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Breast cancer prevention and control among the medically underserved

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Summary

In 1986, the National Cancer Institute published its cancer control objectives for the nation, which included projected reductions in breast cancer mortality. The reductions were estimated to be 25.0% from reducing fat, 16.0% from expanding use of breast cancer screening services, and 14.3% from expanding access to state-of-the-art breast cancer treatment. During the same decade, the U.S. population aged and became significantly more ethnically diverse, and accompanying this increase in ethnic diversity was endemic poverty, disproportionately experienced by black and Hispanic minorities. These populations may be seen as medically underserved. With respect to breast cancer, as well as many other cancers, the medically underserved are understudied, not well understood by many in the medical and academic research community, and attended by health care institutions that are under-funded and often do not have the resources necessary to ensure access to state-of-the-art cancer screening, clinical follow-up, diagnosis, and treatment. At the same time, medically underserved women are more likely to be diagnosed with late-stage breast cancer, and some groups (e.g. black women) bear the greatest breast cancer mortality burden in the nation. In this special issue of Breast Cancer Research and Treatment, eight papers describe what we know and what we don't about breast cancer prevention and control in medically underserved populations.

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References

  1. Greenwald P, Sondik E (eds): Cancer Control Objectives for the Nation: 1985–2000. NCI Monographs, 1986, 2, 105pp

  2. National Center for Health Statistics: Health, United Sates, 1992. Public Health Service, Hyattsville MD, 1993

    Google Scholar 

  3. Kerner J: Breast cancer in underserved minorities.In: Harris JR, Lippman ME, Morrow M, Hellman S (eds) Diseases of the Breast. Lippincott-Raven Publishers, Philadelphia PA, 1995

    Google Scholar 

  4. Trock B: Breast cancer in African American women: Epidemiology and tumor biology. Breast Cancer Res Treat (this issue)

  5. Health Professions Education for the Future: Schools in Service to the Nation: Report of the Pew Health Professions Commission. The Pew Health Professions Commission, Durham NC, 1993

    Google Scholar 

  6. Thomas SB, Quinn SC: Public health then & now: the Tuskegee syphilis study, 1932 to 1972. Am J Publ Health 81:1498–1505, 1991

    Google Scholar 

  7. Mandelblatt J, Traxler M, Lakin P, et al: Breast and cervical cancer screening of poor, elderly, black women: Clinical results and implications. Am J Prev Med 9(3):133–138, 1993

    PubMed  Google Scholar 

  8. Miller BA, Gloeckler Ries LA, Hankey BF, et al (eds): SEER Cancer Statistics Review 1973–1990. National Cancer Institute, NIH Pub. No. 93-2789, 1993

  9. Chen F, Trapido EJ, Davis K: Differences in stage at presentation of breast and gynecologic cancers among whites, blacks, and hispanics. Cancer 73: 2838–2842, 1994

    PubMed  Google Scholar 

  10. Hughes C, Lerman C, Lustbader E: Ethnic differences in risk perception among women at increased risk for breast cancer. Breast Cancer Res Treat (this issue)

  11. Hiatt RA, Pasick RJ: Unsolved problems in early breast cancer detection: Focus on the underserved. Breast Cancer Res Treat (this issue)

  12. USDHHS: The national strategic plan for the early detection and control of breast and cervical cancers. 1994, pp 30–31

  13. Kerlikowske K, Grady D, Barclay J, et al: Positive predictive value of screening mammography by age and family history of breast cancer. J Am Med Assoc 270:2444–2450, 1993

    Google Scholar 

  14. Kerlikowske K: Timeliness of follow-up after abnormal screening mammography. Breast Cancer Res Treat (this issue)

  15. McCarthy BD, Boohaker EA, Ulcickas M, Wilcock CH, Ward RE: Inadequate follow-up of abnormal mammograms. J Gen Int Med 9(April Supplement 2): 33, 1994

    Google Scholar 

  16. Mandelblatt J, Traxler M, Lakin P, et al: Breast and cervical cancer screening of poor, elderly, black women: clinical results and implications. Am J Prev Med 9:133–138, 1993

    PubMed  Google Scholar 

  17. Lerman C, Trock B, Rimer BK, et al: Psychological and behavioral implications of abnormal mammograms. Ann Int Med 114:657–661, 1991

    PubMed  Google Scholar 

  18. American Cancer Society: Cancer and the poor: A report to the nation. Findings of regional hearings conducted by the ACS. ACS, 1989

  19. NIH Consensus Conference: Treatment of early-stage breast cancer. J Am Med Assoc 265(3): 391–395, 1991

    Google Scholar 

  20. Ayanian JZ, Guadagnoli E: Variations in breast cancer treatment by patient and provider characteristics. Breast Cancer Res Treat (this issue)

  21. Hillner BE, Penberthy L, Desch CE, McDonald MK, Smith TJ, Retchin SM: Variation in staging and treatment of local and regional breast cancer in the elderly. Breast Cancer Res Treat (this issue)

  22. Samet JM, Hunt WC, Farrow DC: Determinants of receiving breast conserving surgery. Cancer 73:2344–2351, 1994

    PubMed  Google Scholar 

  23. Ayanian JZ, Kohler BA, Abe T, Epstein AM: The relation between health insurance coverage and clinical outcomes among women with breast cancer. N Engl J Med 329:326–331, 1993

    PubMed  Google Scholar 

  24. Iscoe NA, Goel V, Wu K, et al: Variation in breast cancer surgery in Ontario. Can Med Assoc J 150: 345–352, 1994

    Google Scholar 

  25. Whelan T, Marcellus D, Clark R, Levine M: Adjuvant radiotherapy for early breast cancer: Patterns of practice in Ontario. Can Med Assoc J 149:1273–1277, 1993

    Google Scholar 

  26. Yabroff KR, Linas B, Schulman K: The evaluation of quality of life for diverse patient populations. Breast Cancer Res Treat (this issue)

  27. Eley JW, Hill HA, Chen VW, et al. Racial differences in survival from breast cancer — Results of the National Cancer Institute black/white cancer survival study. J Am Med Assoc 272:947–954, 1994

    Google Scholar 

  28. Love N: Why patients delay seeking care for cancer symptoms: What you can do about it. Cancer Evaluation 89:151–158, 1991

    Google Scholar 

  29. Breen N, Kessler K, Brown M: Breast cancer control among the underserved: an overview. Breast Cancer Res Treat (this issue)

  30. Feagin JR: The continuing significance of race: antiblack discrimination in public places. Am Soc Rev 56:101–116, 1991

    Google Scholar 

  31. Hunter C, Redmond CK, Chen VW, et al: Breast cancer associated with stage at diagnosis in black and white women. J Natl Cancer Inst 85:1129–1137, 1993

    PubMed  Google Scholar 

  32. Levine DM, Becker DM, Bone LR, et al. Community-academic health center partnerships for underserved minority populations. J Am Med Assoc 272:309–311, 1994

    Google Scholar 

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Correspondence to Jon F. Kerner Ph.D..

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Kerner, J.F. Breast cancer prevention and control among the medically underserved. Breast Cancer Res Tr 40, 1–9 (1996). https://doi.org/10.1007/BF01805998

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