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International Health
Cross-cutting Issues Conclusion
A set of five core issues ‘cut across,’ or affect, all of the main topic African-Americans are now more likely to develop and die from cancer
areas. Based on the feedback and input from stakeholders in the than any other racial or ethnic group. By using reports such as A
African-American community, these were prioritized as follows: National Action Plan for Cancer survivorship—African American
Priorities or Making Cancer Health Disparities History Progress Review
Develop and Promote Patient Navigation Systems for Group
10
as guides, the public health community can better respond to
Cancer Survivors this disparity and effectively address the needs of African-American
Patient navigation can be used to ensure that survivors understand cancer survivors. The NAP has identified the areas of access to care,
their care and to enhance the delivery of optimum care. Navigators cultural competency training, and patient navigation programs as
can ensure timely delivery of care, connect survivors with appropriate priorities for improving the survivorship infrastructure. Organizations
resources, provide educational information on cancer survivorship, and individuals representing healthcare personnel and the public may
and provide general oversight to the delivery and payment of services use this report to focus their current and future cancer survivorship
for each survivor. activities. Local organizations may find the NAP and other reports on
cancer disparities useful as a starting point or as a source for strategic
Develop and Disseminate Public Education Programs on planning goals for local activities. These recommendations could act as
Informed Decision-making for Cancer Survivors a basis for the design of local programs, especially at the early stages of
Cancer survivors are faced with extremely difficult medical decisions planning when there is a need to prioritize objectives for cancer
at each stage of living with, through, and beyond cancer. Survivors survivorship. Foundations, grant-makers, and other funding
need to thoroughly understand their options for care. When patients organizations can use this information as a guide and a credible
are well-informed and participate in deciding how to manage their reference source for both establishing a need for funding and setting
health, the results are more positive and survivors are more likely to funding priorities for the African-American cancer community.
follow the recommendations made by their health providers.
By focusing programmatic and advocacy activities on the identified
Develop and Disseminate Clinical Practice Guidelines for priorities, organizations and individuals can work collaboratively
Each Stage of Cancer Survivorship toward addressing the needs that will ultimately lead to improved
Clinical practice guidelines summarize research on outcomes quality of life for African-American cancer survivors, their families,
pertaining to one specific disease. Physicians select guideline friends, and care-givers. ■
recommendations according to the individual’s healthcare needs.
Guidelines have been developed for the treatment of particular
Melissa Sileo, MSW, LCSW, is a Project Manager in
cancers, but there are not enough for cancer survivors at each stage
Education and Program Development at the Lance
of cancer survivorship (e.g. monitoring survivors after treatment is Armstrong Foundation, where she is involved in several
completed, monitoring long-term healthcare, and end-of-life care).
initiatives that educate and support people affected by
cancer. These initiatives include developing and
maintaining online educational materials, working with
Develop a Comprehensive Database on Cancer Survivorship cancer survivors to provide avenues for them to share
Increasing the capacity of surveillance systems to capture information
their cancer stories, working collaboratively with local and
national organizations to partner on projects, and
on health topics can lead to a better understanding of diseases and the
developing programs that support health professionals in the community to share best
people affected by them. A comprehensive database system could practices. Ms Sileo received her masters in social work from Boston University.
provide information on the ongoing health of survivors and and other
Claire Neal, MPH, CHES, is Director of Education and Program Development at the Lance
issues that they face.
Armstrong Foundation (LAF), working in Programs and Policy to develop new initiatives
that provide support and services for people living with cancer and their families. She has
Develop Comprehensive Evaluation Systems that
served in the Peace Corps in Mali, and her recent experience includes developing and co-
ordinating health education programs and health worker training for both government
Monitor Cancer Survivorship Issues and Services
and non-profit organizations. As the daughter of a pediatric oncologist, Ms Neal grew up
The goal of evaluation is to increase program efficiency and its volunteering in cancer hospitals and attending Camp Kemo with children with cancer. She
impact over time. Effective evaluation requires high-quality
has a BA in public health and human development from Duke University, a masters of
public health from Tulane’s School of Public Health, and a certificate in primary healthcare
indicators that are comprehensively monitored during all steps of
management from the ASEAN Institute of Health and Development in Thailand.
program implementation.
1. National Cancer Institute, DCCPS. Available at: 5. Ross H, Lifting the unequal burden of cancer on minorities 8. Lance Armstrong Foundation and Centers for Disease
cancercontrol.cancer.gov/od/hd-overview.html and the underserved, Office of Minority Health, US Control and Prevention, A National Action Plan for Cancer
2. American Cancer Society, Cancer facts and figures for African Department of Health and Human Services, Closing The Gap, Survivorship: Advancing Public Health Strategies, 2006.
Americans 2007–2008, Atlanta, GA: American Cancer Society, August 2000 issue. 9. Lance Armstrong Foundation and Centers for Disease
2008. 6. HHS, Health People 2010, 2nd Ed., With Understanding and Improving Control and Prevention: A National Action Plan for Cancer
3. SEER Cancer Statistics and Review 1975–2003, Estimated Health and Objectives for Improving Health, Washington, DC: US Survivorship: African American Priorities, 2006.
United States Cancer Prevalence Counts on January 1, 2003, Government Printing Office, November 2000. Available at: 10. Making Cancer Health Disparities History: Report of the
National Cancer Institute.
www.health.gov/healthypeople Trans-HHS Cancer Health Disparities Progress Review Group,
4. Matthews AK, Sellergren SA, Manfredi C, Williams M, Factors 7. Demicheli R, Retsky MW, Hrushesky WJ, et al., Racial March 2004.
influencing medical information seeking among African disparities in breast cancer outcome: insights into host-
American cancer patients, J Health Commun, 2002;7(3):205–19. tumor interactions, Cancer, 2007;110(9):1880–88.
96 US ONCOLOGY
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