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The Unequal Burden of Cancer: An Assessment of NIH Research and Programs for Ethnic Minorities and the Medically Underserved (1999)

Chapter: Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group

« Previous: Appendix E: National Institutes of Health and National Cancer Institute Background Material
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

F

Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

DEPARTMENT OF HEALTH & HUMAN SERVICES
Public Health Service
Centers for Disease Control and Prevention
National Center for Health Statistics
6525 Belcrest Road Hyattsville, Maryland 20782

September 16, 1998

M. Alfred Haynes, M.D., M.P.H.
Chair,
Committee on Cancer Research Among Minorities and the Medically Underserved
Institute of Medicine

2101 Constitution Avenue, N.W. Washington, D.C. 20418

Dear Dr. Haynes:

I am writing in response to your letter of July 24, 1998 in which you asked for an analysis of cancer mortality based on race. Please find enclosed a statement of the methodology we used including several caveats, a summary table, and a detailed table demonstrating the reduction in cancer deaths that could be achieved if differences by race or ethnicity could be eliminated.

A few notes on what we've done: You asked us if we could illustrate the number and percent of deaths that would be avoided if all race or ethnic groups shared the same mortality risks for specific cancer sites. You also asked that we consider that the ''best" mortality experience be the one that all groups could, at least hypothetically, experience.

We departed somewhat from the methodology you recommended in the letter with respect to sex, rates, and race:

First, in consultation with NCI, we performed the calculations separately by sex because of the major differences in cancer experience by sex.

Second, we used age-adjusted death rates to select a "best" group, and age-specific death rates to calculate the "excess" deaths.

Third, we combined both the Asian and Pacific Islander and American Indians into a total Asian and Pacific Island group and a total American Indian group. These groups were formed to stabilize estimates, to use groups for which we have estimates of the degree to which race has been misreported, and to use the most recent data available, which is only available for the broad groups.

Even with these steps, we do have some serious reservations about the procedures used and resulting conclusions because race and ethnicity-specific death rates are known to be substantially too low for certain racial/ethnic groups. The consequence is that excess deaths presented here may be substantially greater than would be the case if the rates were not a function of these errors. Indeed, we are most concerned about using the American Indian rates as a baseline or "best rate" group. Given the errors in reporting, it is difficult to believe that other groups could achieve these rates. The two kinds of errors in reported death rates include serious misclassification of race and ethnicity and misreporting of age, particularly among the elderly. These problems occur on the death certificate and also on censuses and surveys.

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

Given our concerns we decided to make two estimates (Method A and Method B). In Method A, for those sites for which the American Indian rates were "best," we chose the race/ethnic group that was the next lowest in death rate for that cancer site. In Method B, we used American Indian rates when they were the "best." Two sets of tables are provided, but we strongly prefer those that are not based on American Indians as the "best'' or target rate (Method A).

While Method A are preferred estimates, this method does not make any adjustment for known race misclassification. Overall we expect that the estimated number of "excess" deaths from cancer would be around ten percent fewer for women and closer to twenty percent for men. This percentage would vary by cancer site.

Please note that I strongly believe this exercise can be useful. As I mentioned on the phone, I view differences in cancer mortality risk as, first and foremost, reflecting a variety of cancer causes and differential group responses to risk factors. Illustrating the differences between groups provides clues to form hypotheses on cancer causes, risk factors or biology. Secondly, for some cancer sites, we understand the causes and processes of cancer development sufficiently to be able to say how one group can achieve the lower risk shown by another group. Perhaps the best example I know of in the second case is the low rates of cancer among Mormons in Utah and Los Angeles, which reflect life-style choices that could be replicated in other populations.

All of us at NCHS are appreciative to our NCI colleagues who made available their SEER database and helped us make the calculations.

Please contact Mr. Maurer or Drs. Hoyert or Rosenberg (301-436-8884) if you have any additional questions.

Sincerely,

Edward J. Sondik, Ph.D.
Director
National Center for Health Statistics

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

Methodology and Caveats

The methodology that we used in computing the requested approach is as follows:

    1)  

    Our basic data included 1990–95 age-adjusted death rates (using a 1970 population standard), age-specific deaths and death rates, and populations by race and ethnicity following the structure of the 1996 SEER publication cited in your letter (produced by NCI using NCHS and Census data)

    2)  

    Method A: For specific cancer sites, we selected the group with the smallest age-adjusted death rate separately by sex. The groups for which the age-adjusted death rates were compared included white, black, Asian and Pacific Islander, Hispanic (total), and Non-Hispanic (total).

     

    Method B: For specific cancer sites, we selected the group with the smallest age-adjusted death rate separately by sex. The groups for which the age-adjusted death rates were compared included white, black, American Indian, Asian and Pacific Islander, Hispanic (total), and Non-Hispanic (total).

    3)  

    For each cancer site, we multiplied the age-specific death rate for the "best" group by the population of each of the race or ethnic groups to determine an "expected" number of deaths.

