Minorities less likely to survive cancer.

• Position: Mortality - United States

Cancer is a leading cause of death among older people on Medicare, particularly within racial and ethnic minority communities. In addition, racial and ethnic disparities still exist in cancer prevention and treatment, according to a report released by The Schneider Institute for Health Policy (SIHP), Brandeis University, Waltham, Mass. Not only are "racial and ethnic minorities ... more likely to develop some kinds of cancer, they are far less likely to survive cancer in the United States" indicates John Capitman, principal investigator of the study and director of long-term care studies at SIHP. "In addition, screening rates for breast, colon, and prostate cancer are lower than desirable for all Medicare beneficiaries, but notably lower for people of color."

To determine why minorities were less likely to receive suitable treatment, the researchers conducted a review of more than 1,000 studies of epidemiological and intervention research on race, ethnicity, and cancer disparities in elders. They also surveyed 115 cancer prevention programs nationwide. Using the research findings and surveys as a template, they conducted 25 case studies of cancer intervention programs in traditionally underserved communities.

The research analyzed the most-prevalent forms of cancer among racial ethnic minorities, including lung, breast, cervical, colorectal, and prostate. It identified racial and ethnic variations in treatment of patients and focused on four behavioral factors influencing cancer prevention: physical activity, nutrition and weight loss, smoking, and excessive alcohol consumption. "Epidemiological evidence links one or more of these behavioral risks to each of the cancers," notes Sarita Bhalotra, co-principal investigator and a researcher at SIHP. "But there is scant empirical evidence that altering behaviors changes the chances of getting cancer. We found, however, that making the recommended behavior changes reduced morbidity and improved treatment outcomes."

The study found that interventions to improve diagnosis and treatment are especially lacking among the older, racial/ethnic population. The researchers point out that very few studies of physical...