THE UNEQUAL BURDEN OF CANCER.(Brief Article)

National Cancer Institute Grants Awarded to Improve Prevention and Control Efforts in Minority Populations

Some people just aren't comfortable talking about cancer. A 65-year-old man diagnosed with prostate cancer told his doctor that his brother had had the same disease. When the doctor asked for details of the brother's case, his patient said he didn't know. The two brothers never discussed it.

Let's talk about cancer. That's a start.

During the past 25 years, we've learned more about this dreaded disease than we did in the previous 100 years. We know more about what causes different cancers. We know better how to reduce or even eliminate the harms from treatment. The best news is that a diagnosis of most forms of cancer is no longer an automatic death sentence. Today more people diagnosed with cancer will survive it than will die from it.

There is still much to be learned. One of the more perplexing questions in this time of great scientific strides is this: Why does cancer affect minorities and the underserved to a greater extent than whites?

Some disparities are due to cultural differences relating to the acceptance of having a disease and the acceptance of treatment. Others are the result of socioeconomic barriers, the lack of health insurance and the access to treatment, which can delay diagnosis and lead to poor outcome. The bottom line is that while cancers of the colon, breast, lung, cervix, and prostate still show race-based differences in prognosis, the majority of studies indicate that equal treatment yields equal outcome, with race not being an influence.

How can we close the gaps? How can we bring the health of minorities and the underserved up to par with the improving overall health of most Americans?