    4)  

    For each cancer site, we subtracted the "expected" number of deaths from the "observed" number of deaths to determine a value for deaths that would not have occurred.

    5)  

    For each cancer site, we also divided the "expected" number of deaths by the "observed" number of deaths, subtracted 1 from the quotient, and multiply by 100. This yields the percent difference in observed and expected deaths.

    6)  

    For all cancers combined (shown in the summary table), we summed the expected and observed deaths by sex and calculated the "excess" and percent difference from the summation for specific sites.

    7)  

    The detail table expresses the number of deaths for the full time period. The summary table express the number of deaths per year.

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

Caveats of this approach include the following:

    1)  

    Quality of data varies by race and ethnicity in both death certificate data and Census data. The quality of data for the white and black populations are good in contrast to that for other groups. American Indian is estimated to be underreported on the death certificate by more than 20% (probably greater than this) and Asian and Pacific Islander is underreported by about 10%. With respect to population data, perhaps, the most serious problem is the 33% increase in the American Indian population between 1960 and 1990 that reflects increased preference to self-report as an American Indian.

    2)  

    Age-specific death rates, especially those for the elderly, are underestimates.

    3)  

    Hispanic origin and race are separate items. We picked the best rates going across these two variables, but show the deaths for both Hispanic origin and race.

    4)  

    Hispanic origin was not reported on all State death certificates in this time period. The rates used in the calculation were based on 46 States and the District of Columbia. The observed deaths count was inflated to a national total by using the reciprocal of the fraction of the Hispanic population living in these 46 States and D.C.

    5)  

    The number of events, particularly at young ages for certain minority groups, are small. This would affect the stability of the rates. To counter that tendency, we used data for the 1990–95 time period. In the summary table, we have expressed the number of deaths in terms of a single year of data.

    6)  

    The reduction for all cancer sites combined differs depending on whether the values are summed across specific cancer sites or is done separately. The reduction is greater when the values are summed.

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

Summary table of annual reductions "possible" for cancer version excluding American Indians as "best" (i.e. Method A)

Men

Women

All cancers

 

All cancers

 

Best group rates (varies by site)

 

Best group rates (varies by site)

 

 

 

Expected deaths

Observed deaths

 

 

 

Expected deaths

Observed deaths

 

 

TOTAL

140,449

276,146

 

 

TOTAL

126,225

247,702

 

 

White

125,372

239,397

 

 

White

111,714

217,628

 

 

Black

11,479

32,505

 

 

Black

11,428

26,456

 

 

American Indian

672

753

 

 

American Indian

590

716

 

 

Asian Pacific Islander

2,926

3,492

 

 

Asian Pacific Islander

2,492

2,903

 

 

Hispanic

6,916

8,374

 

 

Hispanic

6,103

7,358

 

 

Non-Hispanic

133,533

267,772

 

 

Non-Hispanic

120,122

240,344

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

TOTAL

135,697

-49

 

 

TOTAL

121,477

-49

 

 

White

114,024

-48

 

 

White

105,913

-49

 

 

Black

21,026

-65

 

 

Black

15,027

-57

 

 

American Indian

81

-11

 

 

American Indian

126

-18

 

 

Asian Pacific Islander

566

-16

 

 

Asian Pacific Islander

411

-14

 

 

Hispanic

1,458

-17

 

 

Hispanic

1,255

-17

 

 

Non-Hispanic

134,239

-50

 

 

Non-Hispanic

120,222

-50

Lung and bronchus

Lung and bronchus

 

Best group rates (Hispanic)

 

Best group rates (Hispanic)

 

 

 

Expected deaths

Observed deaths

 

 

 

Expected deaths

Observed deaths

 

 

TOTAL

40,971

91,673

 

 

TOTAL

19,699

54,951

 

 

White

36,643

79,943

 

 

White

17,526

49,416

 

 

Black

3,296

10,578

 

 

Black

1,725

4,890

 

 

American Indian

191

239

 

 

American Indian

86

149

 

 

Asian Pacific Islander

841

914

 

 

Asian Pacific Islander

362

495

 

 

Hispanic

1,947

1,947

 

 

Hispanic

886

886

 

 

Non-Hispanic

39,024

89,726

 

 

Non-Hispanic

18,813

54,065

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

TOTAL

50,702

-55

 

 

TOTAL

35,252

-64

 

 

White

43,300

-54

 

 

White

31,890

-65

 

 

Black

7,281

-69

 

 

Black

3,165

-65

 

 

American Indian

48

-20

 

 

American Indian

63

-42

 

 

Asian Pacific Islander

73

-8

 

 

Asian Pacific Islander

133

-27

 

 

Hispanic

(0)

0

 

 

Hispanic

(0)

0

 

 

Non-Hispanic

50,702

-57

 

 

