ICC Wants Congress to Ensure Implementation of IOM Report

WASHINGTON—The Intercultural Cancer Council (ICC) has urged Congress to act immediately to ensure that the National Institutes of Health implements recommendations of a recent Institute of Medicine (IOM) report. That report, sometimes critical of the National Cancer Institute, urged specific efforts to better understand and correct the unequal burden of cancer among minorities and the medically underserved.

[For a report on the IOM recommendations and a response by the NCI director Richard D. Klausner, MD, see Oncology News International, March 1999.

The ICC prepared its action plan at the request of Sen. Arlen Specter (R-Penn), chairman of the Senate appropriations subcommittee that overseas the NIH budget. The council, which focuses on cancer policies as they affect minorities, unveiled its recommendations at a congressional briefing.

The group received personal pledges of support from five House members who spoke at the meeting: Republican Rick Lazio (NY), who chairs the House Cancer Awareness Group; Democrats Edolphus Towns (NY), Robert C. Scott (Va), and Sheila Jackson Lee (Tex); and independent Bernard Sanders (Vt).

“This is not a minorities issue,” ICC co-chair Lovell A. Jones, PhD, director of experimental gynecology and endocrinology, M.D. Anderson Cancer Center, told members of Congress and staff attending the briefing. “This is not a medically underserved issue. This is an American issue, because it will affect you, your children, and your grandchildren.”

Dr. Jones noted that in the next century, more than half the US population will consist of racial minorities. “If you don’t have the proper staff to take care of these individuals, what you will see is what is happening in Harlem today,” he said. “You won’t see the impact diminishing; you’ll see it spread to the rest of the nation.”

The major emphasis in the ICC agenda is the need for all Americans to have access to screening and cancer treatment and to receive equal screening and treatment. Amelie Ramirez, DrPH, associate director of the Center for Cancer Control Research, Baylor College of Medicine, said that “research is showing that if we applied what we know right now, we could significantly reduce the burden of cancer; the problem is that it is not getting into our communities.”

Added Harold P. Freeman, MD, director of surgery, Harlem Hospital Center, and chair of the President’s Cancer Panel, “We need to understand the science of cancer but it doesn’t help to just discover something if you don’t apply it to everyone.”

Another point emphasized at the ICC briefing was the need to increase the numbers of minorities in cancer research. Minorities and the poor are grossly under-represented in academics, noted John Alderete, PhD, professor of microbiology, University of Texas Health Science Center, San Antonio. “In fact,” he said, “they are so grossly underrepresented in all the research science and technology areas of this country that we almost have to redefine the term gross.”

The ICC urged that Congress provide targeted funds to the National Cancer Institute and all other NIH components directing cancer research to allow them to make a greater effort to attract and train people from minority and medically underserved populations.

The ICC listed three primary short-term objectives in its legislative agenda:

Congress should provide specific targeted funding for a 5-year strategic plan at NIH to achieve the IOM recommendations. NIH should begin its development and initial accountable implementation in this fiscal year.

A 100% increase in FY2000, to at least $300 million, should go to NIH to fund research; data collection and assessment; and cancer prevention, early detection, and prevention trials targeted to minorities and the medically underserved. The increase would pay for implementing the recommendations in those areas.

“This figure represents roughly twice the amount in federal dollars that the NCI reported to the IOM as spent in 1997 on cancer research involving ethnic minority and medically underserved populations,” the ICC said.

The Department of Defense (DOD) appropriation for cancer research should be increased in FY2000, and the Pentagon should be directed to award more grants for research within the ethnic minority and medically underserved populations.

The ICC also urged that Congress direct the Department of Defense to expand its cancer registries and integrate them with other registries, including NCI’s Surveillance, Epidemiology, and End Results (SEER) program, and that the department demonstrate use of mobile screening vans in locales with DOD facilities near ethnic minority and medically underserved populations.

The ICC listed as its longer term objective a renewed War on Cancer with greater emphasis on cancer control, prevention and education, and tobacco control among minorities.

“This initiative should create a National Cancer Program with a National Cancer Plan and a high-level, interdepartmental/interagency cancer coordinating office,” the council said.