August 2005
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Cancer prevention, treatment programs focus on minorities
The facts:
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African Americans with cancer have shorter survival than whites at all stages of diagnosis.
- Cancers among African Americans are more frequently diagnosed after the cancer has metastasized and spread to regional or distant sites.
- African American men have far higher death rates from prostate cancer than any other racial or ethnic group.
- In Mexican American and Puerto Rican women, cervical cancer incidence is two to three times higher than in non-Hispanic White women.
- Only 38 percent of Hispanic women age 40 and older have regular screening mammograms, a simple procedure that can detect breast cancer at its earliest stage, before clinical symptoms develop.
- Even though Hispanic women have lower rates of breast cancer (69.8 per 100,000) compared to non-Hispanic white women or African-American women (111.8 and 95.4 respectively), breast cancer is the leading cause of cancer death among Hispanics.
- Cancer is the leading cause of death for female Asian Americans. In fact, Asian American females are the first American population to experience cancer as the leading cause of death.
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Making a difference in the incidence and treatment of cancer among the ethnic and racial minority populations of the United States requires a program in prevention, education and outreach. The Baylor College of Medicine Cancer Center, serving a diverse population from Houston and around the nation, hopes to make these activities a core goal of its program. For that reason BCM Cancer Center Director C. Kent Osborne, MD, has named Amelie Ramirez, DrPH and professor of medicine at BCM, director of the Office of Outreach and Health Disparities in Cancer. Ramirez also serves as deputy director of the department of medicine's Chronic Disease Prevention and Control Research Center.
The mission of the new Office of Outreach and Health Disparities Research in Cancer will be to investigate the prevalence and causes of cancer health disparities among underserved populations and to develop effective research-based solutions to reduce these disparities in Houston, Texas and the nation.
Ramirez and her team will work closely with colleagues in the CDPCRC, headed by Armin Weinberg, PhD, and other BCM investigators to integrate BCM's nationally recognized research efforts to better design and coordinate efforts of our faculty and partner hospitals to make a difference in our community.
Redes En Acción
A key element of that is the $7.2 million National Cancer Institute grant for Redes En Acción: The National Latino Cancer Research Network, said Ramirez. The grant was recently renewed and represents the most extensive collaboration of organizations ever assembled to address cancer disparities in the Latino population.
With six sites in major U.S. cities, the grant has four components. The first is research into cancer-related issues such as problems faced in accessing services, said Ramirez. The second is training and identifying young Latinos who want to go into cancer research. The third is identifying the health policy issues involved in affecting access to care among Hispanics and the fourth is a broad community education component.
"This is important because the Latino community is growing," said Ramirez. Yet few services are targeted at that group, which includes a significant percentage of uninsured people.
"This population lacks the information needed to reduce the risk of cancer," said Ramirez. "This will take on even greater significance as the population ages and experiences higher rates of cancer, because Latinos are not used to seeking and receiving preventive services. In the Hispanic community, it is taboo to talk about cancer. They feel if you talk about it, you will get it. There are lots of misconceptions out there and we need to educate people about these issues." (For more information, please go to www.redesenaccion.org.)
Tobacco prevention
In Houston, a three-year grant from the federal Centers for Disease Control and Prevention funds a tobacco prevention project among Latinos ages 18 to 25 on the city's east side.
"It is a combined mass media and interpersonal approach to help individuals quit smoking or never start," she said.
Increasing clinical trial participation among ethnic and racial minorities
A $5.5 million, four-year project in collaboration with the Intercultural Cancer Council and Genetech, Inc., a biotechnology firm, is aimed at increasing the participation of minorities and other underserved populations in clinical research studies. The project targets studies of drugs and treatments for cancer and asthma.
"Without adequate representation of ethnic and racial minorities and other underserved populations, researchers are hindered in their assessment and generalization of clinical trial results, " said Armin Weinberg, PhD, professor of medicine and family and community medicine at BCM as well as director of the College's Chronic Disease Prevention and Control Research Center. "The goal of this project is to get information that will help us better serve these groups."
"Of those with cancer, only 5 percent of the adults actually participate in clinical trials," said Ramirez. Yet these studies frequently provide the best, and sometimes only, treatment for patients with diseases that are difficult to treat or whose cancer has come back.
Within that, we find that fewer minorities are participating," she said. "Now as clinical trials become more gene-specific, we need to have better representation to make sure that the drugs and treatments developed are applicable to as many people as possible. It is an opportunity for minorities to get the best treatment there is."
The project has a two-pronged approach. One looks at the policy side and implications of participation in clinical trials. Weinberg is taking responsibility for that portion.
The second is to test new approaches to recruiting people into clinical trials, overcoming the myriad barriers that exist, from patient health problems to physician reluctance to refer patients.
"We are looking at those issues that can be addressed from the national to the local community setting," said Weinberg.
His plan is to build on what has already been accomplished in that area, he said.
One important component is not only determining how best to attract members of underrepresented groups and minorities to sign up for clinical studies, but also how to retain them in the study. That is an issue that has not been well researched in the past, said Weinberg.
He plans to have a summit on the issue in September 2006 in coordination with the Intercultural Cancer Council.
Ramirez hopes to begin her hands-on studies soon.
"We will test different approaches to help the public make more informed decisions," she said. "This project gives us a chance to look at things proactively and determine how to recruit patients to studies at the front end."
Now, through the BCM Cancer Center, she is working on a grant from the New Orleans-based Hellis Foundation that enables her to do community outreach and education on cancer in the Houston area.
"We will examine the multicultural needs of the community and initiate community coalitions involving Latinos, African-Americans and Asian-Americans," she said.
"This is an extremely important part of our overall program," said Osborne. "Dr. Ramirez is a nationally recognized researcher in this area."
For more information on Ramirez's work, please go to www.saludenaccion.org. For more information on Weinberg's activities, please go to http://chronic.bcm.tmc.edu/default.htm.
| A Matter of Health | |
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Researchers must study the whole population |