Non-Hispanic

35,252

-65

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

Summary table of annual reductions "possible" for cancer version excluding American Indians as "best" (i.e. Method A)

Pancreas

Pancreas

 

Best group rates (As & Pac Islander)

Best group rates (As & Pacific Islander)

 

 

 

Expected deaths

Observed deaths

 

 

 

Expected deaths

Observed deaths

 

 

TOTAL

9,008

12,610

 

 

TOTAL

9,179

13,512

 

 

White

8,062

10,951

 

 

White

8,183

11,664

 

 

Black

721

1,449

 

 

Black

794

1,650

 

 

American Indian

42

27

 

 

American Indian

39

34

 

 

Asian Pacific Islander

183

183

 

 

Asian Pacific Islander

163

163

 

 

Hispanic

424

440

 

 

Hispanic

403

441

 

 

Non-Hispanic

8,584

12,169

 

 

Non-Hispanic

8,775

13,071

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

TOTAL

3,601

-29

 

 

TOTAL

4,333

-32

 

 

White

2,889

-26

 

 

White

3,481

-30

 

 

Black

728

-50

 

 

Black

856

-52

 

 

American Indian

(15)

56

 

 

American Indian

(5)

14

 

 

Asian Pacific Islander

(0)

0

 

 

Asian Pacific Islander

0

-0

 

 

Hispanic

16

-4

 

 

Hispanic

38

-9

 

 

Non-Hispanic

3,585

-29

 

 

Non-Hispanic

4,295

-33

 

Ovary

 

Best group rates (As Pacific Islander)

 

 

 

 

Expected deaths

Observed deaths

 

 

 

TOTAL

6,403

13,081

 

 

 

White

5,614

11,888

 

 

 

Black

611

1,012

 

 

 

American Indian

33

35

 

 

 

Asian Pacific Islander

146

146

 

 

 

Hispanic

341

413

 

 

 

Non-Hispanic

6,062

12,668

 

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

TOTAL

6,678

-51

 

 

 

White

6,275

-53

 

 

 

Black

401

-40

 

 

 

American Indian

2

-6

 

 

 

Asian Pacific Islander

(0)

0

 

 

 

Hispanic

72

-18

 

 

 

Non-Hispanic

6,605

-52

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

Summary table of annual reductions "possible" for cancer version excluding American Indians as "best" (i.e. Method A)

 

Breast

 

Best group rates (As Pacific Islander)

 

 

 

 

Expected deaths

Observed deaths

 

 

 

TOTAL

18,236

43,513

 

 

 

White

15,917

38,045

 

 

 

Black

1,783

4,932

 

 

 

American Indian

98

98

 

 

 

Asian Pacific Islander

438

438

 

 

 

Hispanic

1,017

1,328

 

 

 

Non-Hispanic

17,219

42,184

 

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

TOTAL

25,277

-58

 

 

 

White

22,128

-58

 

 

 

Black

3,149

-64

 

 

 

American Indian

(0)

0

 

 

 

Asian Pacific Islander

0

-0

 

 

 

Hispanic

311

-23

 

 

 

Non-Hispanic

24,966

-59

Colon/rectum

Colon/rectum

 

Best group rates (Hispanic)

Best group rates (Hispanic)

 

 

 

Expected deaths

Observed deaths

 

 

 

Expected deaths

Observed deaths

 

 

TOTAL

16,753

28,310

 

 

TOTAL

15,954

28,919

 

 

White

14,964

24,974

 

 

White

14,215

25,303

 

 

Black

1,361

2,910

 

 

Black

1,386

3,244

 

 

American Indian

80

66

 

 

American Indian

69

71

 

 

Asian Pacific Islander

349

360

 

 

Asian Pacific Islander

284

302

 

 

Hispanic

814

814

 

 

Hispanic

709

709

 

 

Non-Hispanic

15,939

27,495   

 

 

Non-Hispanic

15,245

28,210

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

TOTAL

11,556

-41

 

 

TOTAL

12,964

-45

 

 

White

10,009

-40

 

 

White

11,088

-44

 

 

Black

1,550

-53

 

 

Black

1,857

-57

 

 

American Indian

(14)

21

 

 

American Indian

2

-2

 

 

Asian Pacific Islander

11

-3

 

 

Asian Pacific Islander

17

-6

 

 

Hispanic

(0)

0

 

 

Hispanic

(0)

0

 

 

Non-Hispanic

11,556

-42

 

 

Non-Hispanic

12,964

-46

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

Summary table of annual reductions "possible" for cancer version excluding American Indians as "best" (i.e. Method A)

Stomach

Stomach

 

Best group rates (White)

Best group rates (White)

 

 

 

Expected deaths

Observed deaths

 

 

 

Expected deaths

Observed deaths

 

 

TOTAL

7,329

8,198

 

 

TOTAL

5,004

5,634

 

 

White

6,539

6,540

 

 

White

4,463

4,463

 

 

Black

599

1,327

 

 

