NCI to focus on cancer disparities in Asians

The National Cancer Institute is devoting $10 million over five years to reduce cancer disparities among Asian-Americans. Though Asians have the lowest cancer mortality rate of any ethnic group, they have the highest incidence rates for liver and stomach cancer and have the lowest screening rates for cervical, breast and prostate cancer.

The money has been awarded in roughly equal measures to Temple University's Center for Asian Health in Philadelphia and the University of California, Davis Cancer Center.

"We're trying to put in place a community-based infrastructure that allows communications to occur at a culturally competent level," said Kenneth Chu, PhD, project leader of the NCI's Community Networks Plan. Both sites were awarded grants under NCI's earlier Special Populations Network for Cancer Awareness, Research and Training and were tasked with developing culturally and linguistically appropriate outreach materials. Now both are charged with actually reducing disparities.

"The No. 1 factor in these disparities is the cultural factor," said Moon Chen Jr., PhD, MPH, associate director for disparities and research at UC Davis. "I would attribute almost 40% of this to just the cultural tendency to not even want to see a physician."

Dr. Chen pointed to data showing that Asians were least likely among all ethnic groups to have seen a physician in the last 12 months. They also are less likely than whites, Hispanics or blacks to get screened for cancer. The 2001 California Health Interview Survey showed that only 72% of Asian women had a recent Pap test, 67% a recent mammogram and 27% of Asian men a recent prostate-specific antigen test. That compares with 90% of black women who reported a recent Pap test, 79% of black women who obtained a recent mammogram and 48% of white men who obtained a recent PSA test.

Limited English proficiency, lack of health insurance and women's modesty are contributing factors, Dr. Chen said. The UC Davis project is focusing on one Asian subgroup and cancer type in five different cities from Seattle to Honolulu.

As part of the same initiative, the NCI has awarded another $85 million to 23 other sites targeted at underserved, black, Hispanic, native Hawaiian/Pacific Islander and American Indian/Alaskan Native populations.