. "2 The Burden of Cancer Among Ethnic Minority and the Medically Underserved Populations." 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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TABLE 2-18 Five-Year Survival Rates by Selected Cancer Sites and Ethnic Group
SOURCE: Gilliland, Hunt, and Key (1998).
of ethnic minority groups. For example, a study using the New Mexico (a SEER program state) tumor registry data from 1983 to 1994 found significant differences in the rate of survival from cancer among Hispanic, Native American, and white patients (Gilliland, Hunt, and Key, 1998). The study found that whites had the highest 5-year survival rates, that the rates among Hispanics were intermediate, and that Native Americans had the poorest rates of survival (see Table 2-18).
Similarly, Samet et al., (1987) in an earlier study found that the diagnosis of cancer at a late stage was correlated with poor survival rates (see Table 2-19), supporting the rationale for increased early detection services in special populations.
Gilliland and Key (1998), in a study of prostate cancer among American Indians in New Mexico from 1969 to 1994, also point to late stage at diagnosis as a factor in disproportionate mortality rates in relation to incidence rates. For example, among American Indian men, 23.3 percent of prostate cancers were diagnosed after distant spread, whereas among non-Hispanic white men 11.6 percent of prostate cancer were diagnosed after distant spread (Gilliland and Key, 1998). Other studies of cancer survival rates for this population (covering 1973 to 1992) supports the findings that American Indian women have poorer survival rates than non-Hispanic whites (Frost et al., 1996). For example, survival was poorer among American Indian women during both the period from 1973 to 1982 and the period from 1983 to 1992. Survival among Hispanic women was also notably poor during the latter time period. The authors note that the lower survival rates among this population is amplified by increasing breast cancer incidence rates among New Mexico Hispanics and American Indians (Frost et al., 1996).
In addition to early detection, cancer survival is highly dependent upon effective treatment. Evidence indicates that there are ethnic differences