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Screening rates lower among Hispanic and Asian Americans.
The percentage of U.S. citizens screened for cancer remains below national targets, with significant disparities among racial and ethnic populations, according to the first federal study to identify cancer screening disparities among Asian and Hispanic groups. The report by the Centers for Disease Control and Prevention and the National Cancer Institute (NCI), part of the National Institutes of Health, was published Jan. 26 in the CDC Morbidity and Mortality Weekly Report.
In 2010, breast cancer screening rates were 72.4 percent, below the Healthy People 2020 target of 81 percent; cervical cancer screening was 83 percent, below the target of 93 percent; and colorectal cancer screening was 58.6 percent, below the target of 70.5 percent, according to the study, “Cancer Screening in the United States – 2010.”
Hispanics were less likely to be screened for cervical and colorectal cancer (78.7 percent and 46.5 percent, respectively) when compared to non-Hispanics (83.8 percent and 59.9 percent, respectively).
“It is troubling to see that not all Americans are getting the recommended cancer screenings and that disparities continue to persist for certain populations. Screening can find breast, cervical, and colorectal cancers at an early stage when treatment is more effective,” said Sallyann Coleman King, M.D., an epidemic intelligence service officer in CDC’s Division of Cancer Prevention and Control and lead author of the study. “We must continue to monitor cancer screening rates to improve the health of all Americans.”
- Women aged 50-74 years should be screened for breast cancer with a mammogram every two years.
- Women who have been sexually active for three years or are aged 21-65 years should be screened for cervical cancer with a Pap test at least every three years.
- Colorectal cancer screening is recommended for average-risk men and women aged 50-75 years, using high-sensitivity fecal occult blood test (FOBT), done at home every year; sigmoidoscopy every five years, with high-sensitivity FOBT every three years; or colonoscopy every 10 years.
To assess the use of currently recommended cancer screening tests by age, race, ethnicity, education, length of residence in the United States, and the source and financing of health care researchers analyzed data from the 2010 National Health Interview Survey, which tracks progress toward the achievement of Healthy People 2020 objectives. For the ethnic subgroups, Asians were classified as Chinese, Filipino, or other Asian and Hispanics as Puerto Rican, Mexican, Mexican-American, Central or South American, or other Hispanic.
Significant findings include:
- Screening rates for breast cancer remained relatively stable and varied no more than 3 percent over the period 2000-2010.
- From 2000-2010, colorectal cancer screening rates increased markedly for men and women, with the rate for women increasing slightly faster so that rates among both sexes were nearly identical (58.5 percent for men and 58.8 percent for women) in 2010.
- From 2000-2010, a small but statistically significant downward trend of 3.3 percent was observed in the rate of women who reported getting a Pap test within the last three years.
- Considerably lower breast, cervical, and colorectal cancer screening use was reported by those without any usual source of health care or health insurance.
The authors note that this study reinforces the need to identify and track cancer screening disparities. Additionally, the report provides guidance for the development programs to increase the use of screening tests in order to meet Healthy People 2020 targets and simultaneously reduce cancer morbidity and mortality.
Hispanics were 13.4% less likely to receive colorectal cancer screenings & 5.1% less likely to receive breast cancer screenings than non-Hispanics.
“Healthy People objectives are important for monitoring progress toward reducing the burden of cancer in the United States. Our study points to the particular need for finding ways to increase the use of breast, cervical, and colorectal cancer screening tests among Asians, Hispanics, as well as adults who lack health insurance or a usual source of health care,” said Carrie Klabunde, Ph.D., an epidemiologist inNCI’s Division of Cancer Control and Population Sciences and a co-author of the study.
According to the authors, the Affordable Care Act is expected to reduce financial barriers to care by expanding insurance coverage. Other efforts are needed such as developing systems that identify individuals eligible for cancer screening tests, actively encouraging the use of screening tests, and monitoring participation to improve screening rates, they say.