Black

432

928

 

 

American Indian

35

38

 

 

American Indian

21

25

 

 

Asian Pacific Islander

155

293

 

 

Asian Pacific Islander

88

219

 

 

Hispanic

362

519

 

 

Hispanic

220

374

 

 

Non-Hispanic

6,967

7,679

 

 

Non-Hispanic

4,784

5,260

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

TOTAL

869

-11

 

 

TOTAL

630

-11

 

 

White

0

-0

 

 

White

0

-0

 

 

Black

728

-55

 

 

Black

495

-53

 

 

American Indian

3

-8

 

 

American Indian

4

-14

 

 

Asian Pacific Islander

138

-47

 

 

Asian Pacific Islander

131

-60

 

 

Hispanic

157

-30

 

 

Hispanic

154

-41

 

 

Non-Hispanic

712

-9

 

 

Non-Hispanic

476

-9

 

Cervix

 

Best group rates (White)

 

 

 

 

Expected deaths

Observed deaths

 

 

 

TOTAL

3,976

4,578

 

 

 

White

3,438

3,439

 

 

 

Black

410

997

 

 

 

American Indian

23

34

 

 

 

Asian Pacific Islander

105

109

 

 

 

Hispanic

245

336

 

 

 

Non-Hispanic

3,731

4,242

 

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

TOTAL

602

-13

 

 

 

White

0

-0

 

 

 

Black

588

-59

 

 

 

American Indian

10

-30

 

 

 

Asian Pacific Islander

4

-4

 

 

 

Hispanic

91

-27

 

 

 

Non-Hispanic

511

-12

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

Kidney/renal/pel

Kidney/renal/pel

 

Best group rates (As Pac Islander)

Best group rates (As Pacific Islander)

 

 

 

Expected deaths

Observed deaths

 

 

 

Expected deaths

Observed deaths

 

 

TOTAL

2,433

6,350

 

 

TOTAL

1,685

4,099

 

 

White

2,163

5,715

 

 

White

1,501

3,678

 

 

Black

204

550

 

 

Black

146

369

 

 

American Indian

12

31

 

 

American Indian

7

23

 

 

Asian Pacific Islander

54

54

 

 

Asian Pacific Islander

30

30

 

 

Hispanic

127

257

 

 

Hispanic

75

150

 

 

Non-Hispanic

2,306

6,093

 

 

Non-Hispanic

1,610

3,949

 

 

 

Estimated excess excess deaths

Percent difference in observed and expected deaths

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

TOTAL

3,917

-62

 

 

TOTAL

2,414

-59

 

 

White

3,552

-62

 

 

White

2,177

-59

 

 

Black

346

-63

 

 

Black

222

-60

 

 

American Indian

19

-61

 

 

American Indian

15

-68

 

 

Asian Pacific Islander

0

-0

 

 

Asian Pacific Islander

0

-0

 

 

Hispanic

130

-51

 

 

Hispanic

75

-50

 

 

Non-Hispanic

3,786

-62

 

 

Non-Hispanic

2,339

-59

Other

 

Best group (Asian or Pacific Islander)

 

 

 

Expected deaths

Observed deaths

 

 

 

Expected deaths

Observed deaths

 

 

TOTAL

43,975

88,231

 

 

TOTAL

42,373

75,355

 

 

White

39,044

77,673

 

 

White

37,556

66,372

 

 

Black

3,738

9,352

 

 

Black

3,814

7,950

 

 

American Indian

225

238

 

 

American Indian

196

225

 

 

Asian Pacific Islander

968

968

 

 

Asian Pacific Islander

808

808

 

 

Hispanic

2,363

3,026

 

 

Hispanic

2,036

2,462

 

 

Non-Hispanic

41,612

85,205

 

 

Non-Hispanic

40,337

72,893

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

TOTAL

44,256

-50

 

 

TOTAL

32,981

-44

 

 

White

38,629

-50

 

 

White

28,816

-43

 

 

Black

5,614

-60

 

 

Black

4,136

-52

 

 

American Indian

13

-6

 

 

American Indian

29

-13

 

 

Asian Pacific Islander

0

-0

 

 

Asian Pacific Islander

(0)

0

 

 

Hispanic

662

-22

 

 

Hispanic

425

-17

 

 

Non-Hispanic

43,594

-51

 

 

Non-Hispanic

32,556

-45

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

Summary table of annual reductions "possible" for cancer version excluding American Indians as "best" (i.e. Method A)

Prostate

 

 

Best group rates (As Pacific Islander)

 

 

 

 

Expected deaths

Observed deaths

 

 

 

TOTAL

14,221

34,070

 

 

 

White

12,826

28,261

 

 

 

Black

1,082

5,477

 

 

 

American Indian

59

78

 

 

 

Asian Pacific Islander

254

254

 

 

 

Hispanic

587

917

 

 

 

Non-Hispanic

13,634

33,153

 

