A pair of reports issued by the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) have sent conflicting messages about the current level of cancer care in the United States-and what steps should be taken to improve it.

In the first report, HHS Secretary Tommy Thompson released findings that showed a significant overall improvement in the health of racial and ethnic minorities, but also indicated that important disparities persist among different populations.

The study, "Healthy People 2000," reported on national trends in racial- and ethnic-specific indicators for 17 health-related categories during the 1990s. It found that all racial and ethnic groups experienced at least some improvement in rates for 10 of the indicators, including: prenatal care; infant mortality; teen births; death rates for heart disease, homicide, motor vehicle crashes, and work-related injuries; tuberculosis cases; syphilis cases; and poor air quality.

However, for five more indicators-total death rate, and death rates for stroke, lung cancer, breast cancer, and suicide-there was improvement in rates for all groups except American Indians and Alaska Natives. The percent of children under 18 years old living in poverty improved for all groups except Asian-Pacific Islanders, and the percent of low birthweight infants improved only for African American non-Hispanics.

"Our goal is to eliminate disparities in health among all population groups by 2010," Thompson said. "While we are making progress, this report shows how far we still have to go."

The second study, the CDC's "Recent Trends in Mortality Rates for Four Major Cancers," noted that 53% of all cancer-related deaths in the United States were associated with four sites: lung/bronchus, colon/rectum, prostate, and female breast.

This report found that, except for lung cancer in women and lung, colorectal, and breast cancer in American Indians and Alaska Natives, trends in death rates from these cancers have generally declined. But the rates remained high for African-Americans, and they have not decreased equally among all populations.

For example, female breast cancer death rates were highest for African Americans, followed by Caucasians, Hispanics, American Indians, Alaska Natives, and Asian-Pacific Islanders. During the period 1990 - 1998, breast cancer-related death rates decreased for Caucasions (2.5% per year) and Hispanics (1.2% per year), but were unchanged for African Americans, American Indians, Alaska Natives, and Asian-Pacific Islanders.

"Continuing research and prevention efforts are needed to reach high-risk and underserved populations," the CDC concluded, "and to understand the reasons for differences in cancer mortality among racial/ethnic populations."

SOURCES:
"Trends in Racial and Ethnic-Specific Rates for the Health Satus Indicators: United States, 1990-1998," U.S. Department of Health and Human Services (http://www.hhs.gov)
"Recent Trends in Mortality Rates for Four Major Cancers, by Sex and Race/Ethnicity - United States, 1990-1998," U.S. Centers for Disease Control and Prevention (http://www.cdc.gov)