined for both Whites and African Americans/Blacks
living in the United States, African Americans/Blacks continue to suffer
the greatest burden for each of the most common types of cancer (see Question
4).
- American White women have the highest incidence rate for breast cancer,
although African American/Black women are most likely to die from the disease
(see Question 5).
- African American/Black men have the highest incidence rate for prostate
cancer in the United States and are more than twice as likely as White men
to die of the disease (see Question 9).
- NCI is pursuing a variety of programs and initiatives to address cancer
health disparities. In 2001, the Center to Reduce Cancer Health Disparities
(CRCHD) was established to serve as the cornerstone of NCI's efforts to
reduce the unequal burden of cancer in our nation (see Questions 15
and 16).
- How does the National Cancer Institute (NCI) define
"cancer health disparities"?
The National Cancer Institute (NCI) defines "cancer health disparities"
as adverse differences in cancer incidence (new cases), cancer prevalence
(all existing cases), cancer death (mortality), cancer survivorship, and
burden of cancer or related health conditions that exist among specific
population groups in the United States. These population groups may
be characterized by age, disability, education, ethnicity, gender, geographic
location, income, or race. People who are poor, lack health insurance, and
are medically underserved (have limited or no access to effective health
care)—regardless of ethnic and racial background—often bear
a greater burden of disease than the general population.
A close look at cancer incidence and death statistics reveals that certain
groups in this country suffer disproportionately from cancer and its associated
effects, including premature death. For example, African Americans/Blacks,
Asian Americans, Hispanic/Latinos, American Indians, Alaska Natives, and
underserved Whites are more likely than the general population to have higher
incidence and death statistics for certain types of cancer.
- What factors contribute to cancer health disparities?
Complex and interrelated factors contribute to the observed disparities
in cancer incidence and death among racial, ethnic, and underserved groups.
The most obvious factors are associated with a lack of health care coverage
and low socioeconomic status (SES).
SES is most often based on a person's income, education level, occupation,
and other factors, such as social status in the community and where he or
she lives. Studies have found that SES, more than race or ethnicity, predicts
the likelihood of an individual's or a group's access to education, certain
occupations, health insurance, and living conditions—including conditions
where exposure to environmental toxins is most common—all of which
are associated with the risk of developing and surviving cancer. SES, in
particular, appears to play a major role in influencing the prevalence of
behavioral risk factors for cancer (for example, tobacco smoking, physical
inactivity, obesity, and excessive alcohol intake, and health status), as
well as in following cancer screening recommendations.
Research also shows that individuals from medically underserved populations
are more likely to be diagnosed with late-stage diseases that might have
been treated more effectively or cured if diagnosed earlier. Financial,
physical, and cultural beliefs are also barriers that prevent individuals
or groups from obtaining effective health care.
- How does NCI gather data on cancer incidence and death for various
population groups in the United States?
The Surveillance, Epidemiology, and End Results (SEER) Program is NCI's
authoritative source for information about cancer incidence and survival.
SEER collects cancer incidence and survival data from cancer registries
that cover approximately 26 percent of the U.S. population. Over several
decades, SEER has worked diligently to better represent racial, ethnic,
and socioeconomic diversity and currently covers 23 percent of African Americans/Blacks,
40 percent of Hispanic/Latinos, 42 percent of American Indians and Alaska
Natives, 53 percent of Asian Americans, and 70 percent of Hawaiian/Pacific
Islanders living in the United States. In addition, SEER statistics reflect
the U.S. population in regard to poverty and education, with both urban
and rural groups represented. The Methods for Measuring Cancer Disparities:
A Review Using Data Relevant to Healthy People 2010 Cancer-Related Objectives
report (http://seer.cancer.gov/publications/disparities/)
describes how data are collected to measure cancer health disparities.
The incidence and death statistics presented in this fact sheet are from
Tables I-23 through I-28 of the SEER Cancer Statistics Review, 1975-2004
(http://seer.cancer.gov/csr/1975_2004).
