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Study concludes improving access to care could close much of racial gap

Differences in insurance account for a substantial proportion of the excess risk of death from breast cancer faced by black women, according to a new study appearing in the Journal of Clinical Oncology. It concludes that equalizing access to care could address much of the existing black/white disparity in breast cancer mortality.

Breast cancer mortality was higher in white women than in black women until the 1980s, when improvements in early detection and treatment began to create a gap between black and white women. Whites benefitted more from these improvements, and since then, the black-white mortality gap has continued to widen. In 2014, the most recent year for which data is available, breast cancer mortality rates were 41% higher in black women than white women.

For the new study, investigators from the American Cancer Society, Emory University, and Dana-Farber Cancer Institute examined the contributions of demographics, other medical conditions (comorbidities), insurance, tumor characteristics, and treatment to black-white mortality disparities among more than 550,000 nonelderly women diagnosed with early stage breast cancer. The data come from the National Cancer Database, a national hospital-based cancer registry cosponsored by the Commission on Cancer (CoC) of the American College of Surgeons and the American Cancer Society.

Compared with white women, black women were more likely to be uninsured or have Medicaid insurance (22.7% v 8.4%) and were more likely to have tumors that were larger, higher grade, and hormone receptor negative. Hormone receptor negative cancers have fewer treatment options and tend to grow faster than hormone receptor-positive cancers.

Among women with hormone receptor–positive tumors, the risk of death in blacks was twice that of whites (100% higher). The excess risk among black patients decreased to 25% when they were matched to white patients by demographics (age, year of diagnosis, and area of residence), comorbidities, insurance, tumor characteristics, and treatment. In other words, these factors together accounted for 75.0% of the total excess risk of death in black patients. Insurance accounted for 37% of the total excess, followed by tumor characteristics (23.2%), comorbidities (11.3%), and treatment (4.8%).

Among women with hormone receptor–negative disease, blacks had a 49.5% excess risk of death compared to whites. As with patients with hormone receptor–positive disease, the excess risk decreased when adjusted for demographics, other conditions, insurance, tumor characteristics, and treatment. These factors combined accounted for 63.6% of the total excess risk of death in blacks. Insurance accounted for 34.1% of the total excess, followed by tumor characteristics (22.0%), comorbidities (3.8%), and treatment (3.6%).

"We found that differences in insurance explained one-third of the total excess risk of death in nonelderly black women compared to white women diagnosed with early-stage breast cancer, while differences in tumor characteristics explained approximately one-fifth of the excess risk," write the authors. "Health policy makers should ensure that the benefits of important scientific advances in prevention, early detection, and treatment of breast cancer are made available to all women, especially black women, who experience an undue share of the mortality burden from this disease," they conclude. "Equalization of access to care in nonelderly black women could substantially reduce ethnic/racial disparities in overall mortality of women diagnosed with breast cancer."

  • ACS helps evacuate cancer patients from Puerto Rico

    Since Hurricane Maria devastated Puerto Rico, the American Cancer Society has been able to get a number of cancer patients off the island, thanks to four donated flights. The patients range in age from 2 to 74.

    Our Southeast Region has been in high gear since the storm occurred, with all patient and provider calls from Puerto Rico being re-routed to the team in Tampa, where several staffers speak Spanish.

    "We've had more than 125 patients contact us for support. Most of the patients we encounter are dealing with significant challenges -- no power, no water, and limited food, including nutritional supplements such as Ensure, lost or severely damaged homes, and limited or no access to pain medication or treatment," said Megan Wessel, MPH, vice president, Regional Cancer Control.

    Our team in the Southeast has been working diligently to supply the patients with what they need, from lining up transportation and care on the island, to coordinating four humanitarian flights off the island. Those flights were courtesy of four generous donors: PepsiCo, Johnsonville, a Wisconsin-based sausage company; an anonymous donor from West Palm Beach; and a flight arranged by Board member Jorge Luis Lopez.

    The work is not over once these patients reach the mainland. The Southeast Region team, in partnership with our colleagues around the country, has been working with our hospital partners to secure charity care.  "It's extremely challenging, but we've been able to help in some cases," Megan said. 

