Cancer Health Disparities: What You Should Know

1. Cancer Health Disparities: What You Should Know Updated 05/16/14

2. Objectives • The objectives of Cancer Health Disparities: What You Should Know are to: • Share information about cancer • Talk about cancer health disparities in the African-American community in the United States and South Carolina • Learn ways for members of the African-American community in South Carolina to address cancer health disparities; and • Talk about cancer awareness and education that can take place in your community

3. Health Disparities • Health disparities are differences between groups of people. These differences can affect how frequently a disease affects a group, how many people get sick, or how often the disease causes death • The National Cancer Institute defines “cancer health disparities” as differences in the incidence, prevalence, mortality, and burden of cancer and related adverse health conditions that exist among specific population groups in the United States • They are also sometimes referred to as health inequalities. • When African Americans have poorer health compared to White counterparts • This is a health disparity, and there are things that can be done to eliminate them.

4. Cancer Health Disparities • In South Carolina, African Americans die more often as compared to Whites of: • Breast Cancer • Cervical Cancer • Colorectal Cancer • Prostate Cancer • And this is despite sometimes being less likely to get the cancer (ex: breast cancer) or more likely to be screened for the cancer (ex: cervical cancer).

5. The Human Body With so many cells a lot can go wrong. More than 10 Trillion Cells

6. How Cancer Starts • Nothing in our world is perfect. For each of us, abnormal cells appear during our lifetime. • Fortunately, the body is prepared for these abnormal cells that result from errors in cell reproduction. • The body has a system that seeks out and destroys abnormal cells before they can over reproduce and turn into a tumor (cancer). Cell Repair System—Identifies abnormal cells and eliminates them before they can reproduce and become tumors.

7. How Cancer Starts • Cancer often happens when the body is exposed to higher amounts of cancer causing substances (called carcinogens). • When there is a low level of exposure to carcinogens, the body can control and eliminate abnormal cells. • At higher levels the body misses some abnormal cells that may become tumors and then possibly cancers. Carcinogens Tumors

8. 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 Cancer Cells Blocked

9. Two Types of Tumors • Benign (not cancer) tumor cells do not spread through the body. Tumors may have a “skin” around them that keeps cells from spreading. • Malignant (cancer) tumor cells spread through the body.

10. What Can You Do? • Learn more • Make healthy choices • Follow screening guidelines • Talk and plan with your doctor and take action • Celebrate surviving with a plan • Share your experience, take part in cancer research

11. Awareness and Education • Learn more about cancer and cancer screening • Know your family history of cancer • Speak up about cancer and cancer screening with family members and friends • Talk to your doctor about cancer and cancer screening

12. Cancer Prevention 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

13. Cancer Screening Breast Cancer • Screening can find and treat some types of cancer early. • Some types of screening can even prevent cancer • In most cases, the treatment for cancer is better when the cancer is found early. Cervical Cancer Colorectal Cancer Prostate Cancer 13

14. Cancer Disparities: Breast Cancer • In South Carolina: • African-American women get breast cancer slightly less often than White women. • African-American women get mammograms more often than White women. • But, for every three White women who die of breast cancer, four African-American women die of breast cancer. • Help find out why and change these rates, take part in cancer research.

15. 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. 15

16. Cancer Disparities: Cervical Cancer • In South Carolina: • African American women get Pap tests more often than White women. • For every two White women who get cervical cancer, three African American women get cervical cancer. • For every White woman who dies of cervical cancer, almost three African-American women die of cervical cancer.

17. Cervical Cancer • Pap Test (with 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. • Can get as early as age 9 and up to age 26. Cancer screening recommendations are from the American Cancer Society.

18. Cancer Disparities: Colorectal Cancer • In South Carolina: • For every four Whites who get colorectal cancer, five African Americans get colorectal cancer. • For every two Whites who die of colorectal cancer, three African Americans die of colorectal cancer. • African Americans over age 50 are less likely to have “ever had” a colonoscopy compared to Whites.

19. 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. 19

20. Colorectal Cancer Flexible Sigmoidoscopy Fecal Occult Blood Test (FOBT) Colonoscopy A test that finds colorectal cancer. A test that finds colorectal cancer and sometimes finds polyps. A test that finds colorectal cancer and polyps.

21. Cancer Disparities: Prostate Cancer • In South Carolina: • For every one White man who gets prostate cancer, almost two African American men get prostate cancer. • For every one White man who dies of prostate cancer, almost three African American men die of prostate cancer. • African Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65) are at high risk for prostate cancer. Men with more than one first degree relative who had prostate cancer at an early age are at highest risk.

22. Prostate Cancer • The American Cancer Society does not support routine testing, but recommends informed decision making education for men before considering getting prostate cancer screening: • All men should start talking with their doctor about screening at age 50 and older, and 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 • Men should not be screened unless they have received this information about risks, benefits and uncertainties of prostate cancer screening. Cancer screening recommendations are from the American Cancer Society.

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

24. Sources of Cancer Information and Services • American Cancer Society (ACS) • Contact ACS at 1-800-ACS-2345 (1-800-227-2345) to learn more about screening information. • Community Health Centers • Call a health center in your area for more information about screening services at 1-800-438-3895 or visit http://www.scphca.org/. • Best Chance Network • Breast and cervical cancer screening • Females, aged 47-64 • Meet income guidelines • Call: 1-800-ACS-2345 (1-800-227-2345) • DHEC Immunization Division • For information about the HPV vaccine for children, please call DHEC at • 1-800-277-2175 for information about the VAFAC program.

25. Survivorship • Over half of the people who get cancer today will survive five years or more • Network with support groups • Advocate for your rights and good policy • Have a positive attitude • Create a cancer plan and act on it

26. 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.

27. 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...

28. What Can I Do? • Learn more about cancer • Talk with your healthcare provider about cancer • Do not use tobacco products • Eat a low fat, healthy diet • 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.

29. 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

30. ~In Memory of ~ Ms. Cassandra R. Kearse Trained Cancer Health Disparities Presenter Region 4 For her dedication and hard work to the Cancer Health Disparities Project in her community.

31. 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.