Saving Black Lives: In the wake of a new report by the Institute of Medicine, which shows a disproportionately low federal investment in cancer research among minorities, some researchers are demanding a change
The way Dr. Lucile L. Adams-Campbell sees it, cancer research by minority-serving institutions has gotten less than adequate consideration by the federal government's cancer research establishment. Moreover, she says, research efforts that include people of color as subjects, either conducted by majority or minority institutions, also have lagged considerably.
As the director of the Howard University. Cancer Center (HUCC) and one of a handful of minority cancer researchers in the U.S., Adams-Campbell regularly competes for grant money administered by the National Cancer Institute (NCI).
"HUCC faculty have been discouraged from applying to NCI because the reviews are viewed as biased against minorities," Adams-Campbell wrote in a Feb. 4, 1999, letter to U.S. Sen. Arlen Specter (R-Pa.), chairman of the Senate Labor-HHS Appropriations Subcommittee. "Yet, a proposal from a predominant school will receive funds to study minority populations without having a successful track record among these ethnic groups."
In January, a report was published by the Institute of Medicine (IOM), a Washington, D.C.-based agency that is affiliated with the National Academy of Sciences. The report offered stark statistics on the disparities of cancer occurrence and survival rates among minorities and the medically underserved, when compared to Whites and non-poor. The study also criticized the institute's treatment of minority populations in cancer research, reporting that the NCI, which is funded by the National Institutes of Health, spends only 1 percent of its budget -- or $24 million -- on studies of ethnic and medically underserved groups.
"There was no surprise in the report for many of us," Adams-Campbell says.
The Unequal Burden of Cancer: An Assessment of NIH Research and Programs for Ethnic Minorities and the Medically Underserved, found, for example, that the poor in the United States have a greater chance of dying from cancer than the non-poor. African American males, it reports, are more likely than White men to get prostate cancer. The study also shows evidence that Asian Americans run an increased risk of stomach and liver cancer, and that Hispanic American and Vietnamese American women develop cervical cancer in greater numbers.
In response to these disturbing findings, the report's authors urged the NIH to substantially increase efforts to determine why poor Americans and some ethnic minorities are more susceptible and die from certain cancers.
"Several of the study's findings reinforce what many of us have known for years -- that the culture, structure, and programs of the National Cancer Institute (NCI) and NIH as a whole serve the White population well, but fall short in addressing the needs of ethnic minorities," testified Louis W. Sullivan, M.D., president of the Morehouse School of Medicine upon the report's release. "This is frustrating...because ethnic minorities represent the fastest growing segment of the U.S. population and suffer a disproportionately high burden of disease and disability."
Heart of the Conflict
As the second leading cause of death among Americans, cancer has given rise to a multi-billion dollar research industry in the United States over the past several decades. In the early 1970s, the federal government declared "war" on cancer, and it became a leading area of medical research. Just last year, U.S. health officials announced that cancer incidence and death rates for all cancers "declined between 1990 and 1995, reversing an almost 20-year trend of increasing cancer cases and deaths in the U.S."
The NCI budget, the nation's largest funder of cancer research, was $2.5 billion in FY 1998 and $2.9 billion in FY 1999. The Clinton administration has proposed a $2. …