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

TOTAL

19,849

-58

 

 

 

White

15,436

-55

 

 

 

Black

4,394

-80

 

 

 

American Indian

19

-24

 

 

 

Asian Pacific Islander

(0)

0

 

 

 

Hispanic

330

-36

 

 

 

Non-Hispanic

19,519

-59

 

Nasopharynx

Nasopharynx

 

Best group rates (Hispanic)

 

Best group rates (Hispanic)

 

 

 

Expected deaths

Observed deaths

 

 

 

Expected deaths

Observed deaths

 

 

TOTAL

299

450

 

 

TOTAL

145

233

 

 

White

264

312

 

 

White

128

186

 

 

Black

26

62

 

 

Black

13

24

 

 

American Indian

2

6

 

 

American Indian

1

2

 

 

Asian Pacific Islander

7

71

 

 

Asian Pacific Islander

3

21

 

 

Hispanic

17

17

 

 

Hispanic

7

7

 

 

Non-Hispanic

282

433

 

 

Non-Hispanic

137

226

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

TOTAL

151

-33

 

 

TOTAL

88

-38

 

 

White

47

-15

 

 

White

58

-31

 

 

Black

36

-58

 

 

Black

10

-44

 

 

American Indian

4

-71

 

 

American Indian

1

-66

 

 

Asian Pacific Islander

63

-90

 

 

Asian Pacific Islander

18

-86

 

 

Hispanic

0

-0

 

 

Hispanic

0

-0

 

 

Non-Hispanic

151

-35

 

 

Non-Hispanic

88

-39

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

Summary table of annual reductions "possible" for cancer version excluding American Indians as "best" (i.e. Method A)

Liver & intrahepatic bile

Liver & intrahepatic bile

 

Best group rates (White)

 

Best group rates (White)

 

 

 

Expected deaths

Observed deaths

 

 

 

Expected deaths

Observed deaths

 

 

TOTAL

5,340

5,936

 

 

TOTAL

3,571

3,829

 

 

White

4,759

4,759

 

 

White

3,174

3,174

 

 

Black

440

752

 

 

Black

315

461

 

 

American Indian

26

31

 

 

American Indian

16

21

 

 

Asian Pacific Islander

114

394

 

 

Asian Pacific Islander

66

174

 

 

Hispanic

269

429

 

 

Hispanic

163

252

 

 

Non-Hispanic

5,071

5,507

 

 

Non-Hispanic

3,407

3,577

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

TOTAL

596

-10

 

 

TOTAL

258

-7

 

 

White

(0)

0

 

 

White

0

-0

 

 

Black

312

-41

 

 

Black

146

-32

 

 

American Indian

4

-15

 

 

American Indian

5

-23

 

 

Asian Pacific Islander

280

-71

 

 

Asian Pacific Islander

108

-62

 

 

Hispanic

160

-37

 

 

Hispanic

89

-35

 

 

Non-Hispanic

436

-8

 

 

Non-Hispanic

169

-5

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

Summary table of annual reductions ''possible" for cancer (Method B)

Men

Women

All cancers

All cancers

 

Best group rates (varies by site)

Best group rates (varies by site)

 

 

 

Expected deaths

Observed deaths

 

 

 

Expected deaths

Observed deaths

 

 

TOTAL

133,397

276,146

 

 

TOTAL

125,214

247,702

 

 

White

119,013

239,397

 

 

White

110,822

217,628

 

 

Black

10,942

32,505

 

 

Black

11,335

26,456

 

 

American Indian

643

753

 

 

American Indian

585

716

 

 

Asian Pacific Islander

2,799

3,492

 

 

Asian Pacific Islander

2,471

2,903

 

 

Hispanic

6,624

8,374

 

 

Hispanic

6,052

7,358

 

 

Non-Hispanic

126,773

267,772

 

 

Non-Hispanic

119,161

240,344

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

TOTAL

142,749

-52

 

 

TOTAL

122,488

-49

 

 

White

120,383

-50

 

 

White

106,806

-49

 

 

Black

21,562

-66

 

 

Black

15,120

-57

 

 

American Indian

110

-15

 

 

American Indian

131

-18

 

 

Asian Pacific Islander

693

-20

 

 

Asian Pacific Islander

431

-15

 

 

Hispanic

1,750

-21

 

 

Hispanic

1,306

-18

 

 

Non-Hispanic

140,999

-53

 

 

Non-Hispanic

121,182

-50

Lung and bronchus

Lung and bronchus

 

Best group rates (Hispanic)

Best group rates (Hispanic)

 

 

 

Expected deaths

Observed deaths

 

 

 

Expected deaths

Observed deaths

 

 

TOTAL

40,971

91,673

 

 

TOTAL

19,699

54,951

 

 

White

36,643

79,943

 

 

White

17,526

49,416

 

 

Black

3,296

10,578

 

 

Black

1,725

4,890

 

 

American Indian

191

239

 