    In addition, the team has been busy coordinating lodging and transportation here in the U.S. "Although the work is far from over, the efforts to date have been a remarkable example of the American Cancer Society coming together in a time of great need," Megan said.

    On Friday, Oct. 13, the American Cancer Society was able to fly five cancer patients and their caregivers out of Puerto Rico so they can resume their cancer treatments in the U.S. We transported additional cancer patients off the island on Saturday. The other flights occurred earlier in month.

    Friday's humanitarian mission was made possible by Johnsonville owners and ACS supporters, Ralph and Shelly Stayer, who donated the use of their private plane to help transport the cancer patients from Puerto Rico to the Orlando Executive Airport. From there, the patients were heading to a variety of locations, some to be with relatives, where ACS had arranged for treatment.

    Watch a TV news story about the flight.

    "Being part of this humanitarian flight gives me hope. The living conditions in the island are unbearable, and having to face cancer in the midst of it, it's really hard," said Xiomara Rodriguez, director of Communications, Southeast Region. "Hearing that ACS, with the help of generous donors, were able to help some patients and facilitate their access to care on the mainland was a like a bright shining beam of light in the darkness. As an ACS employee, I am extremely proud of the efforts. As a Puerto Rican living afar, this makes me feel like Puerto Rico is not facing this humanitarian crisis alone." 

    One of the patients on the Johnsonville pane, Jose Carrero, was diagnosed with cancer in June. He was in the hospital during hurricanes Irma and Maria. When he was released on Oct. 8, he had no water, no electricity, and no communications at his home. His daughter, Nilsa Carrero, who lives in North Carolina, reached out to ACS for help, saying her dad had a place with better care in the U.S. if he could only get there.

    Puerto Rico is still struggling with water shortages and power outages. CNN reported Oct. 16 that only 13.7% of customers were getting power off the island's grid, down from 15% a week before that. Puerto Rico Gov. Ricardo Rosselló said Sunday that he hopes to have 95% of power restored by December. About 64% of the population has running water, and there have been recent news reports about island residents drinking contaminated water. Islanders are having a tough time finding food and gas, as well.

    Also on the Johnsonville plane was a volunteer from an Orlando church who was delivering water to the western side of the island, where the water shortage has been most severe. Also, on the flight were battery-operated fans and batteries of all sizes for our staffers there, paid for by the Southeast Region and our national senior Leadership team donated money to purchase battery-operated fans for our staff in Puerto Rico. 

    Patients remain at our Hope Lodge in San Juan, still being powered by a generator. Those patients are receiving treatment in the capital, a city with about 395,000 people. 

    PHOTOS: Pictured in the top image, from left: Lillian Santos, EVP, in Puerto Rico; a caregiver, a cancer patient, a PepsiCo representative, a 6-year-old patient, and her mom and dad. Those patients and caregivers left Puerto Rico on Saturday, on a plane supplied by PepsiCo. Pictured in the smaller image are cancer patients being interviewed by local media at the San Juan airport, before their flight to Florida last Friday.

  • Two weeks left in the Chevrolet #IDriveFor campaign

    ​There are just over two weeks left in the Chevrolet #IDriveFor social media campaign in support of Making Strides Against Breast Cancer. For every Tweet or Instagram post using #IDriveFor in the month of October, Chevrolet will donate $5 (up to $400,000). 

    You can help by tweeting, posting to Instagram, and asking your social networks to do the same! Get online and share who you are driving for this October! 

    Below are some suggested posts.

    • Post on Twitter using one of the below sample tweets: 
      • #IDriveFor a world free from the pain & suffering of #breastcancer. RT @Chevrolet will contribute $5 with every use of #IDriveFor. 
      • Share the drive against #breastcancer by retweeting. @Chevrolet will contribute $5 with every use of #IDriveFor. 
    • Post on Instagram using the below sample message. Note: You must update your privacy settings in Instagram in order for posts to count toward this promotion. Visit this site for details on how to make this change.
      • #IDriveFor _________. When it comes to fighting #breastcancer, no one should have to do it alone. @Chevrolet will make a $5 contribution to @AmericanCancerSociety for every use of #IDriveFor. [Instructions: Insert who drives you to raise awareness of breast cancer and add a picture of them – ex: My Mom, My GrandMa, My Sister, etc.] 

