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Cancer Prevention and Control in Diverse Populations

This special focus issue of Health Promotion Practice contains articles addressing cancer prevention and control in diverse populations. The American Cancer Society (ACS) estimates that 1,372,910 new cases of invasive cancer will be diagnosed in 2005 (ACS, 2005). The existing literature, including the National Healthcare Disparities Report (U.S. Department of Health and Human Services, 2004) and the Institute of Medicine’s report on the unequal burden of cancer (Haynes & Smedley, 1999), has detailed the excess burden borne by racial and ethnic minorities as well as other populations for certain types of cancer. For example, African Americans continue to have higher rates of cancer incidence (except for female breast) and mortality than Whites for colorectal, male lung, female breast, and prostate cancers, and Hispanic/Latina women have the highest rate of cervical cancer (ACS, 2005). In this special focus issue, Wilson and Orians report on efforts to recruit focus group participants to two studies aimed at increasing screening for cervical cancer among rarely and never screened African American women and Latinas. The authors stress that researchers should recognize that additional resources need to be allocated to reach and recruit these important populations. They emphasize the value of working with community networks and using novel approaches to reach never or rarely screened populations. Coughlin and Thompson examine whether U.S. men and women have received physician recommendation for colorectal cancer screening using data from the 2000 National Health Interview Survey. Most interesting was their finding that among men and women who had been seen by a physician in the past year and had not received a fecal occult blood test, nearly 95% reported no physician recommendation for this test in the past year. For endoscopy (colonoscopy and sigmoidoscopy), African Americans, Hispanics, and American Indians/ Alaska Natives were less likely to receive physician recommendation for these tests than were Whites. This is a troubling finding as studies have suggested that physician recommendation is a strong predictor of patient cancer-screening adherence (Taylor et al., 2003). Cooper and colleagues present methods for developing “Screen for Life” public service announcements in English and Spanish to increase screening for colorectal cancer. The use of consultants with expertise in marketing to Hispanic/Latino populations was a key element in the success of this project. In addition, the successful collaboration between the research team and native Spanish speakers provided the opportunity to assess both the quality of the Spanish translation and the cultural appropriateness of the campaign materials. Solomon and colleagues discuss the development of an education pamphlet for Hispanic/Latino cancer survivors. They suggest adaptation or “transcreation”—as opposed to translation—as a method that will result in materials that are both language and culture appropriate. The focus groups that the authors conducted provide useful information for anyone considering the development of literature on preventing and controlling cancer in this important population. Christopher and colleagues detail the development of a manual for training interviewers to be used on the Apsáalooke (Crow Indian) Reservation. Although this manual was created for a project on cervical health, the authors include suggestions for working with Native American populations that would be useful regardless of cancer site. Finally, Fernandez and colleagues report on the use of intervention mapping in their development of a screening program for breast and cervical cancer targeted to Hispanic/Latino migrant and seasonal farmworkers. Intervention mapping is a process that uses theory and empirical evidence to guide the planning of interventions. Among the strengths of intervention mapping is that it enhances collaboration and communication between academic researchers and community organizations. As seen from these contributions, efforts to promote cancer screening and increase education about cancer Forward