 

American Indian

86

149

 

 

Asian Pacific Islander

841

914

 

 

Asian Pacific Islander

362

495

 

 

Hispanic

1,947

1,947

 

 

Hispanic

886

886

 

 

Non-Hispanic

39,024

89,726

 

 

Non-Hispanic

18,813

54,065

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

TOTAL

50,702

-55

 

 

TOTAL

35,252

-64

 

 

White

43,300

-54

 

 

White

31,890

-65

 

 

Black

7,281

-69

 

 

Black

3,165

-65

 

 

American Indian

48

-20

 

 

American Indian

63

-42

 

 

Asian Pacific Islander

73

-8

 

 

Asian Pacific Islander

133

-27

 

 

Hispanic

(0)

0

 

 

Hispanic

(0)

0

 

 

Non-Hispanic

50,702

-57

 

 

Non-Hispanic

35,252

-65

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

Summary table of annual reductions "possible" for cancer (Method B)

 

Breast

 

Best group rates (As Pacific Islander)

 

 

 

 

Expected deaths

Observed deaths

 

 

 

TOTAL

18,236

43,513

 

 

 

White

15,917

38,045

 

 

 

Black

1,783

4,932

 

 

 

American Indian

98

98

 

 

 

Asian Pacific Islander

438

438

 

 

 

Hispanic

1,017

1,328

 

 

 

Non-Hispanic

17,219

42,184

 

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

TOTAL

25,277

-58

 

 

 

White

22,128

-58

 

 

 

Black

3,149

-64

 

 

 

American Indian

(0)

0

 

 

 

Asian Pacific Islander

0

-0

 

 

 

Hispanic

311

-23

 

 

 

Non-Hispanic

24,966

-59

Colon/rectum

Colon/rectum

 

Best group rates (American Indian)

Best group rates (Hispanic)

 

 

 

Expected deaths

Observed deaths

 

 

 

Expected deaths

Observed deaths

 

 

TOTAL

13,258

28,310

 

 

TOTAL

15,954

28,919

 

 

White

11,805

24,974

 

 

White

14,215

25,303

 

 

Black

1,100

2,910

 

 

Black

1,386

3,244

 

 

American Indian

65

66

 

 

American Indian

69

71

 

 

Asian Pacific Islander

288

360

 

 

Asian Pacific Islander

284

302

 

 

Hispanic

676

814

 

 

Hispanic

709

709

 

 

Non-Hispanic

12,582

27,495

 

 

Non-Hispanic

15,245

28,210

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

TOTAL

15,052

-53

 

 

TOTAL

12,964

-45

 

 

White

13,169

-53

 

 

White

11,088

-44

 

 

Black

1,811

-62

 

 

Black

1,857

-57

 

 

American Indian

0

-0

 

 

American Indian

2

-2

 

 

Asian Pacific Islander

72

-20

 

 

Asian Pacific Islander

17

-6

 

 

Hispanic

138

-17

 

 

Hispanic

(0)

0

 

 

Non-Hispanic

14,914

-54

 

 

Non-Hispanic

12,964

-46

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

Summary table of annual reductions "possible" for cancer (Method B)

Pancreas

Pancreas

 

Best group rates (Mer Indian)

Best group rates (American Indian)

 

 

 

Expected deaths

Observed deaths

 

 

 

Expected deaths

Observed deaths

 

 

TOTAL

5,504

12,610

 

 

TOTAL

8,168

13,512

 

 

White

4,910

10,951

 

 

White

7,290

11,664

 

 

Black

450

1,449

 

 

Black

701

1,650

 

 

American Indian

27

27

 

 

American Indian

34

34

 

 

Asian Pacific Islander

117

183

 

 

Asian Pacific Islander

142

163

 

 

Hispanic

273

440

 

 

Hispanic

353

441

 

 

Non-Hispanic

5,232

12,169

 

 

Non-Hispanic

7,815

13,071

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

TOTAL

7,105

-56

 

 

TOTAL

5,344

-40

 

 

White

6,041

-55

 

 

White

4,374

-37

 

 

Black

999

-69

 

 

Black

950

-58

 

 

American Indian

0

-0

 

 

American Indian

0

-0

 

 

Asian Pacific Islander

65

-36

 

 

Asian Pacific Islander

20

-13

 

 

Hispanic

167

-38

 

 

Hispanic

88

-20

 

 

Non-Hispanic

6,938

-57

 

 

Non-Hispanic

5,255

-40

 

Ovary

 

 

Best group rates (As Pacific Islander)

 

 

 

 

Expected deaths

Observed deaths

 

 

 

TOTAL

6,403

13,081

 

 

 

White

5,614

11,888

 

 

 

Black

611

1,012

 

 

 

American Indian

33

35

 

 

 

Asian Pacific Islander

146

146

 

 

 

Hispanic

341

413

 

 

 

Non-Hispanic

6,062

12,668

 

