Cancer is the second leading cause of death in the United States, and accounts for one in every four deaths. (16). The risk of getting cancer increases with age, with most cases and deaths occurring in adults 55 years or older. Between 2010 and 2030, cancer incidence will increase by approximately 45%, from 1.6 million in 2010 to 2.3 million in 2030 (17). During this time frame, it is expected that disparities in cancer incidence will increase by 99% among ethnic minorities, and by 67% among older adults (17). The past few decades have seen a steady decline in cancer deaths. This reflects progress in early detection, and improvement in treatment effectiveness (18). However, not all segments of the U.S. population have benefited equally from these advances. Cancer disparities have many causes, including differences in access to screening (for breast, cen/ical, and colorectal cancer), as well as delayed diagnosis and treatment (16). Since older adults are insured through Medicare, cancer disparities could be reduced by promoting use of Medicare benefits to obtain evidence-based screenings. However, older adults, especially minority older adults, underutilize Medicare screening benefits, (19) including for mammograms and Pap smears (20, 21). Moreover, racial and ethnic minority seniors are disproportionately poor, and there is a strong association between poverty and reduced screening rates for all cancers (22). Underutilization of cancer screening by minority populatons translates into later-Stage diagnosis and poorer sun/ival rates (18, 21, 23, 24);however, when cancer patients receive comparable treatment for same-stage disease, they experience similar treatment outcomes (18,25-28).

National Institute of Health (NIH)
National Cancer Institute (NCI)
Specialized Center--Cooperative Agreements (U54)
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Special Emphasis Panel (ZCA1-PCRB-G (M1))
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Johns Hopkins University
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Marshall, Jessie Kimbrough; Mbah, Olive M; Ford, Jean G et al. (2016) Effect of Patient Navigation on Breast Cancer Screening Among African American Medicare Beneficiaries: A Randomized Controlled Trial. J Gen Intern Med 31:68-76
Hararah, Mohammad Khalid; Pollack, Craig Evan; Garza, Mary A et al. (2015) The Relationship Between Education and Prostate-Specific Antigen Testing Among Urban African American Medicare Beneficiaries. J Racial Ethn Health Disparities 2:176-83
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