    This is such an easy way to help ACS raise money and it takes just a minute to post a message. You can post as often as you like.

  • Mothers of the Year Luncheon honors Hoda Kotb and NYC breast cancer surgeon

    On Oct. 16, the American Cancer Society hosted the 22nd Annual Mothers of the Year Luncheon at The St. Regis Roof in New York City.

    The 2017 Mothers of the Year Honorees are breast cancer survivor Hoda Kotb, co-host of the fourth hour of NBC's TODAY Show, who adopted a baby girl in February, and Susan K. Boolbol, MD, FACS, chief of the Division of Breast Surgery and chief of the Appel-Venet Comprehensive Breast Service at Mount Sinai Beth Israel. Ms. Kotb's award was presented by her TODAY Show co-host Kathie Lee Gifford, while Dr. Boolbol's award was presented by her children, MacKenzie and Emma.

    This year's Luncheon included a special performance by Carolee Carmello, an American actress and three-time Tony Award nominee, who sang "Road to Recovery," written by David Friedman and Kathie Lee Gifford. 

    The Mothers of the Year Luncheon is supported by prominent members of New York City's social and philanthropic community, and is one of the American Cancer Society's signature events in Manhattan. 

    The Luncheon was created in 1995 to shine a spotlight in recognition of the outstanding accomplishments of mothers, their extraordinary community service efforts, and contributions to cancer control. Since the event's inception, the Mothers of the Year Luncheon has raised more than $5 million for the fight against cancer. 

    Previous Mothers of the Year honorees include: former First Lady of New York Libby Pataki; Katie Couric; Paula Zahn; Vera Wang; Kathie Lee Gifford; Susan Bloomberg; Anne and Charlotte Ford; Carolina Herrera; Sarah Ferguson Duchess of York; Cynthia Lufkin; Ann Curry; Tory Burch; Grace Hightower De Niro; Muffie Potter Aston; Anne Hearst McInerney; Deborah Norville; and Rosanna, Marion and Elaina Scotto. Last year's event honored Dr. Laura Forese, Karen Walsh, and the life of Suzanne Wright.

    The event began with cocktails at 11:45 a.m. followed by lunch and the awards presentation at 12:30 p.m. Tickets began at $500 and table sponsorship packages at $5,000. Social media users can follow the event using #MOTY2017 or by following @CancerNYNJ on Facebook, Twitter, and Instagram.

    PHOTOS: Top photo, from left, Kathie Lee Gifford, co-host of the fourth hour of NBC's TODAY Show; Kris Kim, EVP, Field Operations, Northeast Region; Arnold Baskies, MD, chair of the Board of Directors; and honoree Hoda Kotb. Smaller image, from left, Lainie Jones, senior development manager, Distinguished Events, who managed the event; and MacKenzie, Emma, and their mom, honoree Susan Boolbol, MD.

  • Collaboration to promote 80% by 2018 and colorectal cancer awareness wins prestigious Scopy Award

    The American Cancer Society, Fight Colorectal Cancer, National Colorectal Cancer Roundtable (NCCRT), and advocate Katie Couric were recognized over the weekend with the 2017 SCOPY (Service Award for Colorectal Cancer Outreach, Prevention and Year-Round Excellence) Spirit of Collaboration Award for the awareness event held in New York City's Hard Rock Café on March 1. 

    If you recall, our Countdown to 2018 event featured Couric, whose first husband died of colon cancer at age 42, and actor Luke Perry, whose best friend's wife was diagnosed with the disease, interviewing lots of impressive people involved in the fight against colon cancer, including Rich Wender, MD, our chief cancer control officer.

    SCOPY awards are given each year by the American College of Gastroenterology to honor the most innovative and impactful community education programs aimed to raise awareness of colorectal cancer. 

    Emily Butler Bell, associate director of NCCRT, accepted the award on behalf of the American Cancer Society and the NCCRT at an award ceremony on Sunday in Orlando, Florida. 

