FIGURE 2-9 Distribution of cancer survivors by year since diagnosis, 2002.

DATA SOURCES: U.S. prevalence counts were estimated by applying U.S. populations to SEER 9 and historical Connecticut Limited Duration Prevalence proportions and adjusted to represent complete prevalence (2004 submission). Complete prevalence is estimated using the completeness index method (Capocaccia and De Angelis, 1997; Merrill et al., 2000). Populations from January 2002 were based on the average of the July 2001 and July 2002 population estimates from the U.S. Census Bureau. Includes invasive/first primary cases only. The estimated size of the survivorship population in 2002 was 10.1 million.

SOURCE: NCI (2005c).

complex interplay of economic, social, and cultural factors, with poverty being a key determinant of poor outcomes (Freeman, 2003). In general, when compared to non-Hispanic whites, members of racial and ethnic minority groups are more likely to be poor, have lower education levels, lack health insurance coverage, and have no source of primary care (ACS, 2004a). Cultural factors, including language, values, traditions, and trust in providers, can influence underlying risk factors, health behaviors, beliefs about illness, and approaches to medical care. Social inequities and racial discrimination can also influence the interactions between patients and physicians (IOM, 2003). Racial and ethnic disparities in the receipt of cancer treatment have been documented that could not be completely explained by racial/ethnic variation in clinically relevant factors (Shavers



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