Center for Disease Control
Through the National Breast and Cervical Cancer Early Detection Program, CDC provides low-income, uninsured, and underinsured women access to timely breast and cervical cancer screening and diagnostic services in all 50 states, the District of Columbia, five U.S. territories, and 12 American Indian/Alaska Native tribes or tribal organizations. The CDCs Colorectal Cancer Control Program funds 25 states and four tribal organizations to implement population-based approaches to increase screening among men and women aged 50 years and older. Population-based approaches include policy and health systems change, outreach, case management, and selective provision of screening services. For information about CDC efforts to prevent cancer, visit www.cdc.gov/cancer
National Cancer Institute
NCI leads the National Cancer Program and NIH’s effort to dramatically reduce the burden of cancer and improve the lives of cancer patients and their families, through research into prevention and cancer biology, the development of new interventions, and the training and mentoring of new researchers. For more information about cancer, visit www.cancer.gov or call NCI’s Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).
“CDC works 24/7 saving lives, protecting people from health threats, and saving money through prevention. Whether these threats are global or domestic, chronic or acute, curable or preventable, natural disaster or deliberate attack, CDC is the nation’s health protection agency.”
For the original CDC press release, click here.
The Hispanic Access Foundation is committed to helping Hispanic Americans live better, healthier lives. We provide a searchable online database of healthcare services for Hispanics in communities across the nation. Search our database for healthcare services near you.
According to research conducted by the American Cancer Society and the Intercultural Cancer Council, cancer is the second leading cause of death among Hispanic adults after heart disease. Hispanic women have two to three times the cervical cancer rates of non-Hispanic white women. Hispanic men and women have higher rates of stomach cancer than non-Hispanic populations. Lung cancer and breast cancer are the deadliest cancers among Hispanic men and Hispanic women, respectively.
Despite these alarming statistics, only 38% of Hispanic women age 40 and older regularly receive mammograms, and Hispanic women are less likely to receive regular pap smears than non-Hispanic white women. Deaths from breast and cervical cancers could easily be avoided if cancer screening rates increased among women at risk. Unfortunately, rates of preventive cancer screenings are proportionally linked to insurance coverage– the less insured an ethnic group is, the less likely they are to be screened. Latinos are the most likely of any ethnic in the United States to be under-insured due to a disproportionate lack of job-related insurance.
In response, HAF has launched “Juntos Podemos Contra El Cancer” (Together We Can Fight Cancer)—a national Spanish-language communications campaign financed by the Centers for Disease Control and Prevention (CDC). The campaign is designed to reach Spanish-speaking Latinos through both mass media channels and grassroots outreach activities, and strengthen links between community-based service providers and Latino communities. Ultimately the campaign’s objective is to increase cancer screening among Latinos and thereby decrease cancer mortality rates in Latino communities.
In support of the campaign HAF is actively seeking to expand partnerships with community health service providers and cancer screening centers. The campaign’s print, radio, Internet and cell phone messages will build awareness of the importance of cancer screening, and encourage the public to contact HAF’s helpline by phone or by email to find the location of their local cancer screening centers that provide bilingual or Latino-friendly services. In order to better serve the Latino community, HAF is therefore building its database of relevant cancer-related service providers.
If you or your organization provides health services to the Latino population, please join our newsletter and stay tuned for more campaign-related information. If you are not yet part of our service provider network, please contact us to become a member. If you provide cancer-related referrals or screening services, please be sure to join our network. Together we can make a difference!
September 17, 2012 by Jennifer Brandt
Letter from the Executive Director from 2011 HAF Annual Report
2011 marked the first full-year for Hispanic access Foundation and we have truly been blessed by all of those that have supported us in one-way or another.
Hundreds of leaders in our faith-based and community network took up the torch in transforming information into action. Partners like H&R Block and the Center for Disease Control and Prevention recognized the importance of grassroots outreach into Hispanic communities. Thousands of Latino families throughout the country embraced our organization, took advantage of the information in our campaigns and took action to improve their futures.
The bridges that we are building are changing lives.
