The University of South Alabama (USA) has the only University hospital within a 150 mile radius of Mobile, Alabama on the Gulf Coast. It serves the urban population of a Gulf coast Port City and a surrounding rural deep south population of patients from Alabama, Southern Mississippi and the panhandle of Florida. It provides the only hospital service in the region which is willing and capable of providing oncologic care for patients regardless of payment capability. The hospital system has approximately 840 beds and 32 beds are in a designated adult oncology unit. Approximately 500 new cancer patients are seen yearly at this facility and subsequently followed in the Cancer Center following discharge. Approximately half of the population come from minority groups to include African Americans, native Americans and immigrants from Vietnam and Cambodia. The USA has been a designated MBCCOP since the inception of the program. The grant supports cancer treatment protocols programs, the administration and data management of cancer treatment protocols and cancer control programs at USA where the majority of cancer patients are female and one half are members of minority populations. Cancer treatment protocols are mostly associated with either the Southwest Oncology Group (SWOG) or the Pediatric Oncology Group (POG). However, treatment protocols of the National Surgical Adjuvant Breast and Bowel Program (NSABB) and the M.D. Anderson Program (MSKCC) are utilized whenever a SWOG protocol is unavailable for a patient. Currently over 400 living cancer patients are in active follow-up. USA keeps available about 150 active IRB approval cancer protocols for eligible patients at any given time. We do not engage in any studies sponsored by pharmaceutical firms. Affiliations were established with MSKCC and the University of Rochester in order to increase access to national cancer control programs. We have no difficulty in recruiting minority patients for cancer treatment protocols. However, recruitment of minority individuals to cancer control programs which involve either a procedure or a medication with potential side effects has been difficult. USA is a participant in both the Breast Cancer Prevention Trial (BCPT) and the Prostate Cancer Prevention Trial (PCPT). In these trials minority participation has been poor even though efforts for recruitment were aimed at the African American community via radio, newspaper, health fairs, churches and social organizations. Minority patients who were recruited were college education and relatively affluent. A population study of this observation suggested that """"""""fatalism"""""""" may play an important role in delayed diagnosis and failure to use cancer preventative means. Methods of interdiction are being initiated to ascertain whether they will motivate minority patients to seek medical attention at an early stage of disease and use methods of cancer prevention and early detection.
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