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Health Disparities in cancer screening and prevention
A novel approach to community outreach for at risk communities.
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Objectives Cancer incidence and mortality in Washington,
DC Risk in Ward 5 Health disparities in cancer screening as it relates
to cancer incidence and mortality. Community outreach strategies/interventions Community resources Prevention strategies
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Washington, DC National Capitol of Cancer
• High cancer incidence rate for the “big four” screenable cancers.Prostate, Breast, Cervical, Colon
• High cancer mortality rate:Death rate total DC 198.3 per 100,000 US 181.3 per 100,000
High cancer incidence rate:Incidence rate total DC 462.9 per 100,000
US 465.0 per 100,00
http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&001
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Prostate Cancer2004-2008
Incidence Rate:
DC 187.9 per 100,000 (all races)
US 152.7 per 100,000
DC 126.3 per 100,000(Caucasian)
DC 205.9 per 100,000 African American)
Mortality Rate:DC 41.7 per 100,000 (all races)
US 24.4 per 100,000
DC 11.7 per 100,000(Caucasian)
DC 41.1 per 100,000(African American)
http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&066
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Breast Cancer 2004-2008
Incidence Rate:DC 126.7 per 100,000
US 121.0 per 100,000DC 130.0 per 100,000(Caucasian)DC 120.9 per 100,000(African American)
Mortality Rate:DC 27.6 per 100,000
US 23.5 per 100,000DC 15.8 per 100,000(Caucasian)DC 33.3 per 100,000(African American)
http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&055
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Cervical Cancer 2004-2008
Incidence Rate:DC 10.9 per 100,000 (all races)
US 8.1 per 100,000
DC 7.1 per 100,000(Caucasian)
DC 11.5 per 100,000 (African American)
Mortality Rate:DC 3.2 per 100,000 (all races)
US 2.4 per 100,000
DC Data suppressed (Caucasian)
DC 4.5 per 100,000 (African American)
http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&055
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Colon Cancer2004-2008
Incidence Rate:DC 47.6 per 100,000 (all races)
US 47.6 per 100,000
DC 32.4 per 100,000(Caucasian)
DC 54.5 per 100,000(African American)
Mortality Rate:DC 20.1 per 100,000 (all races)
US 17.1 per 100,000
DC 15.8 per 100,000(Caucasian)
DC 22.2 per 100, 000(African American)
http://statecancerprofiles.cancer.gov/cgi-bin/quickprofiles/profile.pl?11&020#incdEAPC
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Ward 5
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US Census Bureau
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Chart 6. Top Ten Causes of Death, 2004, Ward 5
Source: DOH, Center for Policy, Planning and Epidemiology, State Center for Health Statistics
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Source: DOH, Center for Policy, Planning and Epidemiology, State Center for Health Statistics
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Source: DOH, Center for Policy, Planning and Epidemiology, State Center for Health Statistics
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Disparity Race Sex Language Age Income Access
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Barriers to Outreach Government distrust
History of deceptionTuskegee 1940’s-1970’s
Guatemala 1940’s
Misconceptions
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Community Centers vs. Medical Centers Advantage of Medical Center
Access to test/procedure
Presence of medical professionals
Follow-up/referrals
Advantage of Community CentersGoing where the need is
Reaching populations that may not have access to medical care
Less intimidating environment
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Academy of Hope Community Adult GED center
Located in Ward 5
Non-health care provider/center
“Lunch Brunch” opportunities
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Who is Served?
Student statistics Household statistics Female: 51% Male: 49% African-American: 75% African: 12% Asian: 2% Caribbean: 4 % Latino: 7% Caucasian: .5%
• Household Income – Less than $9,999: 46% – $10,000 - $14,999:12% – $15,000 to $29,999: 32% – $30,000 or more: 10%
http://www.aohdc.org/OurImpact/WhoWeServe/tabid/80/Default.aspx
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“The Talk” What is cancer Why is it important to talk about The four screening cancers Public assistance programs for screening Prevention
Tobacco cessation
Safe-sex
Diet
Exercise
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How do you Screen? Prostate
PSA levels/DRE
Men take Ten-Howard University every 3rd Wednesday
Breast Mammograms/CBE
NBCCEDP (National Breast and Cervical Early Detection
Program)
Cervical Pap Smears (NBCCEDP)
Guardesil
Colon/Rectal Colonoscopy
Screen for Life
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Distribution of Women Receiving Pap Tests by Race/ethnicity
http://www.cdc.gov/cancer/nbccedp/data/summaries/district_of_columbia.htm
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Distribution of Women Receiving Mammograms by Race/Ethnicity
http://www.cdc.gov/cancer/nbccedp/data/summaries/district_of_columbia.htm
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Prevention and Risk Tobacco Cessation
Safe Sex
Diet
Exercise
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Source: DOH, Center for Policy, Planning and Epidemiology, State Center for Health Statistics
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Summary High incidence/mortality in DC Screening Cancers Health risk behaviors in DC and Ward 5 Community outreach/intervention Prevention Disparities abound Questions?