Cancer Health Disparities: What You Should Know

1. Cancer Health Disparities: What You Should Know Version 04/21/2015

2. Health Disparities (Inequalities) • When one community has poorer health compared to others, a health disparity exists. • In South Carolina, African Americans die more often as • compared to Whites of: • Breast Cancer • Cervical Cancer • Colorectal Cancer • Prostate Cancer This cancer health disparity does not need to be.

3. Cancer in the Human Body • The body is made up of over 10 trillion cells that are the building blocks for all our bones, muscles, nerves, organs and tissues. • All these cells are continuously dying and new ones being reborn. With so much change going on sometimes something goes wrong. • New cells can lose control. They reproduce fast without many limits. If not stopped, they become tumors that can spread throughout the body and cause cancer. • Fortunately, the body is prepared for these abnormal cells that result from errors in reproduction. The body has a repair system that seeks out and destroys these cells before they can grow into a tumor (cancer). Repair System Carcinogens Good nutrition and adequate exercise Cancer Cells Blocked The body is made up of over 10 trillion cells that are the building blocks for all our bones, muscles, nerves, organs and tissues.

4. Cancer in the Human Body • When the body is exposed to higher amounts of cancer causing substances (called carcinogens) the repair • system is overwhelmed. The body may miss some • abnormal cells that can become tumors. • When there is a low presence of carcinogens, the body better controls and eliminates abnormal cells before they become tumorsand maybe cancer. Carcinogens Tumors

5. Preventing Cancer • Your cell repair system is also affected by your genetics and by how healthy your body is. • Some of us may get better repair systems than others, but regardless of what you get if you don’t take care of it, it will not work very well. • This may be one reason why nutrition and exercise relate to cancer. Exercise and good nutrition help keep your body running right, and a healthy body will mean a healthy cell repair system. Good nutrition and adequate exercise Carcinogens Strong repair system blocks cancer’s start.

6. Preventing Cancer – Reducing your Risk Exercise at least 30 minutes a day Eat a low-fat healthy diet Maintain a healthy weight Do not use tobacco products Limit alcohol Protect yourself from the sun’s UV rays Vaccine for some types of HPV

7. Cancer Screening Breast Cancer • Screening can find some types of cancer early, when treatment is more effective • Some types of screening can even help prevent cancer Cervical Cancer Colorectal Cancer Prostate Cancer 7

8. Cancer Disparities • In South Carolina: • African-American women get breast cancer slightly less often than White women. • African Americans get cervical, colorectal and prostate cancers more often than Whites. • African Americans die more of breast, cervical, colorectal, and prostate cancers than Whites. • You can help find out why and change this picture by taking part in cancer research and getting screened.

9. Breast Cancer • Clinical Breast Exam • Age 20-39: every 3 years • Age 40+: every year • Mammogram (Breast X-Ray) • Age 40+: every year • Breast self-examination (BSE) is an option • Women 20+ Cancer screening recommendations are from the American Cancer Society. 9

10. Cervical Cancer • Pap Test (with Human Papilloma Virus - HPV DNA test) • Start at age 21 • Sometimes called Pap smear • Checks cells of the cervix • Can find abnormal (pre-cancerous) changes and prevent cervical cancer with follow-up care • Follow-up Care • Get follow-up care for an abnormal Pap test • HPV Vaccination • For females and males, recommended age is 11-12. • Vaccine is available for females ages 13-26 and males ages 13-21. Cancer screening recommendations are from the American Cancer Society.

11. Colorectal Cancer • People aged 50 and older should be screened • Earlier age for those with family history • Age 45 and older for African Americans Cancer screening recommendations are from the American Cancer Society and American College of Gastroenterology. 11

12. Colorectal Cancer Stool Sample Tests Fecal Occult Blood Test (FOBT) or Fecal Immunochemical Test (FIT) Flexible Sigmoidoscopy Colonoscopy A test that finds colorectal cancer and polyps. Tests that can find colorectal cancer. A test that finds colorectal cancer and sometimes finds polyps.

13. Prostate Cancer • The American Cancer Society does not support routine testing for prostate cancer, but recommends education for men before considering getting screening: • All men should start talking with their doctor about screening at age 50, earlier if they have a family history of prostate cancer. The DRE (digital rectal exam) and PSA (prostate specific antigen) tests are the most commonly used screening tests. • African-American men should start asking their doctor about screening at age 45 because they are at higher risk. • Men should not be screened unless they have received information about the risks, benefits and uncertainties of prostate cancer screening. • More research with African American men is needed to help answer the many questions about this cancer. Cancer screening recommendations are from the American Cancer Society.

14. Cancer Treatment Chemotherapy and Medication ‘Watchful Waiting’— also called Active surveillance Radiation Surgery Other Medical Options Alternative Medicine

15. I have heard that… Everyone with the same kind of cancer gets the same kind of treatment... I can catch cancer... A positive attitude is all you need to treat cancer ... Surgery always causes cancer to spread... Cancer always means death... No one in my family has cancer so I don’t have to worry...

16. Survivorship • Over half of the people who get cancer today will survive five years or more • Talk with other people and support groups • Stick up for your rights and for fair policies • Have a positive attitude, it matters • Create a plan and act on it

17. Make Your Community Healthier, Take Part in Cancer Research • Help others by contributing to medical research, such as clinical trials, community studies, and surveys • Help develop and improve new drugs, therapies, and devices • Find out about new research treatments before they are widely available • We need to learn more about African-Americans in cancer prevention and treatment.

18. What Can I Do? • Learn more about cancer • Talk with your healthcare provider about cancer • Do not use tobacco products • Eat a low fat diet that includes a variety of fruits, vegetables and whole grains • Exercise at least 30 minutes a day • Limit alcohol • Protect your skin from the sun. • Learn more about vaccines for some types of HPV. • Get screened for cancer and find it early on. • Spread the word about cancer and cancer screening. • Take part in cancer research.

19. How Can I Learn More About Cancer? 1-800-4-CANCER (1-800-422-6237) TTY: 1-800-332-8615 http://www.cancer.gov 1-866-297-6792 http://sccdcn.sph.sc.edu 1-800-ACS-2345 (1-800-227-2345) http://www.cancer.org 1-866-745-5680 http://www.sccanceralliance.org 1-803-898-DHEC (1-803-898-3432) http://www.scdhec.gov

20. Thank you! Please help us develop programs that work. Take some time and complete the evaluation for this program. Your feedback is important. Funding Acknowledgment: This educational program is supported by the South Carolina Cancer Disparities Community Network (SCCDCN) and supported by Grant Numbers U01CA114601 (SCCDCN-I; 2005-2010) and U54CA153461 (SCCDCN-II; 2010-2015) from the Center to Reduce Cancer Health Disparities of the National Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.