Minorities, women, and clinical cancer research: The charge, promise, and challenge

Significant progress has been made since the war against cancer was launche d. Discoveries in molecular medicine, genetics, and epidemiology have led t o the recognition that certain cancers are potentially preventable and that elements of lifestyle, along with genetic, hormonal, and metabolic factors can be altered to reduce cancer risk. Advances in medical technology have led to the development of new imaging methods and computer technologies tha t can aid in efforts to detect, diagnosis, and treat cancer. Since the offe nsive against cancer was initiated, cancer treatments have become more powe rful, more precise, less drastic, and safer. As a result, cancer incidence and mortality have begun to decline. Yet, while the nation boasts of the pr ogress being achieved relative to cancer incidence and mortality, and feder al research agencies retort that research applies to all populations, it is apparent that the declines do not translate to all populations in the Unit ed States. Clinical research is essential to cancer prevention and control. Within the oncology community, clinical cancer research trials are viewed as an effic ient and economical way for patients to secure state of-the-science medical care. Recognizing the need to improve access to state-of-the-science cance r treatment and control programs, minority and female participation in clin ical cancer research trials has been encouraged, This recommendation is bas ed on the belief that increased participation in well-designed clinical can cer research trials adhering to strict protocols and quality controls will, not only help validate the application of research findings to minority an d female populations, but also result in better patient outcomes. Born out of a commitment to social equity, justice, beneficence, and the de sire to ensure that data relevant to cancer prevention and control are both valid and generarizable to populations across the United States, several p rograms of research aimed toward increasing the representation of women and minorities in clinical cancer research have been pursued by the National C ancer Institute. This issue of the Annals of Epidemiology Minorities, Women , and Clinical Cancer Research presents issues and challenges that face the research community and descriptions of effective models, strategies, and p ractices that may be used to increase the participation of minorities and w omen in clinical cancer research trials and facilitate the conduct of resea rch directed toward reducing the cancer burden within the United States. (C ) 2000 Elsevier Science Inc. All rights reserved.