WASHINGTONThe Intercultural Cancer Council (ICC) has urged
Congress to act immediately to ensure that the National Institutes of
Health implements recommendations of a recent Institute of Medicine
(IOM) report. That report, sometimes critical of the National Cancer
Institute, urged specific efforts to better understand and correct
the unequal burden of cancer among minorities and the medically
[For a report on the IOM recommendations and a response by the NCI
director Richard D. Klausner, MD, see Oncology News International,
The ICC prepared its action plan at the request of Sen. Arlen Specter
(R-Penn), chairman of the Senate appropriations subcommittee that
overseas the NIH budget. The council, which focuses on cancer
policies as they affect minorities, unveiled its recommendations at a
The group received personal pledges of support from five House
members who spoke at the meeting: Republican Rick Lazio (NY), who
chairs the House Cancer Awareness Group; Democrats Edolphus Towns
(NY), Robert C. Scott (Va), and Sheila Jackson Lee (Tex); and
independent Bernard Sanders (Vt).
This is not a minorities issue, ICC co-chair Lovell A.
Jones, PhD, director of experimental gynecology and endocrinology,
M.D. Anderson Cancer Center, told members of Congress and staff
attending the briefing. This is not a medically underserved
issue. This is an American issue, because it will affect you, your
children, and your grandchildren.
Dr. Jones noted that in the next century, more than half the US
population will consist of racial minorities. If you dont
have the proper staff to take care of these individuals, what you
will see is what is happening in Harlem today, he said.
You wont see the impact diminishing; youll see it
spread to the rest of the nation.
The major emphasis in the ICC agenda is the need for all Americans to
have access to screening and cancer treatment and to receive equal
screening and treatment. Amelie Ramirez, DrPH, associate director of
the Center for Cancer Control Research, Baylor College of Medicine,
said that research is showing that if we applied what we know
right now, we could significantly reduce the burden of cancer; the
problem is that it is not getting into our communities.
Added Harold P. Freeman, MD, director of surgery, Harlem Hospital
Center, and chair of the Presidents Cancer Panel, We need
to understand the science of cancer but it doesnt help to just
discover something if you dont apply it to everyone.
Another point emphasized at the ICC briefing was the need to increase
the numbers of minorities in cancer research. Minorities and the poor
are grossly under-represented in academics, noted John Alderete, PhD,
professor of microbiology, University of Texas Health Science Center,
San Antonio. In fact, he said, they are so grossly
underrepresented in all the research science and technology areas of
this country that we almost have to redefine the term gross.
The ICC urged that Congress provide targeted funds to the National
Cancer Institute and all other NIH components directing cancer
research to allow them to make a greater effort to attract and train
people from minority and medically underserved populations.
The ICC listed three primary short-term objectives in its legislative agenda:
Congress should provide specific targeted funding for a 5-year
strategic plan at NIH to achieve the IOM recommendations. NIH should
begin its development and initial accountable implementation in this
A 100% increase in FY2000, to at least $300 million, should go to NIH
to fund research; data collection and assessment; and cancer
prevention, early detection, and prevention trials targeted to
minorities and the medically underserved. The increase would pay for
implementing the recommendations in those areas.
This figure represents roughly twice the amount in federal
dollars that the NCI reported to the IOM as spent in 1997 on cancer
research involving ethnic minority and medically underserved
populations, the ICC said.
The Department of Defense (DOD) appropriation for cancer research
should be increased in FY2000, and the Pentagon should be directed to
award more grants for research within the ethnic minority and
medically underserved populations.
The ICC also urged that Congress direct the Department of Defense to
expand its cancer registries and integrate them with other
registries, including NCIs Surveillance, Epidemiology, and End
Results (SEER) program, and that the department demonstrate use of
mobile screening vans in locales with DOD facilities near ethnic
minority and medically underserved populations.
The ICC listed as its longer term objective a renewed War on Cancer
with greater emphasis on cancer control, prevention and education,
and tobacco control among minorities.
This initiative should create a National Cancer Program with a
National Cancer Plan and a high-level, interdepartmental/interagency
cancer coordinating office, the council said.