Journal of Health Care for the Poor and Underserved

Background

Prior to the establishment of the AANCART in April 2000 and despite documentation of cancer health disparities among Asian Americans,^2–9 no National Cancer Institute (NCI)-funded national infrastructure for Asians existed that was parallel to the Black Leadership Initiative on Cancer or Redes en Accion (Hispanic Leadership Initiative on Cancer). In many respects, the cancer burden among Asian Americans has been overlooked. Although heart disease has been the leading cause of death for the U.S. population as a whole, few realize that cancer has been consistently the leading cause of death for Asian or Pacific Islander women ever since 1980, the first year that the Federal government used the Asian or Pacific Islander category.¹⁰ The National Center for Health Statistics reported for the year 2000 Asian or Pacific Islanders as a group to be the first racial/ethnic population to experience cancer as the leading cause of death.¹¹ Being the only population with cancer as the leading cause of death sets Asian Americans apart from all other racial/ethnic populations. Importantly, many of the cancers of Asian Americans are preventable (e.g., tobacco-induced cancers are all preventable).

Thus, it was heartening that in December 1997, the NCI convened a meeting in Boston to discuss cancer control issues for Asian Americans that laid a foundation [End Page 237] for action. The closest approximation to a national movement to address the cancer education needs of Asian Americans was a subsequently funded NCI program, Cancer Concerns for Asian Americans and Pacific Islanders, awarded to the author through the Asian American and Pacific Islander Health Promotion, Inc., for the period, 1998–2000. The program consisted of a national conference supported by the NCI and a variety of sponsors, and follow-up meetings to discuss the implementation of conference recommendations. A distinct characteristic of this conference was presentations on lessons learned from cancer control from representatives of each of the other major U.S. racial/ethnic minority populations: African Americans,¹² Hispanic Americans,¹³ and American Indians¹⁴ with concluding keynote presentations by the Chair of the President's Cancer Panel¹⁵ and the American Cancer Society's first president for the 21st century.¹⁶ Two hundred forty health professionals, government officials, cancer survivors, American Cancer Society volunteers, and others, from 21 states, the District of Columbia, and 3 U.S.-associated Pacific Island jurisdictions attended. The resulting conference proceedings at the time of its publication constituted the most comprehensive and up-to-date scientific publication on the status of cancer prevention and control among Asian Americans.¹⁷

The AANCART proposal emerged from the work of many of the collaborators at the 1998 conference. The AANCART brought together investigators with portfolios of cancer control grants focused on Asian Americans as well as deeply committed Asian American community and clinical leaders, national and community-based Asian American organizations, the American Cancer Society, and federal and state health agency partners. The author was AANCART's Principal Investigator (PI) and was a professor at The Ohio State University at the time of the initial funding. The NCI approved the transfer of the AANCART to the University of California at Davis...