As you read through this annual Report, it should become apparent that what HAF does in reaching the Hispanic community is unlike any other organization. We’ve developed extensive, trust-filled relationships with Latino churches that provide the access to connect with the community at their level. We’ve gained immediate confidence from large corporations and government branches. We’ve mobilized thousands of individuals through our grassroots outreach. We’ve built community bridges and placed many individuals on the path to a better life.
Our message of responsible citizenship, educational attainment, and active engagement in the improvement of the health, environment, and financial well-being of Latino families is resonating at all levels throughout the United States. and it needs to.
By 2050, the Hispanic population is projected to make up 30 percent of the entire U.S. population. The work that we do now is critical to the long-term prospects of this country as a whole. Hispanics need to understand the U.S. tax system and become responsible taxpayers. Latinos need to become advocates of their health and understand the importance of preventative care. Hispanics need to receive a quality education and gain equal access to higher education opportunities.
But, it’s not just about need. It’s about the future of america and making sure we’re all in position to maximize the potential before us.
Read the complete version of the 2011 Hispanic Access Foundation Annual Report
For more than six years, Lilia Fuentes did not get a Pap test. Lilia, whose name has been changed, didn’t think it was necessary since she always felt healthy.
Then, at the beginning of 2010, she went to see a doctor after she started to bleed profusely. The test results were devastating: she had advanced cervical cancer. From that moment on, her life took a 180-degree turn.
The independent and hard-working woman who cleaned houses in San Jose, Calif., had to undergo intensive treatment that left her bedridden. To prevent the cancer from spreading, her uterus and ovaries were removed and she started chemotherapy and radiation. She spent entire days in the hospital, completely isolated.
“Neither her sister, nor her two kids — a 22-year-old daughter and a 19-year-old son — could see her,” recalls Claudia Colindres, who works for the non-profit organization Latinas Contra el Cáncer (Latinas Against Cancer), which offers support for those who suffer from the disease, as well as their families. Colindres says that despite doctors’ best efforts, the cancer not only did not diminish it became more aggressive.
“She lost a lot of weight and they decided to refer her to a home care program for terminal patients,” she says. “I visited her and the last time I went, I knew I would never see her again. Her skin was yellow and she looked very skinny, very tired.
Lilia died two weeks later, on July 4, 2011.
The family, according to Colindres, is still so upset they refuse to even talk about Lilia, who was 58 years old at the time of her death, originally from Mexico and a single mother.
“At her funeral, the one who looked the most depressed was her sister, who had never lived apart from her. After Lilia died, the family broke up. Her daughter went to live with a friend and her son stayed with his aunt because he was going to school.”
Colindres says that the family is finding it hard to cope with Lilia’s death. They feel guilty for not pressuring her to get tested on time and take better care of her health.
To make matters worse, Colindres adds, they lost the house that Lilia had bought making many sacrifices because they could no longer make the payments.
In California, nearly 1,400 women are diagnosed with this cancer and 400 of them die each year.
“Lilia’s mom, who lives in Mexico, cries a lot because she can’t see her again and can’t even visit her grave because they cremated her here and her ashes remain here,” she says.
Lilia’s story illustrates the tremendous emotional, social and economic impact the death of a middle-aged woman has on a family from a preventable disease.
“In general, (these women) are the cornerstones of their homes, the ones who give unity and strength to the nuclear family,” says Alejandra Casillas, an internist at the Robert Wood Johnson Clinical Scholars Program at the University of California in Los Angeles (UCLA).
Although this type of cancer affects all ethnic groups, Latinas are diagnosed with this disease twice as often as Caucasians. They also have the highest mortality rate in California, according to Casillas.
This is because, among other reasons, many Latinas lack health insurance. It is also due to cultural reasons.
“Latinas don’t take charge of their health; they don’t value the importance of staying healthy to support their families,” Casillas observes.
Cervical cancer is the second-most common cancer worldwide and is responsible for 250,000 deaths a year, of which 4,000 are recorded in the United States.
