. "2 The Burden of Cancer Among Ethnic Minority and the Medically Underserved Populations." The Unequal Burden of Cancer: An Assessment of NIH Research and Programs for Ethnic Minorities and the Medically Underserved. Washington, DC: The National Academies Press, 1999.
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TABLE 2-19 Stage of Cancer at Diagnosis by Selected Cancer Site and Ethnic Group
Percent
Stage of Cancer and Ethnic Group
Colon
Lung
Female Breast
Cervix (invasive)
In Situ
Non-Hispanic white
2.5
0.2
5.0
81.0
Hispanic
1.3
0.0
3.9
72.7
Native American
3.6
0.0
2.2
76.1
Local
Non-Hispanic white
28.4
32.0
52.3
12.3
Hispanic
29.3
32.5
43.8
15.2
Native American
29.1
23.2
33.3
11.3
Regional
Non-Hispanic white
43.1
24.7
36.3
4.8
Hispanic
40.7
21.9
42.9
8.5
Native American
42.7
25.3
48.4
9.2
Distant
Non-Hispanic white
26.0
43.1
6.5
1.9
Hispanic
28.7
45.6
9.5
3.6
Native American
24.5
51.5
16.1
3.3
SOURCE: Samet et al., (1987).
in the aggressiveness of treatment of cancer. For example, one study found that African-American women with advanced breast cancer were less likely than white women to receive surgery, and mortality was higher among African-American women than in white women with advanced disease (Breen and Ching, 1995). Similarly, SEER program data were used to evaluate prostate cancer treatment, and the proportion of African-American men who receive prostatectomy was lower than that of white men (Harlan et al., 1995). This trend appears to be consistent over the time period of evaluation (1984 to 1991).
Socioeconomic Status and Cancer Surveillance
No national database or agency reports the relationship between SES and cancer. Over the last 40 years, many studies have supported the conclusion that SES is somehow related to cancer. However, differences in the measures of SES (education, income, residence, occupation, or a calculated composite value) between studies have resulted in difficulties in examining this relationship in its entirety (Greenwald et al., 1996). Differences