These statistics are most often reported as the numbers of new cases of
invasive cancer and cancer deaths per year per 100,000 persons in the U.S.
population. When the statistics focus on cancer incidence and death in a
single gender—for example, on female breast cancer or male prostate
cancer—the numbers are per 100,000 persons of that gender. In addition,
the SEER statistics are age-adjusted to the 2000 U.S. standard population.
Age-adjustment is done because different population groups may not be comparable
with respect to age. Age-adjustment allows cancer incidence and death statistics
(expressed below as cancer incidence and death “rates”) for
these population groups to be compared.
- What are the overall cancer incidence and death
rates for different populations living in the United States?
Although cancer deaths have declined for both Whites and African Americans/Blacks
living in the United States, African Americans/Blacks continue to suffer
the greatest burden for each of the most common types of cancer. For all
cancers combined, the death rate is 25 percent higher for African Americans/Blacks
than for Whites. Incidence and death rates for all cancers among U.S. racial/ethnic
groups are shown in Table 1.
Table 1. Overall Cancer Incidence and Death Rates
|
All Sites |
Racial/Ethnic Group |
Incidence |
Death |
All |
470.1 |
192.7 |
African American/Black |
504.1 |
238.8 |
Asian/Pacific Islander |
314.9 |
115.5 |
Hispanic/Latino |
356.0 |
129.1 |
American Indian/Alaska Native |
297.6 |
160.4 |
White |
477.5 |
190.7 |
Statistics are for 2000-2004, age-adjusted to the 2000 U.S.
standard million population, and represent the number of new cases of invasive
cancer and deaths per year per 100,000 men and women.*
- How do breast cancer incidence and death rates
differ for women from different racial or ethnic groups?
In the United States, White women have the highest incidence rate for breast
cancer, although African American/Black women are most likely to die from
the disease. Breast cancer incidence and death rates are lower for women
from other racial and ethnic groups than for White and African American/Black
women. Incidence and death rates for female breast cancer are shown in Table
2.
Table 2. Female Breast Cancer Incidence and Death Rates
|
Breast |
Racial/Ethnic Group |
Incidence |
Death |
All |
127.8 |
25.5 |
African American/Black |
118.3 |
33.8 |
Asian/Pacific Islander |
89.0 |
12.6 |
Hispanic/Latino |
89.3 |
16.1 |
American Indian/Alaska Native |
69.8 |
16.1 |
White |
132.5 |
25.0 |
Statistics are for 2000-2004, age-adjusted to the 2000 U.S.
standard million population, and represent the number of new cases of invasive
cancer and deaths per year per 100,000 women.*
- What factors might contribute to the higher breast cancer death
rate observed in African American/Black women?
Lack of medical coverage, barriers to early detection and screening, and
unequal access to improvements in cancer treatment may contribute to observed
differences in survival between African American/Black and White women.
In addition, recent NCI-supported research indicates that aggressive breast
tumors are more common in younger African American/Black and Hispanic/Latino
women living in low SES areas. This more aggressive form of breast cancer
is less responsive to standard cancer treatments and is associated with
poorer survival (1).
- How do cervical cancer incidence and death rates differ for women
from different racial or ethnic groups?
Compared to White women in the general population, African American/Black
women are more likely to be diagnosed with cervical cancer. Hispanic/Latino
women, however, have the highest cervical cancer incidence rate. Interestingly,
White women living in Appalachia suffer a disproportionately higher risk
for developing cervical cancer than other White women. The highest death
rate from cervical cancer is among African American/Black women. Incidence
and death rates for cervical cancer are shown in Table 3.
