Indian." As shown in Table 5-3, starting in 1995, there was a large increase in both the number of publications and the number of titles with some relation to dissemination compared with those in previous years. The reasons for these increases are not clear. For instance, more projects may have been funded, researchers may more frequently have published multiple articles that were based on the same numbers of projects, community and political activism may have increased pressure for both, or there may be other less obvious reasons worth investigating.

Other Sources of Cancer Information

NCI also made available approximately 600 publications and other informational resources. In its response to the Institute of Medicine, NCI listed several examples that are targeted to African-American, Hispanic, Native American, and multiethnic populations. However, no data on the proportion of all materials that are targeted to minority and medically underserved groups were available. The committee did not find any publication comparable to ACS's Cancer Facts & Figures—1997 (American Cancer Society, 1997), which provided a general comparison of the cancer-related needs of different racial and ethnic groups.

NCI's computerized information systems have been designed to help physicians cope with the information explosion by translating the medical literature into usable forms that are accessible by computer and fax. Systems developed by NCI's International Cancer Information Center provide access to a comprehensive source of bibliographic citations on cancer research (the CANCERLIT database) and to current, peer-reviewed syntheses of state-of-the-art clinical information on cancer (the PDQ database [Hubbard et al., 1995]). However, programs such as the NIH Consensus Development Program and Physician Data Query system have not been shown to have major impacts on treatment patterns (Kosecoff et al., 1987; Lomas et al., 1989). A method that assesses how usage patterns for these programs and systems may vary between minority and nonminority physicians does not seem to exist.

Admitting its lack of experience reaching high-risk populations, particularly those characterized by high proportions of socioeconomically disadvantaged individuals, ACS has begun to fund and provide technical assistance to community demonstration projects, followed by dissemination of model projects to selected ACS divisions with various resources and capabilities (e.g., outreach to high-risk populations, planning, program development, and evaluation) for replication (Corcoran and Robinson, 1994). Since January 1996, NCI has sponsored a series of regional conferences on the recruitment and retention of minorities in clinical trials, in part to promote interaction between community groups and researchers



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