Meeting the Challenge of Cancer Health Disparities
August 24, 2006

By Brion J. Fox, SM, JD

What if we had a cure for cancer tomorrow?
The sad reality is that not everyone would benefit equally. In this era of high technology, too many people still do not have access to the prevention, screening and treatment services that are currently available, let alone future advances.

There is vast documentation of differences in the burden of cancer between specific groups of people in Wisconsin and nationwide. Research shows some groups are more likely to be diagnosed with and die from preventable cancers and will be diagnosed with late-stage disease for cancers that could be detected through early screening. Some people receive either no treatment or sub-standard treatment and suffer without adequate pain control or palliative care. Often these people are defined by gender, ethnicity, sexual preference and socioeconomic status.

Despite the best of intentions, existing cancer prevention screening, and treatment programs have not succeeded in resolving these inequities, and society still knows too little about how to overcome the barriers people face.

Why do cancer health disparities exist?
Research indicates that in great measure they result from current and historical social injustices that produce unequal social position, less supportive social networks, and increased environmental exposures. These inequities often lead to one group of people receiving better care than another. Experts believe we will be able to reduce the unequal burden of cancer only by addressing these injustices and the trust issues they engender.

Reducing and eliminating cancer health disparities is a key objective of the National Cancer Institute. The UW Comprehensive Cancer Center (UWCCC) has also taken on the challenge of reducing cancer health disparities in Wisconsin and beyond. For example, UWCCC is home of the North Central region Spirit of EAGLES: American Indian/Alaska Native Leadership Initiative on Cancer. This program promotes comprehensive cancer control through partnership with tribes, research networks, cancer centers, the Cancer Information Service, and the American Cancer Society.

In addition, as part of its stewardship of the Wisconsin Comprehensive Cancer Control Plan, UWCCC is building partnerships with communities around the state that represent underserved and minority populations. These partnerships will assess community readiness to address cancer and the quality of cancer care that exists in these communities. Staff will work with the communities as they prioritize how to reduce barriers to cancer care.

To facilitate more research and outreach in this area, and to establish links to other researchers and organizations working on these topics, UWCCC recently established the Cancer Health Disparities Initiative (CHDI). Its mission is to reduce cancer health disparities by addressing social inequalities. CHDI is partnering with Spirit of EAGLES and the statewide Comprehensive Cancer Control Plan. The Initiative also developed an affiliates program for community partners and UW faculty and staff interested in conducting disparities research.

One of CHDI’s goals is to expand awareness and understanding of cancer health disparities by sponsoring visiting scholars to UWCCC. Its first visiting scholar, Judith Kaur, MD, national director of Spirit of EAGLES and oncologist from the Mayo Clinic, shared lessons about the role of the university in reducing cancer health disparities. Future scholars will include Sandra Underwood, PhD, professor at the University of Wisconsin-Milwaukee School of Nursing and expert on cancer prevention and control in culturally diverse communities. In spring 2007, CHDI will host noted national leader Harold Freeman, MD, medical director of the Ralph Lauren Center for Cancer Care and Prevention, New York City, and former director of the NCI Center to Reduce Cancer Health Disparities.

It will not be easy to eliminate the unequal burden of cancer, but through its research and outreach programs, UWCCC is committed to eliminating barriers to prevention, treatment and clinical trials. Consistent with NCI’s creed, UWCCC seeks equal treatment for all.


Brion J. Fox, SM, JD is an associate scientist within UWCCC Cancer Control program and principal investigator of the Wisconsin Comprehensive Cancer Control Plan Health Disparities Project. He is also co-director of the Cancer Health Disparities Initiative along with Rick Strickland.

For more information about the Cancer Health Disparities Initiative and its Affiliate Program, please contact Strickland at strickla@uwccc.wisc.edu.