Table 3. Cervical Cancer Incidence and Death Rates
|
Cervix |
Racial/Ethnic Group |
Incidence |
Death |
All |
8.7 |
2.6 |
African American/Black |
11.4 |
4.9 |
Asian/Pacific Islander |
8.0 |
2.4 |
Hispanic/Latino |
13.8 |
3.3 |
American Indian/Alaska Native |
6.6 |
4.0 |
White |
8.5 |
2.3 |
Statistics are for 2000-2004, age-adjusted to the 2000 U.S.
standard million population, and represent the number of new cases of invasive
cancer and deaths per year per 100,000 women.*
- What factors might contribute to the greater burden of cervical
cancer among Hispanic/Latino and African American/Black women?
The disproportionate burden of cervical cancer in Hispanic/Latino and African
American/Black women is primarily due to a lack of screening. In an effort
to understand this disparity in cervical cancer screening, NCI conducted
a study of regions within the United States where cervical cancer incidence
rates are high. They found that cervical cancer rates reflected a larger
problem of unequal access to health care. The Excess Cervical Cancer
Mortality: A Marker for Low Access to Health Care in Poor Communities
report (http://crchd.cancer.gov/attachments/excess-cervcanmort.pdf)
supports reaching these medically underserved groups through culturally
sensitive trained care providers; increasing the number of female health
providers, particularly those of the same race or ethnicity; and removing
cultural and economic barriers to break down resistance to screening for
cervical and other cancers.
Persistent infection with certain strains of the human papillomavirus (HPV)
is the major cause of most cases of cervical cancer. An HPV vaccine is now
available that targets two strains of the virus that are associated with
development of cervical cancer and account for approximately 70 percent
of all cases of cervical cancer worldwide. This vaccine prevents infection
by two HPV strains and has the potential to reduce cervical cancer-related
health disparities both in the United States and around the world. More
information can be found in the NCI fact sheet Human Papillomavirus
(HPV) Vaccines: Questions and Answers at http://www.cancer.gov/cancertopics/factsheet/Prevention/HPV-vaccine
on the Internet.
- How do prostate cancer incidence and death rates
differ for men from different racial or ethnic groups?
African American/Black men have the highest incidence rate for prostate
cancer in the United States and are more than twice as likely as White men
to die of the disease. The lowest death rates for prostate cancer are found
in Asian/Pacific Islander men. Incidence and death rates for prostate cancer
are shown in Table 4.
Table 4. Prostate Cancer Incidence and Death Rates
|
Prostate |
Racial/Ethnic Group |
Incidence |
Death |
All |
168.0 |
27.9 |
African American/Black |
255.5 |
62.3 |
Asian/Pacific Islander |
96.5 |
11.3 |
Hispanic/Latino |
140.8 |
21.2 |
American Indian/Alaska Native |
68.2 |
21.5 |
White |
161.4 |
25.6 |
Statistics are for 2000-2004, age-adjusted to the 2000 U.S.
standard million population, and represent the number of new cases of invasive
cancer and deaths per year per 100,000 men.*
- What factors might contribute to the disproportionate burden of
prostate cancer among African American/Black men?
The higher incidence of prostate cancer in African American/Black men compared
with men from other racial/ethnic groups prompted the hypothesis that genetic
factors might account, in part, for the observed differences. Recent findings
from NCI’s Cancer Genetic Markers of Susceptibility (CGEMS) program
(http://cgems.cancer.gov) and other
investigations support this hypothesis. Researchers have identified changes—called
variants—in human DNA that are associated with the risk of developing
prostate cancer. Different combinations of these variants have been found
in men from different racial/ethnic backgrounds, and each combination is
associated with higher or lower risk for prostate cancer. Nearly all of
the variants associated with an increased risk of developing prostate cancer
were found most often in African American/Black men, and certain combinations
of these variants were associated with a five-fold increased risk of prostate
cancer in men of this racial/ethnic group (2).
In addition, research has shown that low SES, lack of health insurance
coverage, unequal access to health care services, and absence of ties to
a primary care physician are barriers to screening for prostate cancer and
the timely diagnosis of this disease, making African American/Black men
less likely to receive regular physical examinations and screening for prostate
cancer (3).
- Do incidence and death rates differ for colorectal or lung cancer
among various racial and ethnic groups?
