Medical community pushes early cancer detection for blacks

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By Erin Larkin, Medill News Service

Chicago doctors and cancer prevention advocates have combined forces in a grassroots effort to increase cancer screening and prevention in African-American communities where cancer continues to take a devastating toll.

African-American men are 24 percent more likely to be diagnosed with cancer and 41 percent more likely to die of it than white men, according to the new report released by the American Cancer Society. The cancer death rate for black women is 19 percent higher than for white women.

The report's authors, along with Chicago medical experts and cancer prevention advocates, blamed poverty as a major cause of the toll cancer takes among African Americans. "Poverty is the most important factor" in explaining the differences for cancer rates and risks, according to the cancer society study.

Poverty limits access to quality health care and to cancer screening, said Adrienne White, vice president of health initiatives and advocacy for the Illinois division of the American Cancer Society. The report states that 20 percent of African Americans lack health insurance nationwide, compared to 8 percent of whites.

"You want to find the cancers earlier," White said. "If you find and treat them earlier, the death rates will go down." Colon cancer, for instance, has a 90-percent survival rate with early detection. But harsh economic circumstances can make it difficult to get screening or even to get information about it.

"If men can't eat, or can't feed their families, the last thing they're worried about is whether they have cancer," White said.

That philosophy led the Illinois Cancer Society to help enlist barbers on Chicago's South Side to spread the message of cancer prevention and to launch a program called Healthy Spirit, Healthy Soul, a partnership with Rainbow/PUSH's 1,000 Churches Connected. The churches reach out to the African-American community with messages about early detection and prevention.

"There's a lot of very difficult social, economic and cultural issues that come to bear" in cancer prevention, said Dr. Timothy Kuzel, associate director for clinical affairs at Northwestern Memorial Hospital's Robert H. Lurie Comprehensive Cancer Center. But there are "simple things that can make a big difference."

Dr. Bonnie Pete Thomas, attending physician at the Woodlawn Health Center, 6337 S. Woodlawn Ave., learned the same lesson in promoting early cancer detection as part of the leadership team for Project Brotherhood. The project was founded in 1998 to combat the trend of "black men dying disproportionately to other folks from preventable causes," he said.

In talking with community representatives to design the program, doctors and social workers found that "what men talk about is their abilities to take care of themselves and their families," Thomas said. "We had to tie it in. We had to say, 'If you die of colon cancer at 50, you could have worked another 20, 25 years, and that's what your family will be missing.'"

The project took an innovative approach to getting that message out: "More men will visit their barbers than will visit their doctors," Thomas said.

So Project Brotherhood started a Barber Night at the health center, offering free haircuts to men in the community on Thursdays.

Last year, with funding from the Cancer Society, the project expanded the program to bring in 12 area barbers and train them to inform their customers about colon cancer. The barbers were "already expert about talking about any subject, and listening," he said. With the information training, "barbers have really taken the ball and run with it," Thomas said. The barbers also handed out colon cancer screening materials to take home.

The $125,000 in Cancer Society funding that expanded the barbershop outreach takes the program through the summer, according to Dr. Thomas Mason, also an attending physician at the center. The project is looking for funding for another year.

Mason said it's early in the program, and "we've been getting [screening] cards back kind of sporadically. I think it really has helped to extend the message to the community about the death rates of colon cancer in black men, which a lot of them didn't know before. I had a lot of people come to me and ask me, 'Do I need to be screened for colon cancer?' after seeing the signs in the center and the barber shops and talking to their barbers."

In general terms, the 2005 Cancer Society report documented that cancer now outpaces heart disease as the number one killer of Americans under age 85. The overall cancer death rate for all races has actually dropped slightly since the 2004 study, but the death rate for heart disease dropped more, which pushed cancer to the forefront. Heart disease still remains the number one killer when Americans of all ages and races are considered.

Lung cancer is the deadliest cancer for both men and women. Prostate and colon cancer come next for men and breast and colon cancer for women. Asian Americans, Native Americans and Hispanics all had lower cancer death rates than both African Americans and whites, and women had lower death rates than men. The 2005 report covers the period 1997-2001, the last year for which data is available.

Women tend to be more concerned about health issues than men and seek out health care more frequently, White said. But the cancer death rate for African-American women is 19 percent higher than for white women, according to the report. Poverty, screening and access to health care are major concerns once again. More affluent women tend to get more frequent mammograms and detect breast cancer earlier. Breast cancer can have a 90-percent survival rate with early detection and early treatment, White said.

Arranging for time off work, paying for baby-sitters and finding transportation to health care appointments far from home can prove critical to early detection, he noted. The cancer society initiated a program locally in 2003 to help provide transportation, baby-sitting money and other services for women.

"What we're doing at the ACS is recognizing that you have to respond to the communities where they are," she said. "Our philosophical concept is to partner with organizations that communities identify with and trust, and to work with those organizations."

"Our goal is to reduce cancer incidence rates by 25 percent and death rates by 50 percent by 2015" in Illinois, White said.

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