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HEALTH DISPARITIES IN CANCER SCREENING AND
PREVENTIONA novel approach to community outreach
to at risk communities.
Objectives
Cancer incidence and mortality in Washington, DC Risk in Ward 5 Health disparities in cancer screening as it relates to
cancer incidence and mortality. Community outreach strategies/interventions Community resources Prevention strategies
Washington, DC National Capitol of Cancer
• High cancer incidence rate for the “big four” screenable cancers.Prostate, Breast, Cervical, Colon
• High cancer mortality rate:Death rate total DC 198.3 per 100,000
US 181.3 per 100,000
High cancer incidence rate:Incidence rate total DC 462.9 per 100,000
US 465.0 per 100,00
http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&001
Prostate Cancer2004-2008
Incidence Rate:
DC 187.9 per 100,000 (all races)
US 152.7 per 100,000
DC 126.3 (Caucasian)
DC 205.9 (African American) Mortality Rate:
DC 41.7 per 100,000 (all races)
US 24.4 per 100,000
DC 11.7 (Caucasian)
DC 41.1 (African American)
http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&066
Breast Cancer 2004-2008
Incidence Rate:
DC 126.7 per 100,000
US 121.0 per 100,000
DC 130.0 (Caucasian)
DC 120.9 (African American) Mortality Rate:
DC 27.6 per 100,000
US 23.5 per 100,000
DC 15.8 (Caucasian)
DC 33.3 (African American)
http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&055
Cervical Cancer 2004-2008
Incidence Rate:
DC 10.9 per 100,000 (all races)
US 8.1 per 100,000
DC 7.1 (Caucasian)
DC 11.5 (African American) Mortality Rate:
DC 3.2 per 100,000 (all races)
US 2.4 per 100,000
DC Data suppressed (Caucasian)
DC 4.5 (African American)
http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&055
Colon Cancer2004-2008
Incidence Rate:
DC 47.6 per 100,000 (all races)
US 47.6 per 100,000
DC 32.4 (Caucasian)
DC 54.5 (African American) Mortality Rate:
DC 20.1 per 100,000 (all races)
US 17.1 per 100,000
DC 15.8 (Caucasian)
DC 22.2 (African American)
http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&020#incdEAPC
Ward 5
US Census Bureau
Chart 6. Top Ten Causes of Death, 2004, Ward 5
Source: DOH, Center for Policy, Planning and Epidemiology, State Center for Health Statistics
Source: DOH, Center for Policy, Planning and Epidemiology, State Center for Health Statistics
Source: DOH, Center for Policy, Planning and Epidemiology, State Center for Health Statistics
Disparity
Race Sex Language Age Income Access
Barriers to Outreach
Government distrust
History of deception
Tuskegee 1940’s-1970’s
Guatemala 1940’s
Misconceptions
Community Centers vs. Medical Centers
Advantage of Medical Center
Access to test/procedure
Presence of medical professionals
Follow-up/referrals
Advantage of Community Centers
Going where the need is
Reaching populations that may not have access to medical care
Less intimidating environment
Academy of Hope
Community Adult GED center
Located in Ward 5
Non-health care provider/center
“Lunch Brunch” opportunities
Who is Served?
STUDENT STATISTICS HOUSEHOLD STATISTICS
Female: 51% Male: 49% African-American: 75% African: 12% Asian: 2% Caribbean: 4 % Latino: 7% Caucasian: .5%
Household Income Less than $9,999: 46% $10,000 - $14,999:12% $15,000 to $29,999: 32% $30,000 or more: 10%
http://www.aohdc.org/OurImpact/WhoWeServe/tabid/80/Default.aspx
“The Talk”
What is cancer Why is it important to talk about The four screening cancers Public assistance programs for screening Prevention
Tobacco sensation
Safe-sex
Diet
Exercise
How do you Screen?
Prostate
PSA levels/DRE
Men take Ten-Howard University every 3rd Wednesday Breast
Mammograms/CBE
NBCCEDP (National Breast and Cervical Early Detection
Program)
Cervical Pap Smears (NBCCEDP)
Guardesil Colon/Rectal
Colonoscopy
Screen for Life
Distribution of Women Receiving Pap Tests by Race/ethnicity
http://www.cdc.gov/cancer/nbccedp/data/summaries/district_of_columbia.htm
Distribution of Women Receiving Mammograms by Race/Ethnicity
http://www.cdc.gov/cancer/nbccedp/data/summaries/district_of_columbia.htm
Prevention and Risk
Tobacco Cessation
Safe Sex
Diet
Exercise
Source: DOH, Center for Policy, Planning and Epidemiology, State Center for Health Statistics
Summary
High incidence/mortality in DC Screening Cancers Health risk behaviors in DC and Ward 5 Community outreach/intervention Prevention Disparities abound Questions?
