Congress and the public. Such a report would not attempt to describe the status of each of the more than 100 diseases classified as cancer, nor would it attempt to describe all possible ethnic groups. Ethnic groups and cancer sites would be aggregated. The five cancer sites responsible for the highest rates of mortality from cancer and the macro-ethnic groups representing the largest segments of the population would be included. These macro-ethnic groups would be white, African American, Hispanic, Asian American (including Pacific Islanders), and Native American. Data for medically underserved individuals may be included as subgroups of data for all ethnic groups in the same table or may be included in a separate table. The report would include all the features mentioned above, including rates, explanations of rates on the basis of current knowledge, gaps in knowledge, and changes in strategy. This summary report would be issued every year.

Another type of report, a special report, would focus on one macro-ethnic group including the medically underserved population. This would permit expanded coverage of a specific ethnic group and its components in comparison with other ethnic groups. This coverage would be summarized but would also include data for a larger range of cancer sites. For example, it could report on data for Asian Americans but would include data for the subgroups of Asian Americans not included in the summary reports. The report would cover the same results and process areas as the summary report. It would also be a report to Congress and the public but would have a more limited circulation since it would be especially targeted to the one or two macro-ethnic groups involved. Because some of the ethnic groups have small populations in terms of the overall U.S. population, it is less likely that there would be statistically observable and reliable differences over a short time. For this reason, a 5-year period would be appropriate for any one group, but the reports may appear annually and may feature a different ethnic group, with the different ethnic groups covered in some form of rotation.

Summary

The reporting to the U.S. Congress and the public should first focus on results and trends primarily by use of mortality data. Progress will not be dramatic but it should be steady. The statistics can be presented in a variety of ways to increase their clarity to a wider audience. One can also examine the processes of early detection, prevention, and treatment as contributing factors. Two kinds of reports have been suggested to be submitted annually. To address the additional concerns of Congress with respect to ethnic minority and medically underserved populations, it has been suggested that a special section of the appropriate reports include



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