incorporate findings from African-American researchers and institutions. "A teaming of representatives from our majority comprehensive medical centers with representatives from our HBCU institutions and facilities has the potential to greatly advance our understanding of cancer incidence and mortality among African Americans," she stated.

Brown pointed to the success of National Human Genome Research Institute-Howard University collaboration on genetically based risk among African Americans as an example of such a collaboration.

3. Greater participation of minorities in cancer review panels is needed.

Brown noted that NCI has simple nondiscrimination provisions in its requirements for the selection of cancer review panels. The U.S. Department of Defense, in contrast, actively recruits minorities for scientific review panels, with minority population representation on some panels being up to one-third or more of the total. Inclusion of minorities on panels can increase NIH's sensitivity to proposals from scientists, particularly minority scientists, who study minority populations, she noted.

4. The portfolio of "special populations" research at NIH must adequately address the range of possible etiologic factors for cancer among racial and ethnic groups.

Brown criticized the NIH portfolio of research on cancer etiology among racial and ethnic groups as too narrow and failing to examine possible biological or genetic differences. "The argument that the results of basic research can be extrapolated to all populations simply does not apply," she stated. "In fact, it is entirely inconceivable that the results of studies [with] African Americans, upon expanded scrutiny, might be legitimately extrapolated to one or more other ethnic groups."

"I have a concern that, in the absence of definitive results from other factors," she continued, "the standard explanation for cancer discrepancies in African Americans might become too comfortably and conveniently couched in terms of culture and economics…. [W]e owe it to the African-American population and to the nation to either rule out or to identify definitively the other factors to which I have alluded."

5. NIH staff must reflect the diversity of the U.S. population.

Brown stated that staff at NIH need to include minorities so that staff are representative of the populations that they study.

6. NIH must improve educational and outreach efforts to minority communities.

Venus Gines criticized NIH outreach efforts as inadequate. "I think



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