Cancer in the Medically Underserved Population.

Cancer is characterized by uncontrolled growth and spread of abnormal cells. It is the second most common cause of death in the United States, and a significant proportion can be prevented. Underrepresented and underserved populations are less likely to receive routine medical procedures and experience a lower quality of health services. Despite the increase in cancer screening, there are disparities in the incidence and mortality of various cancers. These disparities are not fully explained by the correlations between minority race and lower socioeconomic status or minority race and insurance status. Considerations for global cancer control in low-resource settings are presented.

Parallels between the development of therapeutic drugs and cancer health disparity programs: implications for Disparities Reduction.

BACKGROUND: There are analogies between the development of therapeutic drugs for cancer and the development of interventions for reducing cancer health disparities. In both cases, it can take between 12 and 15 years for the benefits to become apparent. METHODS: The initial preclinical phase of drug development is analogous to the development of community partnerships and helping the community learn about cancer. The preclinical phase of in vitro and in vivo testing is analogous to identifying the disparities in the community. Then clinical testing begins with phase 1, toxicity, and dose-establishing studies. Analogously, community-based participatory research is used to develop disparities-reducing interventions (DRIs) within the community. RESULTS: The phase 2 clinical studies to determine whether the drug has activity are analogous to the DRI being implemented in the community to determine whether it can cause behavioral changes that will reduce cancer health disparities. If a drug passes phase 1 and 2 studies, phase 3 clinical trials are initiated. These are controlled studies to examine the efficacy of the drug. The similar activity for disparities research is to determine whether the DRI is better than the current standard/usual practice in controlled trials. If the drug is beneficial, the final phase is the dissemination and adoption of the drug. Analogously in disparities, if the DRI is beneficial, it is disseminated and is culturally adapted to other racial/ethnic groups and finally adopted as standard practice. CONCLUSIONS: The process of creating an effective DRI can be envisioned to have 4 stages, which can be used to aid in measuring the progress being made in reducing cancer health disparities.