National Cancer Institute   U.S. National Institutes of Heath
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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.,

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.