Research Project

癌症是美国的第二大死因，每四个人中就有一个死于癌症。(16)。患癌症的风险随着年龄的增长而增加，大多数病例和死亡发生在55岁或以上的成年人身上。2010年至2030年期间，癌症发病率将增加约45%，从2010年的160万增加到2030年的230万（17）。在这段时间内，预计少数民族的癌症发病率差异将增加99%，老年人的癌症发病率差异将增加67%（17）。在过去的几十年里，癌症死亡人数稳步下降。这反映了早期检测的进步和治疗效果的提高（18）。然而，并不是所有的美国人都同样受益于这些进步。癌症差异有许多原因，包括获得筛查（乳腺癌、中心/临床和结直肠癌）的差异，以及延迟诊断和治疗（16）。由于老年人通过医疗保险获得保险，因此可以通过促进使用医疗保险福利来获得基于证据的筛查来减少癌症差异。然而，老年人，尤其是少数族裔老年人，未充分利用医疗保险筛查福利（19），包括乳房x光检查和巴氏涂片检查（20,21）。此外，种族和少数民族老年人不成比例地贫穷，贫穷和所有癌症筛查率降低之间存在很强的关联（22）。少数民族未充分利用癌症筛查导致晚期诊断和较低的太阳/竞争率（18,21,23,24）；然而，当癌症患者接受相同阶段疾病的类似治疗时，他们的治疗结果相似（18,25-28）。

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).