African American/Black men and women have the highest incidence and death
rates for both colorectal and lung cancers, while Hispanic/Latinos have
the lowest rates. Colorectal and lung cancer incidence and death rates are
shown in Table 5.
Table 5. Colorectal and Lung Cancer Incidence and Death Rates
|
Colorectal |
Lung and Bronchus |
Racial/Ethnic Group |
Incidence |
Death |
Incidence |
Death |
All |
51.6 |
19.4 |
64.5 |
54.7 |
African American/Black |
62.1 |
26.7 |
76.6 |
62.0 |
Asian/Pacific Islander |
41.6 |
12.3 |
39.4 |
26.9 |
Hispanic/Latino |
39.3 |
13.6 |
33.3 |
23.6 |
American Indian/Alaska Native |
40.8 |
17.0 |
44.0 |
39.9 |
White |
51.2 |
18.9 |
65.7 |
55.0 |
Statistics are for 2000-2004, age-adjusted to the 2000 U.S.
standard million population, and represent the number of new cases of invasive
cancer and deaths per year per 100,000 men and women.*
- Which cancers are diagnosed most often in Asian/Pacific Islander
populations?
Asian Americans and Pacific Islanders have the highest incidence rates
for both liver and stomach cancer and are twice as likely to die from these
cancers as Whites. Incidence and death rates for stomach, liver, and bile
duct cancers are shown in Table 6.
Table 6. Liver and Stomach Cancer Incidence and Death Rates
|
Liver and Bile Duct |
Stomach |
Racial/Ethnic Group |
Incidence |
Death |
Incidence |
Death |
All |
6.2 |
4.9 |
8.1 |
4.2 |
African American/Black |
7.6 |
6.5 |
12.5 |
8.2 |
Asian/Pacific Islander |
13.9 |
10.6 |
14.3 |
8.0 |
Hispanic/Latino |
9.7 |
7.6 |
12.3 |
6.8 |
American Indian/Alaska Native |
9.7 |
8.4 |
11.5 |
7.2 |
White |
5.2 |
4.5 |
7.1 |
3.7 |
Statistics are for 2000-2004, age-adjusted to the 2000 U.S.
standard million population, and represent the number of new cases of invasive
cancer and deaths per year per 100,000 men and women.*
- Why is stomach cancer more commonly diagnosed in Asian/Pacific
Islander populations?
Asian/Pacific Islanders, similar to Hispanic/Latinos, have lower incidence
rates than Whites for most common cancers. However, they suffer more often
from cancers that are related to infections. One risk factor for stomach
cancer is infection with a bacterium called Helicobacter pylori,
or H. pylori. Although additional study is needed, infection with
H. pylori may explain, in part, why Asian/Pacific Islander populations
have higher rates for this type of cancer.
- Which cancer is more commonly diagnosed in American Indian and
Alaska Native populations?
American Indians and Alaska Natives have higher incidence and death rates
for kidney cancer than other racial/ethnic groups. However, these rates
should be viewed with caution because the data currently available for American
Indian/Alaska Native populations are not representative. An analysis of
cancer incidence and mortality data within Native American populations is
the focus of the Annual Report to the Nation on the Status of Cancer
1975-2004, Featuring Cancer in American Indians and Alaska Natives
(http://www.interscience.wiley.com/cancer/report2007),
a yearly publication that summarizes the latest cancer statistics. Incidence
and death rates for kidney and renal pelvis cancers are shown in Table 7.
Table 7. Kidney Cancer Incidence and Death Rates
|
Kidney and Renal Pelvis |
Racial/Ethnic Group |
Incidence |
Death |
All |
12.8 |
4.2 |
African American/Black |
14.3 |
4.1 |
Asian/Pacific Islander |
6.3 |
1.7 |
Hispanic/Latino |
12.4 |
3.6 |
American Indian/Alaska Native |
14.7 |
6.5 |
White |
13.3 |
4.3 |
Statistics are for 2000-2004, age-adjusted to the 2000 U.S.
standard million population, and represent the number of new cases of invasive
cancer and deaths per year per 100,000 men and women.*
- How is NCI working in a coordinated way to reduce
cancer health disparities?
