While breast cancer mortality has declined by 31 percent overall in California, data for 2003 through 2007 indicated that mortality rates are significantly higher in women from the Inland Empire compared to the overall average in California.

About 2 million women live in the Inland Empire, an area that spans more than 27,000 square miles, according to the researchers. With funding from Susan G. Komen for the Cure, Inland Empire Affiliate, Tadi-Uppala and colleagues identified factors that may contribute to the unequal burden of breast cancer in the Inland Empire.

The mortality rate for breast cancer was 34.3 deaths per 100,000 non-Hispanic black women compared to 27 deaths per 100,000 non-Hispanic white women. Combining data for all race/ethnicity groups, the average annual age-adjusted mortality rate for breast cancer was 25.4 deaths in the Inland Empire compared to 22.8 deaths per 100,000 women statewide.

"Although this difference is slight, the higher risk of death from breast cancer in the Inland Empire is consistent with later detection of this screening-detectable cancer among these women," Tadi-Uppala said.

Non-Hispanic white women had a higher-risk of death from breast cancer than the statewide average. Results also showed the following:

approximately 11.6 percent of homes had an income below poverty level; 24 percent of participants (mostly black and Latina) aged 16 to 64 years were uninsured; approximately 60 percent were not educated about breast health; 71 percent over 40 years of age did not have a mammogram in the last year; and nearly 80 percent were willing to participate in breast cancer clinical trials, but were not given opportunities to do so.

Tadi-Uppala and colleagues are currently working to educate minority women about the importance of participating in clinical trials, to recruit minority women into clinical trials, and to address lifestyle factors that affect breast cancer among minority women in the Inland Empire.

"We hope funding will be available to schools of public health such as ours that engage in community-based participatory research to reduce breast cancer incidence, morbidity and mortality among minority women who our research demonstrates currently experience an unequal burden of cancer," she said.

990. Fundamental causes of colorectal cancer outcomes

Socioeconomic status plays a role in colorectal cancer mortality rates by hindering health care interventions and/or restricting patient access to care, according to results of a retrospective cohort study.

"Those living in low socioeconomic status counties have yet to benefit from advances made in preventing colorectal cancer deaths more than 30 years ago, whereas those living in high socioeconomic status counties have seen a 33 percent to 50 percent reduction in mortality," said Andrew C. Wang, M.P.H., research assistant and student at Columbia University's Mailman School of Public Health, New York.

Colorectal cancer is a major cause of mortality; last year alone 16.2 people out of 10,000 died from this form of cancer, according to the researchers.

Experts believe that a few theories may help to explain why inequalities in colon cancer mortality rates exist. The first theory, fundamental cause theory, suggests inequalities exist because of the unequal access to resources. This theory works in part with access to health care. Diffusion of knowledge is the theory that the speed of new medical innovations may affect inequalities.

Wang and colleagues used administrative and U.S. census data from 2005 to pinpoint colon cancer mortality rates among whites and blacks from more than 3,000 counties.

Decreased mortality from colorectal cancer was associated with access to health care, living in states with histories of quicker uptake of new information and adoption of technology, and being in a higher socioeconomic county. Most importantly, Wang said, socioeconomic status acted as a form of a catalyst - access to health care and diffusion of knowledge made only a limited difference in low socioeconomic counties, but clearly lowered colorectal cancer mortality rates for high socioeconomic status counties.

Health care professionals are now faced with the challenge to ramp-up efforts to reduce colorectal cancer mortality rates among individuals in low socioeconomic status areas, according to Wang.

"The medical and non-medical communities are not doing enough to prevent colorectal cancer," he said. "Much more can be done for those who are disadvantaged."

Source: American Association for Cancer Research