    Details of all the award winners can be found here

    "The 2017 SCOPY Award Winners deliver yet another class of extraordinary initiatives, meeting the high bar established in past years," said Jordan J. Karlitz, MD, FACG, chair, ACG Public Relations Committee and associate professor of Clinical Medicine, Section of Gastroenterology and Hepatology, Tulane Cancer Center, New Orleans, LA. "Many projects exhibit zeal and a fervent, ongoing commitment to community service, public health, and the national screening goal of 80% of eligible adults by 2018." 

    Twenty-one projects were selected by a panel of three judges that included Dr. Karlitz; Patricia L. Raymond, MD, FACG, ACG Public Relations Committee, assistant professor of Clinical Internal Medicine, Eastern Virginia Medical School; and Eugenia Tsai, MD, GI Fellow, Tulane University School of Medicine.

    "Year after year, the GI community demonstrates its remarkable dedication to support colorectal cancer (CRC) prevention," said ACG President Carol A. Burke, MD, FACG. "The passion and dedication of ACG members to communicate the critical message of CRC screening and prevention is evident in every submission," she added. 

    PHOTOS: The top photo is from the Countdown event. From left, actress Karen Walsh, who was diagnosed with stage IV colon cancer at age 40; Candace Henley, a colon cancer survivor and founder of the Blue Hat Foundation, one of this year's 80% by 2018 National Achievement Award honorees, and journalist Katie Couric.Walsh died several months after the event. Pictured in the smaller image, from left, is Danielle Burgess, director of communication for Fight Colorectal Cancer, and Emily Butler Bell, MPH, associate director, National Colorectal Cancer Roundtable.

  • IT offers 10 tips for safer social media - and the second quiz is here!

    To continue its article series for Cyber Security Awareness Month, the ACS IT department would like to share some tips for staying safe while using social media. 

    Would you let a stranger look in your wallet or purse? Would you let all your friends and acquaintances have a look? These are two important questions to consider when you post information on social media sites. Although it may not be readily apparent, the information you post on Facebook or Twitter can be just as personal as what you carry in your wallet or purse.

    The Internet is a valuable tool for collaboration, communication, and entertainment. Unfortunately, many unsavory groups and individuals have figured out how to use the power of the internet not only to invade personal privacy but also as an avenue for spreading malicious and/or dangerous code. Luckily, there are some relatively easy ways of keeping yourself and your family safe. Here are 10 tips to keep in mind, for safer social media use: 

    1. Think before you post – Do not post information that would make you vulnerable, such as your address or information about your schedule or routine. If your connections post information about you, make sure the combined information is not more than you would be comfortable with strangers knowing.
    2. The internet is public and "forever" – Only post information you are comfortable with anyone seeing. This includes information and photos in your profile and in blogs and other forums. Also, remember that once you post information online, you cannot retract it. Even if you remove the information from a site, saved or cached versions may still exist on other people's machines.
    3. What's in your settings? – Take advantage of a site's privacy settings. The default settings for some sites may allow anyone to see your profile, but you can customize your settings to restrict access to only certain people. There is still a risk that private information could be exposed despite these restrictions, so don't post anything that you wouldn't want the public to see. Sites may change their options periodically, so review your security and privacy settings regularly to ensure your choices are still appropriate.
    4. Use strong and unique passwords – Protect your account with passwords that cannot easily be guessed. If your password is compromised, someone else may be able to access your account and pretend to be you. Never use the same password on social media as you do for work or banking.
    5. Beware of third-party applications – Third-party applications may provide entertainment or functionality, but use caution when deciding which applications to enable. Avoid applications that seem suspicious, and modify your settings to limit the amount of information the applications can access.
    6. Be wary of strangers – The internet makes it easy for people to misrepresent their identities and motives. Consider limiting the people who can contact you on these sites. If you interact with people you do not know, be cautious about the amount of information you reveal or agreeing to meet them in person.
    7. Be skeptical – Do not believe everything you read online. People may post false or misleading information about various topics, including their own identities. This is not necessarily done with malicious intent; it could be unintentional, an exaggeration, or a joke. Take appropriate precautions, though, and try to verify the authenticity of any information before taking any action.
    8. Check privacy policies – Some sites may share information, such as email addresses or user preferences, with other companies. This may lead to you receiving more spam in your email. Additionally, try to locate the policy for handling referrals to make sure that you do not unintentionally sign your friends up for spam. Some sites will continue to send email messages to anyone you refer until they join.
    9. Keep software and browsers up to date – Install official software updates so attackers cannot take advantage of known problems or vulnerabilities. Many operating systems offer automatic updates. If this option is available, you should enable it.
    10. Use and maintain antivirus software – Antivirus software helps protect your computer against known viruses, so you may be able to detect and remove the virus before it can do any damage. Because attackers are continually writing new viruses, it is important to keep your antivirus definitions up to date.

