Cancer Prevention and Control

In the United States, cancer is the second leading cause of death, surpassed only by cardiovascular disease. Although cancer affects the general population, the contributors to this volume have shown in specific terms that certain racial and ethnic groups are more severely and disproportionately affected. For all sites combined, Blacks have the highest overall age-adjusted cancer incidence and mortality rates of any population group in the United States (Baquet et al. 1986). Surveillance, Epidemiology, and End Results (SEER) data indicate that the five-year overall survival for Blacks is 12 percentage points below that of Whites (Table 1). A study of cancer rates over several decades indicated that cancer incidence rates for Black Americans increased by 27%, in contrast to 12% for Whites during the same time period, and that cancer mortality rates increased by 40% for Blacks and 10% for Whites (American Cancer Society 1986). Achieving the National Cancer Institute’s (NCI) goal of reducing the national cancer mortality rate by 50% by the year 2000 therefore requires intervention research activities directed to specific populations, including groups at high risk for cancer—those with excessive cancer rates and those underserved by cancer control intervention research. Blacks are both at high risk of cancer and underserved.