A Deadly Disparity

In an effort to address barriers to screening, diagnosis and treatment, the National Cancer Institute has established the Center to Reduce Cancer Health Disparities, which funds community outreach projects and research. Programs uniting health professionals with community leaders have begun to form in some cities, like Chicago, where the goal is to improve mammography and treatment services. Groups in Houston and Baltimore may follow the Chicago group's example. More than 200 cancer centers around the country now have patient "navigators," health-care workers who help patients coordinate appointments and paperwork and arrange for transportation and babysitters. While new tests and therapies may save lives, they have also "made the path to the best treatment extremely complicated," says Dr. Karen Freund, chief of the women's health unit at Boston Medical Center. "You need someone to see you through it."

Although disparities are still unacceptably high, some researchers think there's reason to be optimistic. A deeper understanding of tumor biology has led to clear improvements in breast-cancer treatment, "and that is only going to continue," says Dr. Harold Burstein, a breast-cancer specialist at the Dana-Farber Cancer Institute in Boston. Just as significant is the fact that both the socioeconomic and biological issues underlying the higher death rates from breast and prostate cancer are now literally on the agenda at cancer research meetings. "There is increasing awareness, and people are finally getting motivated to do something about it," Burstein says. And as the history of the fight against these cancers shows, awareness is the first step to a cure.

Wehrwein is editor and Komaroff is editor in chief of the Harvard Health Letter. For more information go to health.harvard.edu/newsweek .

© 2008