    While this list of tips is not exhaustive, it provides a guide to a more secure social media experience. By following these guidelines, you can get all the enjoyment meant to come from social media, while keeping your personal information private and your computer safe.

    Children are especially susceptible to the threats that social networking sites present. Although many social media sites have age restrictions, children may misrepresent their ages so they can join. By teaching children about internet safety, being aware of their online habits, and guiding them to appropriate websites, parents can ensure that their children become safe and responsible users.

  • Put your training skills to work as a member of the Society’s Volunteer Training Team

    The National Volunteer Training Team (NVTT) is recruiting new members.  If you are a volunteer or know of a volunteer who is skilled in virtual training and passionate about the Society, we have several opportunities!

    The NVTT is a virtual training team.  Here is a little more about the expectations of volunteers in the program:

    • Team members are knowledgeable about the American Cancer Society's mission, programs, and services. They have in-depth knowledge of the subject area they are training on and are able to articulate that information to others.
    • Membership on the NVTT requires a two-year commitment that may be renewed depending upon the team member's interest, expertise, and performance, as well as staff input, audience feedback, and the Society's geographic training needs.
    • Team members facilitate at least eight (8) virtual training sessions per year.
    • Team members maintain the skills and the system and content knowledge necessary for their positions by participating in and completing mandatory and required team training.
    • Timely team communication is critical to the work we do. Team members should have frequent access to email and are expected to reply to communications in a timely manner.

    Interested volunteers should complete one of the three applications:

    • Reach To Recovery volunteers with skills and interest for training new Reach volunteers can apply to join our team that facilitates weekly teleconference trainings.
    • Road To Recovery volunteers with great knowledge about the Road program can apply to join our team that facilitates monthly teleconference trainings for new Road volunteers.
    • Other society volunteers who have an interest in more general Society training like Volunteer Staff Partnership, Change Savvy and Sharing Our Story can apply for one of our other teams by filling out this application.

    Deadline for submitting applications is October 27, 2017.  

    Questions?  Email ACSVolunteerCare@cancer.org.

  • Cross-country motorcycle trip helps support our fight against breast cancer; includes visits to Hope Lodges

    This Breast Cancer Awareness Month, a group of six men led by the CEO of a nutritional supplements company, are driving their motorcycles cross country to help raise awareness and funds for the American Cancer Society. 

    This week they made their second Hope Lodge visit, and later this week the motorcycle entourage will be pulling up to our Hope Lodge in Hersey, PA. The tour will end back home on Sunday, Oct. 15, with a dramatic finish at the starting line of their local Making Strides event at Jones Beach State Park on Long Island, NY.

    This 4,000-mile trek dubbed the first annual #Road2WellnssTour is the brainchild of Frank D'Amelio, Jr., CEO of Nature's Answer®, one of America's largest and oldest family-owned manufacturers of nutritional supplements. He has pledged at least $100,000 to the Society, which is being raised through sponsorships, team fundraising, the sale of promotional items, donations to the Nature's Answer Foundation, and a portion of the total sale proceeds of Nature's Answer products during the month of October. 

