In the year 2006, health care remains one of the most debated topics in America. At a time when health care costs continue to rise and the availability of health insurance to the population comes at increasing personal cost, ensuring equal and fair access to health care for all remains difficult. It is within this already complex framework that we must try and understand and address as the Institute of Medicine report (IOM) describes, "Unequal Treatment: Confronting racial and ethnic disparities in health care."1
The IOM report highlights the disparities for selected cancer sites (lung and bronchus, colon and rectum, female breast, prostate, uterine, cervix, stomach, and liver) that show large variations by race and ethnicity. The exact reasons for these disparities remain unclear but several studies have focused on the possible influence of social, economic, and cultural factors as likely etiologies. The complex interplay among social, economic, and cultural factors as a cause for health care disparity is described in this report and supported by others.2-4 Determining where in our health care system these problems lie can help elucidate areas of intervention. Most of the research in this area has been related to screening, reactions to diagnoses, and early interventions, this research can provide us with some clues regarding where to look, to understand, manage, and prevent health disparities among cancer survivors. This emerging area of inquiry will improve access and quality of care for all cancer survivors.
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