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

1998c, p. 36). In response to these recommendations, the SEER program was expanded in 1992 to include the county of Los Angeles and the San Jose-Monterey area of California to further increase representation of Hispanics and other ethnic groups of interest. This resulted in a 46 percent increase in the overall, population covered by the SEER program, and increases of 41 percent for African Americans and 223 percent for Hispanics. The relative increases for other groups were also substantial. The current coverage areas of the 11 SEER program contractors are shown in Table 2-4.

In 1997, the NCI Cancer Control Review Group also recommended that SEER program coverage "be expanded to include several populations not adequately represented: Appalachia; the rural south (with emphasis

TABLE 2-4 Areas Covered by the 11 SEER Program Contractors

Registry Location	Year of Entry	First Full Year of Data	Coverage Area
Utah	1973	1973	Entire state
Connecticut	1973	1973	Entire state
Iowa	1973	1973	Entire state
New Mexico	1973	1973	Entire state
Hawaii	1973	1973	Entire state
Detroit, Michigan	1973	1973	Macomb, Oakland, and Wayne counties
San Francisco-Oakland, California	1973	1973	Alameda, Contra Costa, Marin, San Francisco, and San Mateo counties
Seattle, Washington	1974	1975	Clallam, Grays Harbor, Island, Jefferson, King, Kitsap, Mason, Pierce, San Juan, Skagit, Snohomish, Thurston, and Whatcom counties
Atlanta, Georgia	1974	1975	Clayton, Cobb, DeKalb, Fulton, and Gwinnet counties
Rural Georgia	1978	1979	Glasock, Greene Hancock, Jasper, Jefferson, Morgan, Putnam, Taliaferro, Warren, and Washington counties
San Jose-Monterey, California	1992	1993	Monterey, San Benito, Santa Clara, and Santa Cruz counties
Los Angeles, California	1992	1993	Los Angeles County
SOURCE: Miller et al., (1996).

Table of Contents

Front Matter R1-R14

Executive Summary 1-15

1 The Struggle Against Cancer 16-32

2 The Burden of Cancer Among Ethnic Minority and the Medically Underserved Populations 33-92

3 Overview of Programs of Research on Ethnic Minority and Medically Underserved Populations at the National Institutes of Health 93-153

4 Evaluation of Priority Setting and Programs of Research on Ethnic Minority and Medically Underserved Populations at the National Institutes of Health 154-186

5 Advancing State-of-the-Art Treatment and Prevention 187-229

6 Cancer Survivorship 230-245

7 Monitoring and Reporting 246-260

References 261-274

Appendix A: Methodology 275-281

Appendix B: A New Agenda for Cancer Control Research: Report of the Cancer Control Review Group 282-282

Appendix C: National Cancer Institute Health Promotion Branch Publications and Public Service Announcements 283-284

Appendix D: Survey of Ethnic Minority Researchers and of Researchers Interested in Cancer Among Ethnic Minority and Medically Underserved Groups 285-292

Appendix E: National Institutes of Health and National Cancer Institute Background Material 293-294

Appendix F: Information Provided by the National Center for Health Statistics on the Potential Reductions in Mortality from Cancer, by Ethnic Group 295-314

Committee and Staff Biographies 315-322

Index 323-338