cover and pages from the Cancer Facts and Figures for Hispanics and Latinos report
image showing the cover and several pages from the Cancer Facts and Figures for African Americans 2019-2021 publication

Analyzing Cancer in Minority Groups

The American Cancer Society publishes detailed analyses of cancer in minority populations including incidence and mortality trends, as well as the latest information on risk factors, early detection, treatment, and current research. These publications include Cancer Facts & Figures for Hispanics/Latinos and Cancer Facts & Figures for African Americans

Research and Training Grants in Disparities

The American Cancer Society (ACS) funds scientists and medical professionals who study cancer. We also fund health professional training grants for nurses, social workers, and doctors to help advance their education and experience cancer research. 

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66

Grants

Total Grants in Effect for Disparities Research as of August 1, 2019

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$52

Million

Total Grants Funding for Disparities Research as of August 1, 2019

Spotlight on Cancer Disparities Grantees

We use a rigorous and independent peer review process to select the most innovative research projects to support. Here are some examples of the research areas and scientists the American Cancer Society funds. 

Developing a Spiritually-Sensitive Palliative Care Program for Muslim Cancer Patients in the US

Grantee: Mark Lazenby, APRN, PhD, FAAN
Institution: Yale School of Nursing in New Haven, Connecticut
Area of Focus: Cancer Nursing Practice
Grant Term: 7/1/2015 to 6/30/2020

The Challenge: Palliative care offers patients relief from pain and may help improve mood, extend life, and reduce the use of medical services. That’s why the American Society of Clinical Oncology (ASCO), an organization for cancer doctors and other cancer professionals, advises patients meet with a palliative care expert at the same time they’re planning other treatment and care—as soon as they learn they have advanced cancer.

Research shows, though, that doctors may not know much about palliative care. That lack of knowledge includes being unaware of how much religious and cultural beliefs influence people’s lives, especially during the dying process.

The Research: With support from the American Cancer Society (ACS), Mark Lazenby, APRN, PhD, FAAN, is studying how well doctors understand the palliative care needs for Muslims, since Islam is the fastest growing religion in the US. He’s an advanced practice nurse and has a doctorate degree in religion.

Lazenby cowrote a review article published in the Journal of Palliative Care, looking at 20 articles that focused on the care needs of adult Muslims with advanced cancer. He identified 4 major themes in all 20 articles: patient experiences, patient care delivery suggestions, Muslim provider experiences, and definitions of death.

The review ultimately found that the care provided to Muslim patients does not meet the standard for culturally-competent care. Muslim patients end-of-life needs are not being met and neither are the needs of their families.

Now, he’s using those findings to develop strategies in health care systems to address these disparities.

Goals and Long-Term Possibilities: Lazenby believes the findings of his work can help improve the quality-of-life for Muslims who are in treatment for cancer, as well as reduce the barriers to care that may arise from providers not understanding patients’ spiritual beliefs. 

Do African Americans and Latinos with Diabetes Have a Higher Risk for Pancreatic Cancer?

Grantee: Veronica W. Setiawan, PhD
Institution: University of Southern California in Los Angeles
Area of Focus: Cancer Control and Prevention: Health Policy and Health Service
Grant Term: 1/1/2017 to 12/31/2019

The Challenge: Research shows a consistent link between diabetes and pancreatic cancer. In fact, people who have diabetes have double the risk of getting pancreatic cancer than people without diabetes. The risk is highest during the first 3 years after a diagnosis of diabetes. However, there haven’t been many studies about the relationship between recently diagnosed diabetes and pancreatic cancer in minority groups.

The Research: Veronica W. Setiawan, PhD, and her fellow researchers found that African Americans and Latinos with diabetes who developed pancreatic cancer followed the same trends seen in previous studies in whites. They used a well-established database from the ongoing Multiethnic Cohort Study (MEC)  to gather information about both of these  understudied populations.

Their results suggest that being diagnosed with diabetes after age 50 (called late-onset diabetes) can be used as a marker to identify people who have a high risk for pancreatic cancer. In fact, as part of the US Consortium on Chronic Pancreatitis, Diabetes and Pancreatic Cancer, Setiawan’s team is working to develop tests that can better identify patients with recent onset diabetes who actually have cancer at its earliest stage.

Finding pancreatic cancer at an early stage and treating it with surgery provides the best chance of cure.

The Goals and Long-Term Possibilities: Setiawan’s work suggests that patients with recent-onset diabetes who go on to develop pancreatic cancer can be studied for more risk predictors. The group may also be used to develop liquid biopsies, which are needed in the field of cancer research to discover cancer earlier.

Creating a Cancer-Specific Health Insurance Decision Guide for Patients

Grantee: Mary C. Politi, PhD
Institution: Washington University in St. Louis, Missouri
Focus of Research: Cancer Control and Prevention: Health Policy and Health Service
Grant Term: 7/1/2017 to 6/30/2020

The Challenge: The Affordable Care Act increased access to health care. Still, many cancer patients and survivors lack adequate health insurance coverage. A diagnosis is often delayed in patients who are uninsured or under-insured. That results in their cancer being more advanced before it is found, which makes it harder to treat. Cancer patients without proper insurance are also more likely to die from their illness than those with it.

The Research: To help change this, Mary C. Politi, PhD, at Washington University in St Louis, Missouri is creating a cancer-specific health insurance decision-support tool. In a randomized experiment with cancer patients and survivors, Politi is evaluating the tool compared to insurance decision-support tools on healthcare.gov and a generic insurance decision-support tool.

