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Health Disparities in Underserved Populations - Landmark Studies

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The contents of this section were published in 2003 as part of SEER's 30th Anniversary celebration.

A study in the early 1980s using data from the New Mexico Tumor Registry examined the link between ethnicity and lung cancer in Hispanic and white citizens of New Mexico and found that variations in lung cancer incidence corresponded to differences in smoking patterns between the two populations. Hispanic culture does not promote smoking, and the lower occurrence of lung cancer in Hispanics corresponded to the lower number of Hispanic smokers. This study encouraged the investigation of environmental carcinogens, and supported the connection between smoking and lung malignancies.

A series of studies in the 1980s concluded that poverty, itinerancy, and the resultant restricted access to care can cause high cancer mortality rates in proportion to relatively low incidence rates. Data on the incidence of cancers of the breast, reproductive and gastrointestinal systems, and cancers related to tobacco use from the Louisiana Tumor Registry were compared to SEER data from other geographical areas. Although incidence rates in Louisiana were lower than elsewhere in the country, mortality rates were higher because the cancers were diagnosed at more advanced stages with less favorable outcomes. Another study that examined the incidence of dysplasia and carcinoma of the uterine cervix, which was higher in Appalachian Kentucky than in the overall SEER database, supported a similar conclusion. Likewise, in a study focused on migrant farm workers in California, many of whom were recent Mexican immigrants, lack of access to care, including screening programs, was thought to be the cause of the elevated rate of cervical cancer. Higher incidences of brain cancer and leukemia were attributed to occupational exposures, particularly to pesticides. These studies point to the need for better cancer prevention and early detection programs, especially for cancers that can be treated effectively if diagnosed in time.

Selected References

Humble CG, Samet JM, Pathak DR, Skipper BJ. Cigarette smoking and lung cancer in 'Hispanic' whites and other whites in New Mexico. Am J Pub Health 1985;75(2):145-148.

Chen VW, Fontham ETH, Craig JF, Groves FD, Culley P, Rainey JM, Ranier AS, Correa P. Cancer in South Louisiana. Part I: tobacco-related cancers. J La Med Soc 1992;144:149-155.

Friedell GH, Tucker TC, McManmon E, Moser M, Hernandez C, Nadel M. Incidence of dysplasia and carcinoma of the uterine cervix in an Appalachian population. J Natl Cancer Inst 1992;84:1030-1032.

Chen VW, Wu X-C, Andrews PA, Fontham ET, Correa P. Advanced stage at diagnosis: an explanation for higher than expected cancer death rates in Louisiana? J La Med Soc 1994;146:137-145.

Mills PK, Kwong S. Cancer incidence in the United Farmworkers of America (UFW) 1987-1997. Am J Ind Med 2001;40:596-603.

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