America's cancer prevention, treatment, research, and education programs must include Hispanic Americans

During the Sixth Biennial Symposium on Minorities, the Underserved and Cancer, several presentations highlighted the unresolved barriers that preclude appropriate levels of Latino participation in the nation's cancer programs. This report summarizes the key demographic data regarding the fastest growing population of eligible U.S. cancer services consumers, Hispanic Americans, as presented in recent federal reports. The barriers that preclude appropriate levels of Latino inclusion in our nation's cancer treatment, prevention, research, and educational programs, likewise, are abstracted from federal sources and from other reports that reflect the national dialogue that has taken place on this topic over the past 5 years. In the nation, as it enters the second millenium, there will be over 39 million Latinos who expect their fair share of the cancer treatment, research, prevention, and education service that they pay for each year in taxes. However, to date, the representation of Latinos in our nation's cancer clinical research is less than 2% of all participants, with very little bilingual services provided, thus raising serious questions about the true safety of the novel cancer treatments that are approved each year by the Food and Drug Administration. Similarly, the Hispanic community faces a staggering 30% overall drop-out rate from our educational system, much higher in the oncology professional series, raising serious concerns about the ability of our nation's cancer infrastructure ever to be able to serve adequately this very large consumer base, many of whom prefer to conduct their cancer health care family decisions in Spanish. This lack of Hispanic customer service capability is clearly highlighted by the recent declaration of Latinos as the only globally underrepresented employment group in the federal government, as in most private health care delivery organizations. In the public health agencies of the federal government, Hispanic employment hovers at around 2.5% and is even lower in the policy-making professional series that deal with cancer. Numerous federal reports have highlighted the specific steps that must be taken to break this vicious cycle of Latino exclusion from the nation's health infrastructure, including, with regard to cancer, 1) recognize that Latino health consumers, as taxpayers, must be served appropriately, including in our cancer clinical trials programs; 2) recognize that appropriate Latino customer service, including service provision in Spanish, is everyone's responsibility; 3) develop special incentive packages to adequately hire and promote Latinos and others with bilingual/bicultural skills in the nation's cancer infrastructure; 4) immediately amend Executive Order 12900, Educational Excellence for Hispanic-Americans, to provide the level of funding required to reverse the enormous Latino educational drop-out rate-our nation requires more Hispanic-American cancer professionals, as well as a better educated Latino cancer consumer base; and 5) insist that all cancer clinical trials include adequate numbers of Latinos, including those with limited English proficiency, to scientifically prove treatment safety in this at-risk population-before any new drug approvals are granted.