TOPICS
				Prostate and Breast Cancer Lead the Gap Between Blacks and Whites
				Solutions Reflect the 'Character of a Nation'
				ACS Efforts to Bring Down High Minority Cancer Rates
				Recommendations to Improve Health Care for Minorities

ATTACKING HIGH CANCER RATES FOR AFRICAN-AMERICANS

Again this year, the rates of cancer and cancer death are expected to be dramatically higher for African Americans than any other racial or ethnic group in the US. Studies are underway to learn whether diet, cultural habits, poverty, or possibly more aggressive disease is to blame.

Recently however, a landmark report called Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care concluded that racial discrimination within health care settings contributes to poor medical care for many blacks and other minorities. Time pressures on medical professionals and low-end health insurance plans were also cited as reasons why minorities were more likely to get substandard medical care. The end result is that more African Americans and other minorities die from serious diseases today than white Americans, according to study authors.

Lower quality medical care was found even when minority patients' income, age, medical condition, and insurance coverage were similar to that of white patients.

Congress requested the report from the non-profit Institute of Medicine to investigate informal charges of unequal medical care. Study authors, led by Alan R. Nelson, MD, sent back to Congress a list of ways to fix what they called "unacceptable" differences in medical care between minorities and whites, rich and poor. (See recommended changes below.)

PROSTATE AND BREAST CANCER LEAD THE GAP BETWEEN BLACKS AND WHITES

Since 1992 cancer incidence and deaths rates for black men have been dropping by 2.1-2.7% each year yet the death rate for all cancers combined is still about 30% higher for blacks than for whites.

About 132,700 new cancer cases and 63,100 deaths are expected among African Americans in 2003 according to the ACS guide, Cancer Facts & Figures 2003. Prostate cancer and breast cancer rates in black Americans provide the most dramatic evidence of the cancer gap.

	Black American men have the highest rate of prostate cancer and death in the world—more than twice the rates for white men in the US.
	African-American women are less likely than white women to develop breast cancer, but more likely to die from the disease.
	African Americans with cancer have shorter survival than white Americans at all stages of diagnosis.

SOLUTIONS REFLECT THE 'CHARACTER OF A NATION'

One way to bring down high cancer death rates among blacks already exists—early detection. Regular cancer-related checkups, mammograms, blood work, and other tests find cancer early when treatment is more successful. About half of all cancers can now be discovered early by such screening methods.

But are African Americans getting these tests regularly? It doesn't look like it, according to a report in the most recent issue of CA: A Cancer Journal for Clinicians.

"Most cancers detectable by screening are diagnosed at a later stage and survival rates are lower within each stage of disease in African Americans than in whites," wrote the authors of "Cancer Statistics for African Americans" (CA Cancer J Clin 2002; 52:326-341).

An editorial by Otis W. Brawley in the same issue called for "adequate and effective preventative care and therapy" for all in need. "This is a matter of social justice. The true measure of the character of a nation is how it addresses the needs of all its people."

ACS EFFORTS TO BRING DOWN HIGH MINORITY CANCER RATES

Currently, the Society provides funding for research into cancer prevalence, prevention, and treatment in low-income communities, and culturally appropriate programs and services for different populations. ACS also works to secure insurance coverage of screening tests and treatment.

Let's Talk About It is a prostate health education program for African-Americans co-sponsored by the 100 Black Men of America, Inc. The ACS Man to Man Program enlists survivors and others concerned about prostate cancer to help people newly diagnosed with the disease and to develop local support groups, screenings and educational events.

To help, call ACS at 1-800-2345 to find the office nearest you, or check our community pages online.

IOC RECOMMENDATIONS TO IMPROVE HEALTH CARE FOR MINORITIES

The IOC panel recommends the following broad actions to improve health care for minorities.

	Increase awareness about the problems among the general public, health care providers, insurance companies, and policy-makers.
	Use "evidence-based" guidelines to promote equal and consistent health care for all Americans.
	Establish guidelines for providers and health plans about which procedures to order or pay for based on the best available science.
	Public programs such as Medicaid should strive to help beneficiaries access the same level of care as privately insured patients. Health care plans should not be fragmented along socioeconomic lines.
	Train more minority health care providers, especially since they are more likely to serve in minority and medically underserved communities.
	Expand patient education programs to increase patients' knowledge of how and where to get the best care.

Document reprinted from the American Cancer Society.

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