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

TOTAL

6,678

-51

 

 

 

White

6,275

-53

 

 

 

Black

401

-40

 

 

 

American Indian

2

-6

 

 

 

Asian Pacific Islander

(0)

0

 

 

 

Hispanic

72

-18

 

 

 

Non-Hispanic

6,605

-52

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

Summary table of annual reductions "possible" for cancer (Method B)

Stomach

Stomach

 

Best group rates (White)

Best group rates (White)

 

 

 

Expected deaths

Observed deaths

 

 

 

Expected deaths

Observed deaths

 

 

TOTAL

7,329

8,198

 

 

TOTAL

5,004

5,634

 

 

White

6,539

6,540

 

 

White

4,463

4,463

 

 

Black

599

1,327

 

 

Black

432

928

 

 

American Indian

35

38

 

 

American Indian

21

25

 

 

Asian Pacific Islander

155

293

 

 

Asian Pacific Islander

88

219

 

 

Hispanic

362

519

 

 

Hispanic

220

374

 

 

Non-Hispanic

6,967

7,679

 

 

Non-Hispanic

4,784

5,260

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

TOTAL

869

-11

 

 

TOTAL

630

-11

 

 

White

0

-0

 

 

White

0

-0

 

 

Black

728

-55

 

 

Black

495

-53

 

 

American Indian

3

-8

 

 

American Indian

4

-14

 

 

Asian Pacific Islander

138

-47

 

 

Asian Pacific Islander

131

-60

 

 

Hispanic

157

-30

 

 

Hispanic

154

-41

 

 

Non-Hispanic

712

-9

 

 

Non-Hispanic

476

-9

 

Cervix

 

Best group rates (White)

 

 

 

 

Expected deaths

Observed deaths

 

 

 

TOTAL

3,976

4,578

 

 

 

White

3,438

3,439

 

 

 

Black

410

997

 

 

 

American Indian

23

34

 

 

 

Asian Pacific Islander

105

109

 

 

 

Hispanic

245

336

 

 

 

Non-Hispanic

3,731

4,242

 

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

TOTAL

602

-13

 

 

 

White

0

-0

 

 

 

Black

588

-59

 

 

 

American Indian

10

-30

 

 

 

Asian Pacific Islander

4

-4

 

 

 

Hispanic

91

-27

 

 

 

Non-Hispanic

511

-12

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

Summary table of annual reductions "possible" for cancer (Method B)

Kidney/renal/pel

Kidney/renal/pel

 

Best group rates (As Pac Islander)

Best group rates (As Pacific Islander)

 

 

 

Expected deaths

Observed deaths

 

 

 

Expected deaths

Observed deaths

 

 

TOTAL

2,433

6,350

 

 

TOTAL

1,685

4,099

 

 

White

2,163

5,715

 

 

White

1,501

3,678

 

 

Black

204

550

 

 

Black

146

369

 

 

American Indian

12

31

 

 

American Indian

7

23

 

 

Asian Pacific Islander

54

54

 

 

Asian Pacific Islander

30

30

 

 

Hispanic

127

257

 

 

Hispanic

75

150

 

 

Non-Hispanic

2,306

6,093

 

 

Non-Hispanic

1,610

3,949

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

TOTAL

3,917

-62

 

 

TOTAL

2,414

-59

 

 

White

3,552

-62

 

 

White

2,177

-59

 

 

Black

346

-63

 

 

Black

222

-60

 

 

American Indian

19

-61

 

 

American Indian

15

-68

 

 

Asian Pacific Islander

0

-0

 

 

Asian Pacific Islander

0

-0

 

 

Hispanic

130

-51

 

 

Hispanic

75

-50

 

 

Non-Hispanic

3,786

-62

 

 

Non-Hispanic

2,339

-59

Other

Other

 

Best group (Asian or Pacific Islander)

Best group rates (As Pacific Islander)

 

 

 

Expected deaths

Observed deaths

 

 

 

Expected deaths

Observed deaths

 

 

TOTAL

43,975

88,231

 

 

TOTAL

42,373

75,355

 

 

White

39,044

77,673

 

 

White

37,556

66,372

 

 

Black

3,738

9,352

 

 

Black

3,814

7,950

 

 

American Indian

225

238

 

 

American Indian

196

225

 

 

Asian Pacific Islander

968

968

 

 

Asian Pacific Islander

808

808

 

 

Hispanic

2,363

3,026

 

 

Hispanic

2,036

2,462

 

 

Non-Hispanic

41,612

85,205

 

 

Non-Hispanic

40,337

72,893

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

TOTAL

44,256

-50

 

 

TOTAL

32,981

-44

 

 

White

38,629

-50

 

 

White

28,816

-43

 

 

Black

5,614

-60

 

 

Black

4,136

-52

 

 

American Indian

13

-6

 

 

American Indian

29

-13

 

 

Asian Pacific Islander

0

-0

 

