Health Disparities in Cancer
(RFA-CA-09-502 and RFA-CA-03-018)
The burden of cancer is not borne equally by all population
groups in the United States. Twenty-nine years have passed
since the War on Cancer was initiated, and during this period,
the disparities in cancer incidence and mortality in segments
of the U.S. population have continued to rise. The unequal
burden is exemplified by differences in cancer morbidity and
mortality as a function of gender, ethnicity and socio-economic
status. Men are about 50%
more likely than women to die from cancer. The incidence
of colon
and rectum, and lung and bronchus cancers in Alaska Natives
and African American men and women is higher than that
of
other ethnic groups. Death rates from prostate cancer among
African American men are almost twice those of white men. http://grants.nih.gov/grants/guide/rfa-files/rfa-ca-09-502.html, http://grants1.nih.gov/grants/guide/rfa-files/RFA-CA-03-018.html
The incidence
of cervical cancer in Hispanic women has been consistently
higher at all ages than for other women, although African
American women have the highest rate of dying from cervical
cancer. Five-year survival rates by selective sites among
populations experiencing the negative consequences of health
disparities in the U.S. (e.g., African Americans, Asians,
Pacific Islanders, Hispanics, Latinos, American Indians, Alaskan
Natives, and/or those of low socioeconomic status) are lower
than the 5-year survival rates of the rest of the population.
The cancer mortality rates for lung, trachea, bronchus, and pleura
for minority males and females differ widely when measured by
state economic area. Examples of geographical differences are
seen in a pattern of excessive prostate cancer among African
American males in the Southeastern U.S., particularly in rural
areas. High rates of esophageal cancer in the District of Columbia
and in the Coastal area of South Carolina appear to be related
to alcohol consumption, tobacco use and dietary deficiencies.
Persons of low socioeconomic status generally have higher cancer
death rates than persons of higher socioeconomic status.
The significant negative consequences of cancer-related health
disparities are also reflected in risk behaviors and health
service utilization. These include higher rates of smoking
among some populations (e.g. American Indians), strikingly
higher rates of obesity among African Americans and Hispanics,
and related dietary practices. Similarly, differentials have
been documented by age, income, education, and race/ethnicity
in these health practices as well as in cancer screening and
treatment. Data confirm lower rates of cancer screening and
early detection, differential treatment patterns, and greater
frequency of a number of chronic diseases with similar risk
profiles to cancer. These and many other factors contribute
to more advanced disease at diagnosis, lower survival, and
higher cancer death rates among certain population groups.
The National Cancer Institute's Cooperative Planning (U56 – RFA-CA-03-018) and Implementation (U54 – RFA-CA-09-502) Grants for Cancer Disparities
(CDRP) Research Partnership Program issued by the Radiation
Research Program is an effort to strengthen the national cancer
program by developing models to reduce significant negative
consequences of cancer disparities seen in certain U.S. populations.
The Program 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 but have not been
traditionally involved in NCI-sponsored research. In addition,
CDRP supports the planning, development, and implementation
of nurturing partnerships between applicant institutions and
committed and experienced institutions actively involved in
NCI-sponsored cancer research.
References:
http://healthdisparities.nih.gov/whatare.htm
http://plan.cancer.gov/