The Goal and Long-term Possibilities: Politi's study aims to help cancer patients and survivors make an informed choice about health insurance. By helping patients understand their needs and options for the best insurance to meet them, her tool has the potential to improve their access to care. It may also help reduce overall disparities in outcomes, which is how well patients do after cancer treatment.

Studying Disparities in Cervical Cancer Treatment to Increase Survivorship Within US Hispanic and Other Minority Populations

Grantee: Autumn Kieber-Emmons, MD, MPH
Institution: Lehigh Valley Health Network in Allentown, Pennsylvania
Area of Focus: Cancer Control Career Development
Grant Term: 7/1/2017 to 6/30/2020

The Challenge: Cervical cancer can be treated successfully, especially if it’s found early. Yet, in the US, Hispanic and other minority women are dying of the disease at higher rates than white women. That’s especially true in Texas, California, and the Northeast states.

The Research: Family physician Autumn Kieber-Emmons, MD, MPH,  is studying looking for specific factors that can affect care in cervical cancer survivors that may contribute to the greater number of deaths in Hispanic and other minority women.

Using data from the Centers for Disease Control (CDC) about disparities in the treatment and survivorship of women with cervical cancer. She’s looking at factors that might be linked to the disparities, such as different education levels and insurance coverage. She’s also traveling to 3 counties in Texas and interviewing people. Her goal is to identify any factors that can possibly be changed and might be easiest to address through better health policy and health systems approaches.

Kieber-Emmons’ grant includes funds to train medical students and residents who plan to be primary care doctors about how to meet a survivor’s follow-up needs after treatment for any type of cancer.

The Goal and Long-term Possibilities: Kieber-Emmons’ hopes her team’s work in system changes and physician education will help minority women with cervical cancer live longer. Her ultimate goal is to help correct disparities not only with care for cervical cancer but all cancer care. 

From Our Researchers

The American Cancer Society employs a staff of full-time researchers who relentlessly pursue the answers that help us understand and eliminate cancer and health disparities.

Disparities Research Informs Advocacy and Policy Actions

The American Cancer Society Cancer Action Network (ACS CAN) is the nonprofit, nonpartisan advocacy affiliate of the American Cancer Society. Its role is to support evidence-based policy and legislative solutions designed to eliminate cancer as a major health problem. American Cancer Society (ACS) researchers collaborated with ACS CAN staff to create the Cancer Disparities: A Chartbook.

The Chartbook  describes how certain groups of people in the US are not benefitting from health care services such as cancer prevention, early detection, and treatment. It also highlights some of the biggest barriers to care for these groups.

Each section of the Chartbook includes current facts from ACS researchers, along with many tables, graphs, and charts. It’s followed by what actions ACS CAN is working on, which are informed by those facts.

Sections include:

  • Disparities in Cancer Incidence, Mortality, and Survival
  • Disparities in Access to [Health Insurance] Coverage
  • Disparities in Cancer Screening and Early Detection
  • Disparities in Cancer Prevention, including information about tobacco use, HPV vaccination, sun exposure, and excess weight and obesity

ACS CAN is attacking disparities by changing or adding new evidence-based public health policies at the local, state, and federal levels. The goal of ACS CAN is to reduce these disparities and improve health outcomes for all US population groups regardless of race, ethnicity, gender, age, sexual orientation, socioeconomic status, or zip code.

A PDF copy of the Chartbook can be downloaded and printed from the ACSCAN web site: www.fightcancer.org

Studying Cancer Disparities

The American Cancer Society’s internal research team is:

  • Analyzing data on an ongoing basis from Cancer Prevention Study II (CPS-II) to explore disparities issues. We are also conducting a new multi-year cancer prevention study, CPS-3, to better understand various cancer issues including disparities. 
  • Publishing high-impact studies looking at personal barriers and health systems barriers to cancer care including financial issues (also called financial toxicity) and geographic availability of health care providers.
  • Researching the use of technology to help certain medically underserved populations get access to health information, preventive services, and evidence-based behavioral ways to change behaviors that may increase cancer risk. 
  • Studying how taxes on tobacco may affect health disparities. 

ACS Is Learning How to Better Integrate Health Equity into Our Organizational Practices and Culture

ACS researchers and the researchers we fund do a lot of work to better understand what health disparities exist, what causes them, and how to decrease them. Still, as all of the ACS Blueprints for Cancer Control stress, we want and need to do more.

A partnership with, and a 3-year grant (2018 to 2020) from, the Robert Wood Johnson Foundation (RWJF) is helping us do that. The RWJF is the largest philanthropic organization focused on health in the United States. They’re committed to working with others to build a “Culture of Health” that provides everyone with a fair and just opportunity for well-being. The purpose of RWJF’s grant to ACS is to advance the culture of health and make health equity a shared value for ACS staff, volunteers, partners, and the community.

The goal of the initiative is for the ACS to enhance the integration of health equity into our organization, including collaborations with communities. ACS will assist community leaders in implementing proven/promising strategies to address topics such as:

  • Financial hardship, including exploring a partnership with private organizations on paid family and medical leave,  living wage polices, and financial capability service
  • Food insecurity
  • Transportation and mobility challenges

ACS researchers is supporting the work of the National Opinion Research Center (NORC) at the University of Chicago. NORC  will conduct site visits to community projects. They will interview program leaders, conduct focus groups, and survey community leaders. That allows NORC to have an on-the-ground perspective of how communities are integrating health equity and social determinants of health into their organizations and their work.

 

More About Our Cancer Health Disparities Work

ACS Cancer Health Disparities News