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'Urgent Need' for Research on Cancer Among Minorities: U.S. Report
Date:4/28/2011

By Madonna Behen
HealthDay Reporter

THURSDAY, April 28 (HealthDay News) -- The United States urgently needs to expand research and improve understanding of cancer among minority populations, according to a special report issued Thursday by the President's Cancer Panel.

While minorities currently account for roughly one-third of the U.S. population, they are expected to become the collective majority by the year 2050, according to the report.

The panel noted that "minority and other underserved populations are disproportionately affected by certain cancers, are often diagnosed at later stages of disease, and frequently have lower rates of survival."

What's more, the incidence of cancer among minority populations is projected to nearly double over the next 20 years.

"Most of what we know about cancer is based on studies of non-Hispanic white people, but by the middle of the century that group will be only 38 percent of the population," said panel member Margaret L. Kripke, a professor emerita of immunology at the University of Texas M.D. Anderson Cancer Center in Houston. "We need more data on cancer among minority populations so that we can begin to implement specific preventive measures."

The report recommends more research into sociological factors that may explain disparities in cancer mortality among minorities.

"There have been a lot of studies in recent years trying to understand genetic differences associated with cancer susceptibility, but there are also cultural factors that can affect cancer mortality," said Kripke. "In some cultures, people are so afraid of a cancer diagnosis that they don't seek treatment until it's very late."

Current cancer screening guidelines should be evaluated, the panel noted, "to determine their accuracy in assessing disease burden in diverse populations."

"One-size-fits-all screening guidelines don't work," Kripke said. "For example, the breast cancer screening guidelines have been loosened up so that women can start having mammograms later and may be screened less often, but we know that there is an early age of onset of breast cancer among Latino populations, and so if you change the guidelines based on the majority of people, these women will be left out."

Another recommendation is that "cultural competency" become an integral part of medical school as well as continuing education for all health-care providers and administrative staff.

Dr. Otis W. Brawley, chief medical officer of the American Cancer Society, praised the report, and said it "hit all the right points."

"The biggest thing we need to do is to get people access to care, the next thing is to make sure they get good quality care, and then we need to make sure that the care is delivered in a friendly environment where the patient feels welcome," said Brawley.

"The first two are actually much easier to do than the third," he noted. "A lot of poor people, but especially poor blacks and poor Hispanics, are suspicious of the medical system, and think the hospital doesn't really want to care for them -- [that] they just want to bill them and utilize them to teach their medical students."

Kripke acknowledged that many of the recommendations involve spending more money at a time when the health-care system is already financially strained.

"For instance, we know that the best way to deliver cancer information to a patient whose primary language is not English is through a medical translator, but how many hospitals can afford to do that?" she said.

The panel concluded that disparities in cancer care and research will ultimately be eliminated only by addressing the social factors involved in poor health outcomes, such as poverty, substandard housing, lower educational status and inadequate access to quality health care.

More information

For more on health care disparities in the United States, read the April 15 report from the U.S. Centers for Disease Control and Prevention.

SOURCES: Margaret L. Kripke, Ph.D., professor, immunology, and Vivian Smith Chair Emerita, University of Texas M.D. Anderson Cancer Center, Houston; Otis W. Brawley, M,D., chief medical officer, American Cancer Society, Atlanta; America's Demographic and Cultural Transformation: Implications for Cancer, April 28, 2011


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