Cancer Disparities

According to the American Cancer Society, about 1,444,920 new cases of cancer will be diagnosed in the U.S. this year. Roughly 559,650 Americans will die of the disease. Currently, 10.5 million Americans have a history of cancer. Some have successfully fought their disease, while others are still in treatment. The average five-year survival rate for all cancers is 66 percent.

Cancer isn't an equal opportunity disease. Cancer incidence, stage of diagnosis, treatments and death rates vary across ethnic groups and socioeconomic classes. These variations are called cancer health disparities. For example, researchers estimate the incidence of cancer is about 10 percent higher in African-Americans compared to whites. Cancer death rates for blacks are 30 percent higher. Native Americans and Native Alaskans have the highest mortality rates from cancer. Cancer is the leading cause of death for Asian Americans and Pacific Islanders. Between 1980 and 1993, death rates for cancer among Asian and Pacific Islander women increased by 240 percent. For men, rates increased 290 percent.

Reducing Disparities - Cancer Navigators

There are many reasons for differences in cancer incidence, treatment and survival. Some patients don't have health insurance or access to adequate medical care. Some may not know how to navigate the health care system. Language or cultural barriers may hamper a patient's ability to understand the complexities of their illness or make informed decisions about treatment. In some cases, a patient may not have transportation to get to appointments for consultations or treatments.

Some hospitals are offering a service, called "Patient Navigators," for cancer patients. The main goals of the program are to reduce disparities in cancer incidence and death rates, and to improve patients' overall quality of life.

At Columbia St. Mary's Hospital in Milwaukee, nurse navigators are able to help patients along any stage of the diagnosis and treatment process. Patricia Quinn-Casper, R.N., M.S.N., Oncology Clinical Nurse, says many patients are in shock when they receive a diagnosis of cancer and often react in anger and fear. Some ask for assistance right after being diagnosed. Others may not ask for help until they reach a crisis or turning point in their disease (such as a need for hospice). A navigator acts like a buddy or partner, helping the patient with many different kinds of issues. Some examples of services include providing social support to help a patient understand diagnosis and treatment options, wading through insurance issues and finding financial assistance, transportation, child care or home health care. A navigator may also arrange services for an interpreter and help patients keep follow-up appointments and screenings.

The first patient navigator program was started at Harlem Hospital in 1990. In 2002, the National Cancer Institute developed the Patient Navigator Research Program Project to develop intervention programs aimed at reducing cancer disparities. The American Cancer Society (ACS) launched its own Patient Navigator Program to provide training for full-time navigators in 2005. Currently, the ACS programs operate in 60 sites across the country - mostly in hospitals and clinics that serve a large number of medically underserved patients. With a recent $10 million grant from AstraZeneca, program coordinators hope to expand the program to 50 more hospitals and clinics over the next five years.

For general information on cancer: American Cancer Society National Cancer Institute

For information on health disparities: Center to Reduce Cancer Health Disparities Intercultural Cancer Council