NCI has a longstanding history of pursuing research aimed at understanding
and addressing cancer health disparities. As many as 20 years ago, NCI established
the Special Populations Studies Branch to study groups of people within
the United States who suffer a greater burden of cancer. NCI's commitment
to underserved populations continued to grow and mature over the years,
and, in 2001, the institute established the Center to Reduce Cancer Health
Disparities (CRCHD) to serve as the cornerstone of NCI's efforts to reduce
the unequal burden of cancer in our nation.
Today, CRCHD is working to strengthen and integrate NCI's studies in basic,
clinical, translational, and community-based research that offer opportunities
to advance our understanding of cancer-related health disparities and ways
to effectively address them. CRCHD manages specific programs and grants
aimed at examining the diverse aspects of cancer-related disparities. These
programs are addressing the cultural barriers and biases that racial and
ethnic minorities encounter in obtaining appropriate and timely treatment,
as well as financial and physical restraints that prevent underserved populations
from obtaining quality health care. CRCHD is also leading NCI's efforts
to train students and investigators from diverse populations to pursue research
in cancer, as well as research examining factors that contribute to cancer
health disparities.
CRCHD also cosponsors an annual Cancer Health Disparities Summit. During
this 3-day meeting, NCI-funded researchers from training, education, and
outreach programs gather to discuss both disparities issues that are present
in their communities and possible solutions for these issues.
- What are some of NCI's programs and projects aimed
at addressing cancer health disparities and increasing access to quality cancer
care for medically underserved communities?
NCI and its divisions support diverse research programs that address the
behavioral, biological, treatment, prevention, and economic issues that
all contribute to cancer health disparities. The programs listed below highlight
NCI's commitment to addressing the needs of the medically underserved.
- NCI Community Cancer Centers Program (NCCCP)
(http://ncccp.cancer.gov/index.htm)
In 2007, NCI launched the pilot phase of the NCCCP, an initiative that
aims to bring the latest advances in cancer care to patients in their
own communities. Over the next three years, 16 community hospitals and
health care systems will work with NCI to identify the best strategies
for delivering state-of-the-art cancer care to the greatest number of
Americans in the communities in which they live. The program seeks to
bring more Americans into a system of high-quality cancer care, increase
participation in clinical trials, reduce cancer health care disparities,
and improve information sharing among community cancer centers. The NCCCP
will focus on underserved communities and groups that are disproportionately
affected by cancer.
- The Centers for Population Health and Health Disparities (CPHHD)
(http://cancercontrol.cancer.gov/populationhealthcenters/)
Initiated in 2003, the CPHHD supports a transdisciplinary approach to
overcoming health disparities. The eight centers of the CPHHD initiative
are supported by a collaboration of NCI and other National Institutes
of Health institutes and offices. NCI supports five of the eight centers
that address cancer health disparities through innovative research to
understand the complex interaction of the social and physical environment,
in combination with behavioral and biological factors that determine health
and disease in diverse populations.
- The Community Networks Program (CNP)
(http://crchd.cancer.gov/cnp/background.html)
The CNP aims to reduce cancer health disparities through community-based
education, training, and research among racial and ethnic minorities and
medically underserved populations. The overall goal of this program is
to significantly improve access to—and use of—beneficial cancer
interventions and treatments in communities experiencing cancer health
disparities.
- Minority-Based Community Clinical Oncology Program (MB-CCOP)
(http://prevention.cancer.gov/programs-resources/programs/ccop)
Initiated in 1990, the MB-CCOP provides underserved cancer patients with
access to state-of-the-art cancer treatment and prevention in their own
communities. In addition, as part of NCI's effort to reduce cancer health
disparities in minority populations, the program encourages physicians
who are practicing in these communities to become involved in NCI-approved
clinical trials. Over the past decade, more than 5,500 minority patients
have enrolled in both treatment and prevention clinical trials sponsored
by NCI through the MB-CCOP network.
