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 100,000DC 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 100,000US 121.0 per 100,000DC 130.0 (Caucasian)DC 120.9 (African American)

Mortality Rate:DC 27.6 per 100,000US 23.5 per 100,000DC 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 100,000DC 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 100,000DC 32.4 (Caucasian)DC 54.5 (African American)

Mortality Rate:DC 20.1 per 100,000 (all races)US 17.1 per 100,000DC 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 deceptionTuskegee 1940’s-1970’sGuatemala 1940’s

Misconceptions

Community Centers vs. Medical Centers

Advantage of Medical CenterAccess to test/procedurePresence of medical professionalsFollow-up/referrals

Advantage of Community CentersGoing where the need isReaching populations that may not have access to medical careLess 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 sensationSafe-sex DietExercise

How do you Screen? Prostate

PSA levels/DREMen 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 ColonoscopyScreen 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?