WASHINGTONIn an effort to better understand and deal with the
unequal burden of cancer among various subgroups of US residents, the
National Cancer Institute has launched a program to engage members of
these minority and underserved populations in community-based cancer
control, prevention, research, and training projects.
According to NCI, it will be the first time that Asian Americans,
Pacific Islanders, Native Americans, and underserved groups such as
the rural poor will participate in grants for cancer awareness
activities and research projects specific to their communities.
Seventeen institutions will share $60 million over 5 years to fund
the 18 projects in the program, called the Special Populations
Networks for Cancer Awareness Research and Training. As part of the
effort, NCI will establish a cancer control academy on the National
Institutes of Health campus to provide training and continuing
education programs in cancer control.
The program seeks to build a new type of community
infrastructure for awareness, for research, and for training,
NCI director Richard D. Klausner, MD, said at a press conference to
announce the new effort. If successful, these new
infrastructures will be both community laboratories and community
vehicles for raising awareness and effecting change through
meaningful, appropriate, and effective communications.
Although overall cancer incidence and mortality have declined in
recent years, great differences exist among and within the various
ethnic and cultural groups that make up the US population. Poverty
and inadequate access to medical care clearly play a significant role
in these disparities. However, other factors, often cultural, also
contribute to the nationwide problem.
The unequal burden of cancer is manifested through all aspects
of cancer, from risk factors, to incidence, to outcome, to
individuals experience of the disease, Dr. Klausner
noted. This initiative is about dramatically broadening the
National Cancer Program. This is about bringing [minority and
underserved] communities into scientific, medical research, and
cancer control activities across the country.
A key goal of the program is to ferret out and learn how to deal with
cultural attitudes that dissuade or inhibit people from ending risky
behavior, participating in screening procedures, or seeking
treatment. Harold P. Freeman, MD, president and chief executive
officer of North General Hospital, New York, and chairman of the
Presidents Cancer Panel, drew a distinction between culture and race.
Culture has to do with people who have similar communications
systems, who live in a similar physical environment, who have the
same values, the same beliefs, the same world view, he said.
If we do not understand the cultures of America and the
interface between culture and poverty, we cannot fundamentally solve
the cancer problems.
Projects receiving funds under the NCI program include the Pacific
Islander Cancer Control Network in California, the National Black
Leadership Initiative on Cancer, and the Latino/a Research and Policy
Center in Denver. Among the other projects are the Native Hawaiian
Cancer Research and Training Network, the Appalachia Cancer Network,
the East Harlem Partnership for Cancer Awareness in New York City,
and the American Indian and Alaska Native Initiative on Cancer.
Three Overlapping Phases
The projects will have three overlapping phases. In the first year, a
variety of cancer awareness activities will be implemented, and
community organizations will join with private and public sector
groups to develop plans for specific community-based projects. In the
second and third years, efforts will focus on increasing the number
of minorities participating in cancer clinical trials, improving the
training of minority scientists, and developing pilot projects within
the community. The final 2 years will emphasize development of the
programs infrastructure and using information gained from the
pilot project to develop investigator-initiated applications for
Cancer research not only means laboratories, mice, monoclonal
antibodies, and molecular biology, it also means seeking to
understand the profound and sometimes elusive reasons why a person
accepts or rejects certain behaviors that can affect his or her
health, said Elmer E. Huerta, MD, MPH, director of the Cancer
Risk Assessment and Screening Center, Washington Hospital Center,