Minorities and Cancer
In many ways, we’ve made great progress in terms of cancer prevention and survival. But one of the great challenges facing cancer researchers and physicians today is improving the ethnic and racial disparities that exist among cancer patients.
In 1998, The National Institutes of Health funded a large study because of concern that ethnic minorities and underserved populations experienced a “greater burden of cancer” than other population groups. The study was a large review of work conducted by The National Cancer Institute and of the work of researchers and community organizations who have special interest in minorities and cancer. The group conducting the review was named The Committee on Cancer Research Among Minorities and the Underserved. The Committee’s role was to investigate the reasons behind the cancer numbers, such as:
- African-American men have a 15 percent higher rate of cancer than Caucasian men.
- African-American women get breast cancer at a lower rate than Caucasian women, but it’s the African-American women who have a higher rate of breast cancer death.
- American Indians have the lowest cancer survival rate of all groups.
- Stomach and liver cancers are highest among Asian Americans.
- Cervical cancer is highest among Hispanic and Vietnamese Women.
- African-American men are twice as likely to die of prostate cancer than men of other racial or ethnic groups
Additionally, the Committee made recommendations to the National Institutes of Health (NIH) that would help the NIH develop a comprehensive plan to address the many possible reasons why ethnic minorities and underserved populations have these poor cancer outcomes. Some of the recommendations the committee made to the NIH, based on its findings from the 1998 study, included:
- Expanding programs that would develop cancer data from state registries across the country
- Acquiring more data about cancer survival among all groups—minority, ethnic, and non-minority—to determine not only what causes lower survival but also to determine what causes higher survival
- Emphasizing ethnicity rather than race, which would shift the focus to an understanding of cultural and behavioral attitudes, beliefs, lifestyle patterns, diet, environmental conditions and other factors that may affect cancer
- Improving coordination among the different research bodies and national health organizations
- Increasing the numbers of minorities participating in cancer research
More questions than answers
For now, there are still many unanswered questions about the cancer numbers in the U.S. Simply put, why exactly do minorities have higher cancer rates and higher death rates?
- Is it genetic?
- Is it about lifestyle issues, such as dietary patterns and higher risk profiles?
- Why do members of ethnic minorities get less preventive screening for cancer?
- Does it have anything to do with the way conventional doctors, who until recently have been predominantly white, treat members of different ethnic and racial backgrounds?
- Is it because of lack of trust that some people feel for the medical community?
- How can the medical community encourage members of varying ethnic backgrounds to participate in clinical trials, so that researchers could learn more about cancer in diverse communities?
- Most importantly, what should you do about this problem if you’re part of these groups that we’re talking about?
You can influence your cancer risk and outcomes
The Committee on Cancer Research Among Minorities and the Underserved has made helpful recommendations to the NIH about how different populations experience cancer, but in the meantime, each individual in this country needs to know as much as possible about their own cancer risk. They need to know how to reduce their risk and increase their survival if they do develop cancer.
There’s no set answer for all people. But many people may be able to look inside their own hearts and minds to ask themselves some difficult questions and see what the answers might be. For example,
If you personally are not getting recommended cancer screening, such as mammograms, PAP smears, colonoscopies, skin cancer checks, etc., why is that? Is it too expensive? Is it difficult to get to the medical appointment? Do you trust your doctor? Do you simply believe that whether or not you get cancer is not in your control?
Probably the most important thing that all people can do, no matter what their ethnicity, is to find a doctor they can trust. From there, the rest will follow—information about why and when to get screening tests, healthy diet, healthy habits (such as getting regular exercise and not smoking) and what your particular risks of cancer are. If you trust your doctor and believe in your doctor’s advice, chances are good that you’ll get on a path that will help you make choices in life that will have a positive impact on your health.
American Cancer Society; National Cancer Institute; The Institute of Medicine, The Unequal Burden of Cancer, National Academy Press, Washington, D.C., 1999.