UC Davis Cancer Center experts discuss cancer-related health disparities affecting ethnic and racial minorities in the United States

-- Cancer as the leading cause of death for Asian Americans
-- Cultural beliefs about cancer among American Indians
-- Promoting cancer awareness with “promotoras”
-- Grocery gap: Lack of fresh fruits and vegetables as a risk factor for cancer
-- Smoking and cancer mortality in African Americans and Asian Americans

CANCER AS THE LEADING CAUSE OF DEATH FOR ASIAN AMERICANS
Asian Americans are the only ethnic group in the nation for whom cancer is the leading cause of death. Moon S. Chen, Jr., associate director for cancer disparities and research at UC Davis Cancer and a professor of public health sciences, is available to talk about the “unique, unusual and unnecessary” cancer burden facing Asian Americans. Chen, widely regarded as one of the nation’s foremost experts on ethnic disparities in cancer, is a Bush appointee to the National Cancer Advisory Board. He is also principal investigator of the Asian American Network for Cancer Awareness, Research and Training, a National Cancer Institute-funded project to reduce cancer in Asian Americans nationwide. Headquartered at UC Davis Cancer Center, the project brings together researchers and community organizations from six cities: Honolulu, Seattle, San Francisco, Sacramento, Los Angeles and Boston. Recent accomplishments include the first one-stop Web resource for Asian-language cancer education materials, developed in partnership with the American Cancer Society (www.aancart.org/apicem); a Vietnamese-language cervical cancer “warm line;” and research showing increasing rates of obesity, a risk factor for cancer, among Asian American children in California.

CULTURAL BELIEFS ABOUT CANCER AMONG AMERICAN INDIANS
Many American Indians have a concern or belief that using the word cancer "will bring it forth or make it real," according to Marlene von Friederichs-Fitzwater, director of the UC Davis Cancer Center's Outreach Research and Education Program and an assistant professor in the Division of Hematology and Oncology. Through her research, including interviews with tribal health educators and leaders across the country, she has learned that American Indians are rarely depicted in media stories about cancer and tend to shun use of the word cancer. Working with an advisory council of 11 American Indian women from six tribes, von Friederichs-Fitzwater is developing breast cancer education materials for American Indian women that incorporate traditional values, beliefs and philosophy with Western medical information. The project, known as the Mothers' Wisdom Breast Health Program, is funded by a grant from the Susan G. Komen Breast Cancer Foundation.

PROMOTING CANCER AWARENESS WITH “PROMOTORAS”
Promotoras are trained to serve as lay health workers in their own communities. UC Davis investigators are involved in two projects that rely on promotoras to deliver cancer prevention and early detection messages. The largest, El Camino El a Salud, is a collaboration of community groups, state agencies and UC Davis to reduce the cancer burden facing low-income Latinos in Sacramento. Investigators are identifying cancer priorities in this population and developing a curriculum to train promotoras to help address these needs. The second, funded by the Susan G. Komen Breast Cancer Foundation, is using promotoras to promote breast self-exams and mammography in medically underserved Islamic, Vietnamese and African American communities in Sacramento. These promotoras are working out of the UC Davis School of Medicine’s Shifa, Paul Hom and Imani student-run clinics. Staffed by UC Davis medical students, these clinics provide free health-care services for people with limited or no health insurance. Joy Melnikow, a professor of family and community health, is principal investigator of the El Camino El a Salud project; Amerish Bera, an assistant dean of the UC Davis School of Medicine, heads the breast cancer project. Melnikow and Bera can talk about the strengths of the promotora model and the challenges these lay health workers face.

GROCERY GAP: LACK OF FRUITS AND VEGETABLES AS A CANCER RISK FACTOR
A diet poor in fruits and vegetables is a risk factor for cancer, heart disease and other illnesses that disproportionately affect minorities. But residents of lower-income and minority neighborhoods in many urban areas face a double bind that limits their access to fresh, healthy food, especially fresh fruits and vegetables: Not only are full-service supermarkets scarce in many inner-city areas, but many residents of these areas lack cars to get to supermarkets in other parts of town. Diana Cassady, assistant professor of public health sciences at UC Davis, is available to talk about this problem and its possible solutions. Her research has included studies of the costs and benefits of inner-city supermarket shuttles, strategies to encourage inner-city markets to stock more fresh produce, and programs to persuade inner-city restaurants to offer healthier menu choices.

SMOKING AND CANCER MORTALITY IN AFRICAN AMERICANS AND ASIAN AMERICANS
As tobacco companies aggressively market cigarettes to ethnic minorities, lung cancer is just one of the adverse health consequences. Bruce Leistikow, an associate professor of public health sciences at UC Davis and a leading expert on the epidemiology of smoking-related illnesses, has developed a body of innovative research suggesting exposure to tobacco smoke is responsible for a far greater share of the cancer burden in blacks and Asian Americans than has been realized. Leistikow is available to talk about a wide range of topics related to smoking, illness and cancer mortality in ethnic minorities.

UC Davis Cancer Center is a National Cancer Institute-designated cancer center that cares for 9,000 adults and children with cancer each year from throughout the Central Valley and inland Northern California. Its Outreach Research and Education Program works to eliminate ethnic disparities in cancer region-wide.