______The SEMPAC Center is funded by the National Cancer Institute U54 CA153606-03______
February, 2013
Greetings, SEMPAC Partners.
Welcome to the February edition of the SEMPAC Newsletter. In this issue, we share information from the American Cancer Society’s report on cancer health disparities, and we provide recommendations for reducing cancer health disparities from the Centers for Disease Control.
As always, if you have something you’d like to share with SEMPAC partners, or if there is something you’re interested in learning more about, please let us know!
Thank you for your work to reduce cancer health disparities among older African Americans in Detroit. We, like you, are committed to making a difference.
Teri Bob
Terrance L. Albrecht, PhD Robert A. Chapman, MD
Population Studies and Disparities Research Josephine Ford Cancer Center
Barbara Ann Karmanos Cancer Institute Henry Ford Health System

American Cancer Society: Death Rates Drop, Inequity Remains

The great news is that overall cancer death rates have steadily decreased for African American men and women. In fact, the most recent data show that death rates dropped faster for African American men than men in any other racial or ethnic group. That's caused the disparity in cancer death rates between African American and white men to shrink considerably. Cancer death rates among African American women are declining at a similar rate as those of white women.
Despite these declines, however, death rates for all cancers combined remain 33% higher in black men and 16% higher in black women, compared to white men and women. African American men also have higher death rates for most of the major cancer sites (including lung, prostate, colon/rectum, liver, pancreas, and others). Notably, the higher overall cancer death rate in African American women compared to white women occurs despite lower incidence rates for all cancers combined and for breast and lung cancer.
For African American men, the drop in cancer death rates is mostly due to decreases in lung cancer; other smoking-related cancers like oral cavity, pharynx, larynx, esophagus, pancreas, bladder, and kidney; and prostate cancer. Remarkably, the disparity in lung cancer death rates among black and white men has been cut in half for men overall, and has been eliminated in younger adults (ages 20-39). This progress is mostly due to the fact that more African American men are quitting smoking, compared to white men. Although African American men have historically higher smoking rates compared to white men, over the last decade smoking rates have become more similar. In addition, smoking rates are lower among African American than white high school students. It is believed that if current smoking trends persist, racial differences in lung cancer death rates will be eliminated in the next 40 to 50 years.
Disparities increase for breast and colon/rectal cancers
On the other hand, the racial disparity has widened for death rates for breast and colorectal (colon) cancer - cancers for which screening tests and treatment truly make a difference. African American women are believed to get mammograms less often and are less likely to quickly follow up on abnormal results, which could result in a later, more advanced diagnosis that makes breast cancer harder to treat. Colorectal cancer screening rates are also lower in blacks compared with whites (56% vs. 62%, respectively). Furthermore, dramatic improvements in breast and colorectal cancer treatments have been introduced over the last two decades, but not all people are able to afford, are offered, or can even get to these treatments.
Disparities in breast and colorectal cancer may also, in part, reflect high rates of obesity found in the African American community. Obesity rates have increased significantly for both African American men and women from 1999 to 2010, and recent data show that half of African Americans are now obese (compared to 35% of whites). Obesity increases the risk for both of these cancers and may also be associated with higher death rates.
Socio-economic status and related behaviors influence rates
Why have African Americans been unduly burdened by cancer with higher death rates, later stage at diagnosis, and poorer survival for most cancer sites compared to whites? It is believed to be due to differences in socio-economic status rather than biological or genetic factors. African Americans are significantly more likely to be poor and uninsured compared to whites. Poor people have less access to quality health care (including cancer screening and treatment) and are more likely to engage in unhealthy behaviors, such as smoking and physical inactivity. In addition, uninsured people are more likely to be diagnosed with advanced cancer.
Information for this article was abstracted from http://www.cancer.org/cancer/news/expertvoices/post/2013/02/04/cancer-statistics-about-african-americans-released.aspx and modified for use in the SEMPAC Newsletter. This newsletter is intended expressly for informational purposes. The views represented in this article are not necessarily reflective of the views of the SEMPAC Center.

Reducing Health Disparities in Cancer
The Center for Disease Control and other public health agencies, health care providers, and communities of all racial and ethnic groups must become partners in a national effort to reduce cancer health disparities.
·  Improve early detection of cancer through routine mammography, Pap tests, and colorectal cancer screening.
·  Implement evidence-based community interventions to increase screening and modify risk behaviors.
·  Develop research projects that will encourage minority groups to participate in clinical trials for cancer prevention to ensure that significant differences between minority and ethnic groups are identified.
·  Undertake research that will inform decisions about interventions to reduce cancer disparities and improve health. There is a growing need for interventions that are available to people regardless of socioeconomic status or lifestyle behaviors that also addresses the social environment.
·  Use a variety of media and channels to market cancer information to diverse populations in a variety of settings.
·  Access to quality cancer care and clinical trials needs to be expanded to ensure that minority groups are provided the same care and access to state-of-the-art technology that patients in major care centers receive.
Fear of cancer, perceived cost of care, and lack of physician referral are common barriers to cancer screening and other preventive services. Health care providers play a critical role in recommending and increasing use of preventive services. Research shows that physician recommendation is a major predictor of screening receipt.
Information for this article was abstracted from http://www.cdc.gov/cancer/healthdisparities/basic_info/disparities.htm and modified for use in the SEMPAC Newsletter. This newsletter is intended expressly for informational purposes. The views represented in this article are not necessarily reflective of the views of the SEMPAC Center.

Carie Francis, Editor

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