In California, nearly 1,400 women are diagnosed with this cancer and 400 of them die each year. The deaths are needless because cervical cancer is a preventable disease. It can be easily detected through a relatively simple, low-cost test and can be prevented by a vaccine.
The majority of cervical cancer cases is caused by the human papilloma virus or HPV. Each year, millions of women are infected with the virus, but because they do not have any symptoms, they don’t realize that they are at risk of developing cervical cancer.
The California Medical Association (CMA) Foundation has undertaken an intensive educational campaign to reduce the number of victims. Carol Lee, president and CEO of CMA Foundation, notes that “with proven prevention methods, including HPV vaccine, regular Pap tests and greater public awareness, we have a tremendous opportunity to reduce the devastating effects of cervical cancer and completely eliminate this disease.”
According to the Centers for Disease Control and Prevention, the highest rate of advanced cervical cancer occurs among Hispanic women between 50 and 79 years of age.
Casillas says that several studies show that in California, Latinas are the least likely to get a Pap test. Ten percent have never had the test in their lives.
Pap tests are available for free for low-income women through the “Every Woman Counts” program, and HPV vaccines are covered by insurance and through the “Vaccines for Children” program.
To see if you qualify for a free cervical cancer test through this program, call 1-800-511-2300, Monday through Friday, 8:30 am to 5 pm. Spanish-speaking operators are available. To see if your children can be vaccinated free of charge, ask your doctor about the Vaccines for Children program. All children eligible for California’s Child Health and Disability Prevention (CHDP) program may also qualify for free or low-cost vaccines.
The 2011 CMAF/Cervical Cancer Reporting Fellowship is sponsored by the California Medical Association Foundation (CMAF), a charitable arm of the California Medical Association, to bridge physicians to their communities to address community health. The journalism fellowship program, administered by New America Media, is designed to raise awareness and provide public health information on cervical cancer to the at-risk Latina population in Los Angeles.
Source: Latinas – The Main Victims of Cervical Cancer in California by Maria Luisa Arredondo, New America Media, Posted: Jan 12, 2012
About New America Media
New America Media is the country’s first and largest national collaboration and advocate of 2000 ethnic news organizations. Over 57 million ethnic adults connect to each other, to home countries and to America through 3000+ ethnic media, the fastest growing sector of American journalism.
Founded by the nonprofit Pacific News Service in 1996, NAM is headquartered in California with offices inNew York and Washington D.C., and partnerships with journalism schools to grow local associations of ethnic media.
NAM is dedicated to bringing the voices of the marginalized – ethnic minorities, immigrants, young people, elderly – into the national discourse. The communities of the New America will then be better informed, better connected to one another, and better able to influence policy makers.
Posted by Amelie Ramirez on WhiteHouse.org/blog
I hear that a lot from Latina women, unfortunately. They see statistics on how Latinas don’t get breast cancer nearly as often as black or white women.
They need to know: Breast cancer is the No. 1 Latina cancer killer.
Latinas are 20% more likely to die of breast cancer than white women diagnosed at similar ages and stages. Critical cultural beliefs continue to interfere with Latinas’ approach to cancer screening and early detection. Latinas still greatly fear breast cancer and don’t think there’s anything they can do to prevent it, so they put off screening. Latina moms take care of others first. Few Latinas recognize breast cancer often progresses slowly enough to be detected and treated. And even if Latinas are screened, they are more likely to delay/miss follow-up appointments and start treatment later once cancer is confirmed—leading to worse cancer outcomes.
But Latinas also need to know: Breast cancer doesn’t have to kill.
Prevention is the key, and timely screening, diagnosis, treatment, and follow-up care are critical if Latinas are to survive cancer and sustain a good quality of life.
Editors note: Dr. Amelie G. Ramirez is a foremost cancer expert at The University of Texas Health Science Center at San Antonio, a partner of the Hispanic Access Foundation’s “Juntos Podemos Contra El Cancer” Project, contributing bilingual material used to teach Latinas how to best reduce their cancer risk, obtain needed screening and reduce fear.