As the 17th annual National Minority Cancer Awareness Week unfolds April 20-26, the high toll cancer takes on racial and ethnic minority groups and medically underserved Americans is crystal clear. Research shows:

• African Americans are about 30% more likely to die of all cancers combined than white Americans.
• Invasive cervical cancer occurs in Hispanic/Latino women twice as often as non-Hispanic white women.
• A new study suggests Puerto Rican women are 50% more likely to receive substandard care for breast cancer.
• In one county in West Virginia breast cancer is less common than the national average, yet breast cancer deaths in that county are more than 79% higher than the US rate.

The problems are well documented and many of the causes are clear as well: people do not know about, cannot afford, or don't have access to cancer screening tests and the best treatments.

“Despite significant progress in the prevention, detection, and treatment of cancer, today’s health advances have not benefited all Americans equally,” explained Harold P. Freeman, MD, head of the National Cancer Institute's Center to Reduce Cancer Health Disparities and past national president for the American Cancer Society.

African-American cancer rates are the focus of intense study because overall they are dramatically higher than for any other racial or ethnic group in the US. In some cases, they are finally beginning to inch down.

In the last 10 years, death rates for all cancers combined have been dropping slowly but steadily for African American men. Asma Ghafoor, PhD and colleagues reported the most recent cancer statistics for African Americans in the November/December 2002 issue of CA: A Cancer Journal for Clinicians. Ghafoor, an epidemiologist at the American Cancer Society, suggests better awareness and more widespread cancer screening may be helping bring down mortality rates.

"In the last five years public health workers have tried to involve the African-American community, churches, and to use word of mouth in order to bring more African Americans in for cancer screening."

Unfortunately, the improvements seen for African American men are only a small part of the picture. In general, African Americans are still more likely to develop and die of cancer than any other racial or ethnic group. Ghafoor and colleagues trace much or all of these differences to a lack of awareness, reduced access to medical care, inferior medical treatment, or discovering cancer at a later stage, when treatments are less successful.

"For almost every cancer we talk about, higher death rates in African Americans come down to unequal cancer treatment," said Ghafoor.

Asian American and Hispanic/Latino people are generally less likely to develop cancer than black or white Americans. But the life-saving progress made against cancer does not reach far into these communities either. Many people have poor access to the tests that find cancer early, have no health insurance, or no regular health care provider. This same recipe of neglect has led to the high number of cancer deaths among African Americans.

As immigrants and their children adapt to American ways, our diet and lifestyle behaviors may increase the risk for cancer. Experts say about one third of all cancer deaths can be prevented by not using tobacco. Another one third could be prevented with a good diet, enough physical activity, and maintaining a healthy weight. Yet in our fast-food nation, overweight and obesity have reached epidemic levels--causing a wide range of serious, chronic illnesses.

The latest counts show 64% of all adults are either overweight or obese. For African Americans the numbers are even higher. Among black women 77% are either overweight or obese. Looking only at clinical obesity, 50% of all black women are now obese according to health guidelines.

American Cancer Society staff and volunteers are working with underserved communities to understand and reduce the barriers that prevent people from having timely cancer screening tests or from getting appropriate cancer treatment. For example,

In Miami, Florida, the ACS Hispanic Development Center reaches out to areas across the country with large Hispanic/Latino populations. One successful ad campaign called “Mi Vida,” or “My Life,” encourages early detection of breast, cervical, and colon cancer.

In Native American communities, the Society helped develop Circle of Life, a breast health program that trains Native women to contact family and friends and encourage them to get a mammogram.

ACS collaborations work to raise awareness of cancer issues in African-American communities. The ACS and Phi Beta Sigma fraternity have created Sigmas Waging War Against Cancer (SWWAC). Members have held cancer awareness days at community centers and campuses across the country to encourage the early detection and prevention of prostate and colon cancer among black men.

The Alpha Kappa Alpha Sorority will be working with the Society this year to implement a healthy lifestyle program called Body & Soul through African-American churches, recruit Relay For Life teams, and expand local networks of volunteers who help fight cancer.

More than 20% of current research funds have been awarded to projects involving poor and underserved populations

In Washington, DC and local communities, the American Cancer Society advocates for improved access and programs for the medically underserved. One program has already helped about 1.5 million minority and low-income women receive mammograms and Pap tests for the early detection of cancer. It's the CDC's National Breast and Cervical Cancer Early Detection Program (NBCCEDP). The program has provided over 3.5 million screening exams, diagnosed more than 9,000 breast cancers, 48,170 pre-cancerous cervical lesions and 831 cervical cancers.

The ACS went on to help pass new laws in 49 states and the District of Columbia enabling women diagnosed with cancer through this program to receive coverage for their treatment through Medicaid. This ensures that women detected with breast or cervical cancer through the program have a reliable way to seek cancer care. The American Cancer Society continues to work in support of both state and federal funding for both the screening and treatment elements of the program.

This year, the American Cancer Society has reintroduced Patient Navigator legislation in Congress. Trained patient navigators help people with cancer find the best information, the latest treatments, and help low-income patients get help paying for medical care. Navigators also help overcome language or cultural barriers.

Other American Cancer Society efforts include research studies into cancer issues in poor and underserved communities; information available in other languages in print, on the Internet, and over the phone; and legislative advocacy for better insurance coverage of cancer screening and treatment. For information or to volunteer call 1-800-ACS-2345.