But the incidence and mortality rates for some cancers are disproportionately high among low-income, rural Appalachians. Dr. Gilbert H. Friedell, director for cancer control at the University of Kentucky's Markey Cancer Center in Lexington, notes that the Appalachian program is the third in a series created by the National Cancer Institute in response to studies showing that some groups of Americans have higher rates of, and greater risk of developing, cancer than others. First came a program for African-Americans, then one for Hispanics. After that, some of us in Appalachia began pointing out that much the same problem seemed to be the case in our geographic region. Each of the four has a steering committee, a principal investigator, and a program manager, but no two are organized or operated exactly alike.
People have to be able to participate and make their voices heard.
You can't just tell people what to do. They have to want to do. The program's flexible approach regarding organization provides an opportunity to find out what methods work best. Those lessons may then be transferred to other regions of the country which, like Appalachia, have substantial numbers of rural poor who are medically underserved. So all four are focusing on a goal of trying to increase screening for cervical and breast cancer among low-income, older women.