. "3 Overview of Programs of Research on Ethnic Minority and Medically Underserved Populations at the National Institutes of Health." 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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in VA medical centers to create a large specimen bank for a prospective study of nutritional and genetic hypotheses of colorectal neoplasia. Specimens will be obtained from patients with large adenomas, patients with small polyps, and asymptomatic individuals to assess their relationship with serum micronutrients and molecular genetic markers. These studies are classified as Category I and II research by NCI.
NCI-supported research on the etiology of pancreatic cancer includes a series of case-control studies among African Americans that examine the roles of smoking, diet, various medical conditions, and genetic factors. The role of hepatitis viruses in conjunction with other environmental and lifestyle risk factors in the development of pancreatic cancer is also being investigated in a case-control study in Senegal, West Africa. These studies are classified as Category I studies.
NCI-supported case-control studies are comparing risk factors for multiple myeloma among African-American and white populations. Findings indicate that occupational exposures (especially for those residing on farms and reporting exposure to pesticides) increase the risk for this cancer. NCI also supported a workshop on the epidemiology of multiple myeloma, with special attention to factors that may contribute to the excess incidence among African Americans.
Cancer Prevention and Control
An NCI document notes that behavioral and environmental influences are responsible for the majority of cancers in the United States. Reducing the cancer burden therefore requires "a balanced partnership between the biomedical and behavioral/public health sectors" (National Cancer Institute, 1998b, p. 46). NCI's definition of cancer control research attempts to reflect this view: "cancer control research is now defined as basic and applied research in the behavioral, social, and population sciences to create or enhance interventions that, independently or in combination with biomedical approaches, reduce cancer risk, incidence, morbidity, and mortality" (National Cancer Institute, 1998b, p. 46). Much of this research is funded through the newly established DCCPS.
Primary Prevention and Intervention Studies
Tobacco Use and African Americans
NCI has funded Category I research examining the effectiveness of culturally appropriate behavioral interventions to decrease the level of tobacco use among African Americans. In