    "The effort to support the American Cancer Society in educating people about cancer prevention is so important to all of us at Nature's Answer," said D'Amelio, pictured in the smaller image, being interviewed by a local Nashville TV station. "Many of us have first-hand experience in dealing with this terrible disease. We decided to time the launch of the Nature's Answer Foundation and the cross-country tour with Breast Cancer Awareness Month, capping it off by arriving at the Making Strides walk in our own community." 

    The group of New York-based men left Los Angeles on Oct. 1, and stops included visits to our Hope Lodge communities in Phoenix and Nashville.  

    Their last Hope Lodge visit will be in Hersey, PA, on Oct. 14, then they'll head home to Long Island, NY, just in time for the start of Sunday's Making Strides Against Breast Cancer event at Jones Beach, our largest Making Strides event. There they will join thousands of walkers plus 250 employees, family members and friends awaiting their arrival.

    Pink care packages for the Hope Lodge guests were shipped in advance. They contained essential oils and natural lotions and were valued at $70 each. During their stops, the riders toured the Lodges and visited with guests.

    In preparation for the three Hope Lodge visits, our media teams on the ground have been working hard to provide media opportunities.

    "We are very excited about this newly established partnership," said Marie Cimaglia, director, Community Development.  "Nature's Answer came to us, asked questions, invested their time, witnessed our work in action – even meeting patients and volunteers at the Society's Hope Lodge in NYC.  Nature's Answer values our work in providing information and support to those touched by breast cancer and funding cutting-edge research to better understand, prevent, find, and treat the disease, and decided to head on a tour to meet others benefitting from the Society's Hope Lodge sites across the U.S."

  • The Relay gift that keeps on giving

    Over the past two weeks, we've had some significant accomplishments on the Global front. With two inaugural Relay For Life events and the most successful Relay event Kenya has seen in years, we are proud to highlight the impressive work of three of our 29 partners. 

    Inaugural Relay For Life of Norway

    With a surprise appearance from the sun (a rare sighting in Scandinavia), the inaugural Relay For Life in Randaberg, Norway, took place on September 30.  

    While this was the first Relay to take place in Norway, you would never have known it! The 24-hour event brought together more than 1,600 registered participants, 48 teams and 44 survivors (known as fighters) to raise awareness and funds in the fight against cancer. Watch a video of the event now! 

    The Relay not only united a community around a common cause, but it served as a training opportunity for seven other regions in Norway where key leaders have been identified to build full Relay committees.

    Inaugural Relay For Life (Revelo Por la Vida) of Uruguay

    On October 6, our new partners in Uruguay exceeded all expectations for producing the very first Relay For Life (Relevo Por La Vida) in South America. The story behind how Relay came to life in Uruguay is truly inspirational. It was a Relayer from Puerto Rico who shared the idea with her fellow graduate student from Uruguay more than two years ago. From this conversation, an idea was born and they went straight to the office of the president of Uruguay, an oncologist, who endorsed the partner organization that ACS granted a Relay For Life license to. Not only did a Relay participant from Puerto Rico seed the idea for a Relay in Uruguay, the training was delivered – in Spanish – by a volunteer board member from Puerto Rico.

    We encourage you to watch this video about the Uruguay event, and share it with your Relay volunteers.  

    Relay in Kenya

    "If you want to go quickly, go alone. If you want to go far, go together."  This African proverb was the inspiration and driving force to reignite the Relay For Life spark in Kenya. Its Relay this year was its most successful event in four years, with 50 teams surpassing their goal by $35,000. That's a 90% increase from the year before. 

    The success of the Relay is not only a testament to the passion and strategic efforts of the volunteers of KENCANSA, but also a tribute to the internal collaboration and support provided to our Kenyan partners. Earlier this year, two volunteer Global training leads, Melissa Park and Perry Reed, traveled to Kenya and hosted a three-day training to rebuild the Relay foundation and improve the understanding of what Relay is to their community. The Global training team hosted weekly calls up until the event with the volunteers, while Kristen Solt, strategic director, Global Stakeholder Engagement, helped to reinforce the fundraising messaging and brought awareness to the work being done by our Global Cancer Control department in in Kenya. 

    For more information and stories about Global Relay, visit our Global Relay blog.

    PHOTOS: Both photos are from the Relay For Life in Uruguay.

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