- The Cancer Disparities Research Partnership (CDRP) Program
(http://www3.cancer.gov/rrp/CDRP/index.html)
The CDRP is a unique research program that supports the planning, development,
and conduct of radiation oncology clinical trials in institutions that
care for a disproportionate number of medically underserved, low-income,
ethnic and minority populations that have not been traditionally involved
in NCI-sponsored research. The CDRP works to establish partnerships between
large comprehensive centers and smaller community centers so that the
smaller centers can build and sustain an effective radiation oncology
clinical trial program.
- Patient Navigation Program (PNP)
(http://crchd.cancer.gov/pnp/background.html)
The PNP was developed to help guide cancer patients from underserved populations
through the complex journey of seeking treatment and overcoming language,
financial, and cultural barriers that often undermine their care. The
PNP places patients in contact with trained, culturally sensitive health
care workers, or "navigators," from local communities. Navigators help
minority cancer patients obtain accurate information about their diagnosis
and treatment procedures, assist in gaining access to hospitals and clinics,
provide guidance on financial assistance, and help with tracking their
medical records and obtaining prescriptions.
- Southern Community Cohort Study
(http://epi.grants.cancer.gov/ResPort/Southern.html)
This NCI-funded study will follow about 100,000 residents from six southeastern
states—two-thirds of whom are African American/Black—to determine
what roles diet, lifestyle, occupation, and environmental factors play
in the development of common types of cancer, such as prostate, lung,
breast, and colon cancers.
- Cancer Information Service (CIS)
(http://www.cancer.gov/cancertopics/factsheet/Information/CIS)
NCI established the CIS in 1975 to educate people about cancer prevention,
risk factors, early detection, symptoms, diagnosis, treatment, and research.
The three components of this program—the Partnership Program, Information
Service, and Research Program—work together to reach many audiences,
particularly those who are adversely affected by health disparities. Through
a network of 15 regional offices across the country, the CIS serves the
United States and its territories. Each regional center collaborates with
partners in their communities to disseminate cancer control information
and develop education programs to improve the health of minority and medically
underserved populations. Currently, there are over 600 partners from nonprofit,
private, and other government organizations at the national, regional,
and state levels that are working with the CIS Partnership Program. Through
the Information Service, CIS information specialists provide the latest,
most-accurate information about cancer by telephone (1-800-4-CANCER),
instant messaging, and e-mail through NCI's Web site. The CIS Research
Program participates in cancer control and health communications research
that supports NCI's priorities and programs. To date, the CIS has collaborated
on more than 50 studies that have helped researchers learn better ways
to communicate with people about healthy lifestyles, health risks, and
how to prevent, diagnose, and treat cancer.
- NCI Spanish-language Web Site
(http://www.cancer.gov/espanol)
NCI launched its Spanish-language Web site in April 2007 to address the
language and cultural barriers that many Hispanic/Latinos face when seeking
cancer-related information. NCI's Spanish Web site is not simply a translation
of information available on the English-language Web site; the content
is tailored to meet the needs and concerns of the Hispanic community.
The Spanish Web site is a complement to existing Spanish-language resources
from NCI, such as those available through the Cancer Information Service
(CIS) and the NCI Publications Locator (http://www.cancer.gov/Publications).
NCI established the CIS in 1975 to educate people about cancer prevention,
risk factors, early detection, symptoms, diagnosis, treatment, and research.
CIS information specialists provide the latest, most-accurate information
about cancer by telephone (1-800-4-CANCER), instant messaging, and e-mail.
