Charles L. Bennett, MD, PhD

CHICAGO-Advances in cancer screening, prevention, and treatment have led to decreased cancer incidence and mortality. However, the benefits of new early detection measures and treatment options are not shared equally among ethnic minorities and the medically underserved, and disparities in cancer morbidity and mortality remain.

Over the past decade, extensive research and promotion efforts have led to increased awareness and utilization of cancer prevention and screening methods. Many minority groups, however, have not benefited equally from these advances, and continue to have elevated cancer incidence or mortality rates compared with whites.

CHICAGO-While the main objective in caring for cancer patients has been to prolong life and to focus on short-term and long-term survival, more recent efforts include considerations of health-related quality of life (QOL).[1,2] The World Health Organization defines QOL as “not merely the absence of disease but a state of physical, emotional, and social well being.”[3]

Cervical cancer has a high incidence and is a rapidly progressive illness among human immunodeficiency virus (HIV)-infected women. This cancer has received increasing attention since 1993 following its addition to the list of AIDS-defining illnesses monitored by the Centers for Disease Control and Prevention (CDC).[1] With increased heterosexual transmission of HIV and frequent co-infection with the human papillomavirus (HPV),[1] invasive cervical cancers will appear more often among HIV-infected women.

The VA Cancer of the Prostate Outcomes Study (VA CaPOS) is collecting quality-of-life (QOL) information from prostate cancer patients, spouses, and physicians at six VA medical centers. Currently, 601 men with prostate

Managed care is transforming numerous aspects of health care delivery, and the specialty of oncology, in particular, is being increasingly affected for several reasons.

Prostate cancer is the most common cancer in the United States, with an estimated 200,000 new cases diagnosed in 1998.[1] Compared with white men, African-American men have a 66% higher incidence of prostate cancer and mortality rates twice as high.[1]

Use of hematopoietic colony-stimulating factors (CSFs) following induction and consolidation chemotherapy for elderly patients with acute myeloid leukemia (AML) is a controversial area. Studies have shown that CSFs can decrease the likelihood and/or shorten the duration of therapy-related neutropenic complications when given following induction chemotherapy.[1-7]

Detecting rare but serious side effects of drugs after they have been approved by the FDA is a difficult task. Postmarketing drug safety relies extensively on clinicians’ voluntary reporting of adverse effects to the FDA’s spontaneous reporting system, known as Med-Watch. The MedWatch program examines adverse effect reports and evaluates the possibility of drug causality. In some cases, the program identifies an adverse effect of a drug that was not reported in clinical trials.

Skin cancer is the most common malignancy in the United States, with approximately 1 million cases being diagnosed in 1997.[1] Of these cases, more than 40,000 will be classified as malignant melanoma, the most serious and aggressive form of skin cancer.[1] The worldwide incidence of melanoma is increasing more rapidly than any other form of cancer, and has shown an increase of about 4% per year in the United States.[1,2]

Epithelial ovarian cancer is the leading cause of death from gynecologic malignancies. In 1996, an estimated 26,000 new cases were diagnosed, and approximately 14,000 women died of this disease in the United States alone.[1] Between 75% and 80% of ovarian cancer patients present with advanced disease at diagnosis, and these patients have a 5-year survival rate of 21%.[2,3]

In October 1996, the FDA approved ProstaScint (capromab pendetide), a new diagnostic imaging agent for prostate cancer, manufactured by Cytogen Corporation, Princeton, NJ.[1-5]

The US blood system is a vast network comprised of approximately 190 regional blood centers, which collect 90% of the nation's blood, and 621 hospital blood centers, which collect the remaining 10%.[1] Many of the regional blood centers are operated by the American Red Cross, which collects approximately 45% of the blood in the United States.[2]

The modern pandemic known as AIDS continues to spread at an alarming rate, with approximately 5,000 people becoming infected with HIV daily.[1] The World Health Organization estimated in 1995 that 20 million people worldwide were HIV infected, and that there were more than 4 million cases of AIDS.[1]

In most developed nations, cancer is second only to heart disease as a cause of death; in less developed countries, it is second to infectious disease. It is estimated that if the current trends of rising worldwide incidence continue, cancer will become the leading cause of death in the 21st century. This is particularly troubling since many of the factors contributing to cancer (eg, occupation, diet, lifestyle, and tobacco use) are known.

The financial burden of a long-term illness such as cancer can be devastating, with as much as 66% of the costs of cancer being nonmedical[1]. These financial concerns are leading some Americans to buy insurance policies that, upon diagnosis of cancer, assist them in paying for their care.

With the recent surge in interest in health care reform and the growth of managed care organizations, the cost of care has become a major determinant of the types and intensity of therapy that patients receive. If data on the