 

Asian Pacific Islander

(0)

0

 

 

Hispanic

662

-22

 

 

Hispanic

425

-17

 

 

Non-Hispanic

43,594

-51

 

 

Non-Hispanic

32,556

-45

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

Summary table of annual reductions "possible" for cancer (Method B)

Prostate

 

 

Best group rates (As Pacific Islander)

 

 

 

 

Expected deaths

Observed deaths

 

 

 

TOTAL

14,221

34,070

 

 

 

White

12,826

28,261

 

 

 

Black

1,082

5,477

 

 

 

American Indian

59

78

 

 

 

Asian Pacific Islander

254

254

 

 

 

Hispanic

587

917

 

 

 

Non-Hispanic

13,634

33,153

 

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

TOTAL

19,849

-58

 

 

 

White

15,436

-55

 

 

 

Black

4,394

-80

 

 

 

American Indian

19

-24

 

 

 

Asian Pacific Islander

(0)

0

 

 

 

Hispanic

330

-36

 

 

 

Non-Hispanic

19,519

-59

 

Nasopharynx

Nasopharynx

 

Best group rates (Hispanic)

 

Best group rates (Hispanic)

 

 

 

Expected deaths

Observed deaths

 

 

 

Expected deaths

Observed deaths

 

 

TOTAL

299

450

 

 

TOTAL

145

233

 

 

White

264

312

 

 

White

128

186

 

 

Black

26

62

 

 

Black

13

24

 

 

American Indian

2

6

 

 

American Indian

1

2

 

 

Asian Pacific Islander

7

71

 

 

Asian Pacific Islander

3

21

 

 

Hispanic

17

17

 

 

Hispanic

7

7

 

 

Non-Hispanic

282

433

 

 

Non-Hispanic

137

226

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

TOTAL

151

-33

 

 

TOTAL

88

-38

 

 

White

47

-15

 

 

White

58

-31

 

 

Black

36

-58

 

 

Black

10

-44

 

 

American Indian

4

-71

 

 

American Indian

1

-66

 

 

Asian Pacific Islander

63

-90

 

 

Asian Pacific Islander

18

-86

 

 

Hispanic

0

-0

 

 

Hispanic

0

-0

 

 

Non-Hispanic

151

-35

 

 

Non-Hispanic

88

-39

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×

Summary table of annual reductions "possible" for cancer (Method B)

Liver & Intrahepatic bile

Liver & Intrahepatic bile

 

Best group rates (White)

 

Best group rates (White)

 

 

 

Expected deaths

Observed deaths

 

 

 

Expected deaths

Observed deaths

 

 

TOTAL

5,340

5,936

 

 

TOTAL

3,571

3,829

 

 

White

4,759

4,759

 

 

White

3,174

3,174

 

 

Black

440

752

 

 

Black

315

461

 

 

American Indian

26

31

 

 

American Indian

16

21

 

 

Asian Pacific Islander

114

394

 

 

Asian Pacific Islander

66

174

 

 

Hispanic

269

429

 

 

Hispanic

163

252

 

 

Non-Hispanic

5,071

5,507

 

 

Non-Hispanic

3,407

3,577

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

 

Estimated excess deaths

Percent difference in observed and expected deaths

 

 

TOTAL

596

-10

 

 

TOTAL

258

-7

 

 

White

(0)

0

 

 

White

0

-0

 

 

Black

312

-41

 

 

Black

146

-32

 

 

American Indian

4

-15

 

 

American Indian

5

-23

 

 

Asian Pacific Islander

280

-71

 

 

Asian Pacific Islander

108

-62

 

 

Hispanic

160

-37

 

 

Hispanic

89

-35

 

 

Non-Hispanic

436

-8

 

 

Non-Hispanic

169

-5

Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
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Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 295
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 296
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 297
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 298
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 299
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 300
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 301
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 302
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 303
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 304
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 305
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 306
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 307
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 308
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 309
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 310
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 311
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 312
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 313
Suggested Citation:"Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group." Institute of Medicine. 1999. 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. doi: 10.17226/6377.
×
Page 314
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We know more about cancer prevention, detection, and treatment than ever before--yet not all segments of the U.S. population have benefited to the fullest extent possible from these advances. Some ethnic minorities experience more cancer than the majority population, and poor people--no matter what their ethnicity--often lack access to adequate cancer care. This book provides an authoritative view of cancer as it is experienced by ethnic minorities and the medically underserved. It offers conclusions and recommendations in these areas:

  • Defining and understanding special populations, and improving the collection of cancer-related data.
  • Setting appropriate priorities for and increasing the effectiveness of specific National Institutes of Health (NIH) research programs, to ensure that special populations are represented in clinical trials.
  • Disseminating research results to health professionals serving these populations, with sensitivity to the issues of cancer survivorship.

The book provides background data on the nation's struggle against cancer, activities and expenditures of the NIH, and other relevant topics.

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