African Americans, women immigrants from Vietnam, Mexicano women living near the border -- these are some of the minority people in the US that face a higher than average risk of developing and dying of cancer

Does a more aggressive disease occur in African-American women, who are less likely to develop breast cancer than white women but more likely to die from it? Why do twice as many African-American men die of prostate cancer than white men? Scientists and public health experts are actively looking for answers to such question.

More immediately, the American Cancer Society is working to reach minority communities and individual cancer patients with support that's available right now.

The ACS provides treatment information in English and Spanish on this site and by calling 1-800-ACS-2345 toll-free, 24 hours a day. We also offer one-on-one support for breast cancer patients, rides to and from treatments, help finding a low-cost Pap test or mammogram, prostate education for black men, and other services for minority communities and for anyone touched by cancer -- even tips on how to style a wig. Specialists who answer the toll-free phone number can connect callers with these services and more.

Public scrutiny and research funds have grown since the first National Minority Cancer Awareness Week 18 years ago. As we mark the occasion this year April 18-24, research has identified several interdependent causes for high minority cancer rates. A significant cause is poor access to health care. For instance, people who don't get mammograms, colon exams, and Pap tests on schedule are more likely to be diagnosed with a cancer at a later stage in the disease, when survival rates are lower.

Why don't minority people have full access to high quality health care? The ACS special report Cancer Disparities notes that in general, when compared to non-Hispanic whites,

"….members of racial and ethnic minority groups are more likely to be poor, to have lower education levels, and not to have health care coverage or a source of primary care."

“We know that poverty is the most critical factor affecting health and longevity in this country,” explained Harold P. Freeman, MD, director of the Ralph Lauren Center for Cancer Care and Prevention in New York City and past president of the ACS.

Freeman also stresses that it's important to unravel each factor contributing to high minority cancer rates, including a lack of accurate information about cancer and the environmental or lifestyle issues that may put minority people at greater risk for some types of cancer. "We must address every one of these issues to ensure that all Americans receive the same quality of information and care," he said.

• ACS National Cancer Information Center: 1-800-ACS-2345 (toll-free) Specialists answer questions in English or Spanish 24 hours a day, 7 days a week, and help callers find help in their communities.
• www.cancer.org: read our sitemap or search for prevention, early detection, treatment, and coping information in English and Spanish.
• Low-Cost Mammograms and Pap Tests -- National program offering low-cost or free cancer screening tests for women, and treatment if needed.
• Free Quitline for smoking cessation: 1-800-ACS-2345
• Tell-A-Friend - grassroots program to encourage mammograms. Also in Spanish and Asian languages.
• Let's Talk About It – Prostate cancer education for black men
• Body & Soul – Nutrition program for African-American churches.
• Cancer Survivors Network – Online discussion by and for people facing cancer, including Mandarin, Cantonese, and Spanish content, as well as information for gay/lesbian survivors and their partners.
• Reach to Recovery - Peer Counseling for Newly Diagnosed Breast Cancer Patients
• I Can Cope – Educational workshops help people understand medical issues, build positive attitudes and coping skills.
• Road to Recovery – Helps cancer patients get to and from treatments.
• "tlc" Tender Loving Care – Wigs, breast forms, and other products for women facing cancer, available by mail.
• Look Good…Feel Better – Grooming and beauty workshops for women in cancer treatment.

"Having health insurance coverage is the single greatest determinant of access to health care services," explained Eve Nagler, ACS director of special populations -- but racial and ethnic minority people are less likely to have their medical expenses covered by insurance than whites. Surveys show about a third of Hispanic/Latinos and 20% of black Americans have no coverage -- coverage that could help pay for early detection exams like a colonoscopy.

Nagler says that poor quality health insurance is also a barrier to good care for people of all ethnicities. Some policies have many out-of-pocket costs and high deductibles.

"A rural farm family may be self-insured, but the deductible is $5,000, so they are not going to go get a mammogram," she said, "yet they don't qualify for the low-cost mammogram program." The result is that people often ignore health problems until they become severe or skip routine check-ups and tests that can find cancer early, when treatment is most successful.

"These are not people on welfare," stressed Nagler. "Eighty percent of the uninsured are working. They're people who are struggling to get by. At certain incomes, you may make too much money to qualify for Medicaid, but not enough to buy private health insurance."

The American Cancer Society is actively working to be sure cancer early detection tests reach every adult in minority and medically underserved communities. And the Society works both independently and collaboratively with others to influence public policies and laws that may help reduce cancer disparities among ethnic groups such as better insurance coverage for cancer screening and treatment.

More information about minority cancer issues can be found in the ACS publication Cancer Facts & Figures 2004, within the special section called Cancer Disparities.