- Continuing Umbrella of Research Experiences (CURE) and Minority Institutions/Cancer
Center Partnership (MI/CCP) Programs
(http://minorityopportunities.nci.nih.gov/mTraining/index.html
and http://minorityopportunities.nci.nih.gov/institutions/miccp.html)
NCI supports training programs for students and investigators from diverse
populations. The CURE program provides long-term funding to qualified
minority students interested in pursuing scientific and cancer-related
careers. The MI/CCP program provides funding to support NCI Cancer Centers
and other institutions in recruiting minorities to pursue cancer research.
- The Network for Cancer Control Research Among American Indian/Alaska
Native Populations (AI/AN)
(http://crchd.cancer.gov/spn/aian-spcn-pilot.html)
The network is an NCI program that fosters collaborations between American
Indian/Alaska Native researchers and other researchers and educators.
The program's goals are to facilitate the exchange of cancer control information
among researchers and to encourage American Indian researchers and medical
students to become involved in their community health care programs. The
network established the Native Cancer Information Resource Center (Native
C.I.R.C.L.E.) in 1998, which serves as a clearinghouse for cancer educational
materials that are specific to American Indian and Alaska Native communities.
- NCI's Atlas of Cancer Mortality in the United States, 1950-94
(http://www3.cancer.gov/atlasplus/new.html)
NCI's Atlas of Cancer Mortality in the United States, 1950-94
is a book of maps, text, tables, and figures showing the geographic patterns
of cancer death rates throughout the United States from 1951-1994 for
more than 40 types of cancer. Included are maps of cancer mortality specific
to African Americans/Blacks. These maps can be used to pinpoint areas
of high cancer mortality in the United States and provide avenues to focus
future cancer health disparities research.
- Body and Soul
(http://www.bodyandsoul.nih.gov)
NCI and the Centers for Disease Control and Prevention (CDC) are supporting
this program that forms partnerships with local communities and churches
to provide information about healthy foods and diet. Through Body and
Soul, pastors are encouraged to lead their congregations in eating a diet
rich in fruits and vegetables every day for better health.
- Tobacco Research Network on Disparities (TReND) Program
(http://dccps.nci.nih.gov/tcrb/trend/index.html)
To address the high rates of lung cancer in minority populations, NCI,
in collaboration with the American Legacy Foundation, initiated the TReND
program. This program supports collaborations among researchers to develop
new solutions that address tobacco use in underserved communities and
to better understand tobacco-related health disparities.
For information about other NCI programs that address cancer health disparities, go to http://www.cancer.gov/cancertopics/types/disparities on the Internet.
Selected References
- Carey LA, Perou CM, Livasy CA, et al. Race, breast cancer
subtypes, and survival in the Carolina Breast Cancer Study. JAMA,
2006; 295(21); 2492-2502.
- Haiman CA, Patterson N, Freedman ML, et al. Multiple regions
within 8q24 independently affect risk for prostate cancer. Nature Genetics,
2007; 39(5); 638-644.
- Talcott TA, Spain P, Clark JA, et al. Hidden barriers between
knowledge and behavior: The North Carolina Prostate Cancer Screening and Treatment
Experience. Cancer, 2007; 109(8); 1899-1606.
*The data sources for all tables in this fact sheet are the following:
Source for incidence statistics:
Surveillance, Epidemiology, and End Results (SEER) Program (http://www.seer.cancer.gov)
SEER*Stat Database: Incidence—SEER 17 Regs Limited-Use, Nov 2006 Sub (2000-2004)—Linked
To County Attributes—Total U.S., 1969-2004 Counties, National Cancer Institute,
DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April
2007, based on the November 2006 submission.
Source for mortality statistics:
Surveillance, Epidemiology, and End Results (SEER) Program (http://www.seer.cancer.gov)
SEER*Stat Database: Mortality—All COD, Total U.S. (1990-2004)—Linked
To County Attributes—Total U.S., 1969-2004 Counties, National Cancer Institute,
DCCPS, Surveillance Research Program, Cancer Statistics Branch, released November
2006. Underlying mortality data provided by the National Center for Health Statistics
(http://www.cdc.gov/nchs).
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