After being diagnosed with breast cancer two and a half years ago, the Rev. Tammie Denyse was deeply troubled by the statistics showing that African American men and women have the highest mortality rate from breast cancer than any other race or ethnicity.

Hoping to raise awareness about breast cancer and to increase education, research and support programs for cancer survivors, Denyse founded Carrie’s Touch, Inc. (Teaching, Outreach, Understanding, Caring, Healing), an African-American breast cancer organization. She partnered with UC Davis Cancer Center and Sutter Cancer Center in Sacramento to get out the message that disparities in cancer incidence, mortality and survival for various racial, ethnic and socioeconomic groups are unacceptable.

“I want to make a difference, beginning with the patient-doctor relationship,” says Denyse, who is part of the ministerial staff at St. Andrews African American Episcopal Church in Sacramento. “All patients — no matter what their color, insurance coverage or resources – should receive the same information when diagnosed with cancer and treatment plans are being discussed. We have to do whatever we can to reduce health disparities among diverse communities.”

Denyse’s community-based organization is a member of the year-old Diversity Coalition of Greater Sacramento, a group of some 50 health care, community and faith-based organizations. The coalition’s mission is to serve as a catalyst and advocate for diverse communities in the Sacramento region to reduce factors contributing to cancer-related health disparities.

Denyse spoke passionately about her battle with breast cancer during the Sacramento Dialogue on Cancer, a June 21 forum sponsored by the Diversity Coalition at California State University, Sacramento. The forum brought together some 150 community leaders to discuss information regarding health disparities faced by underserved ethnic communities in the greater Sacramento area and to strategize about how these populations can greatly reduce their risk of developing cancer.

Forum participants hoped to lay the foundation for a community-driven Sacramento Cancer Control Plan. Cancer control strategies noted at the forum include improved nutrition; increased exercise; optional vaccination against Hepatitis B, a disease that often leads to liver cancer; optional vaccination against HPV, a virus causing cervical cancer; and appropriate and timely screenings for breast, cervical, colorectal and prostate cancers.

The dialogue featured panels with community leaders and researchers in health care disparities and cancer control, representatives of community organizations engaged in cancer control, and health care providers and insurers.

Researchers at the forum, including Monica Brown, regional cancer epidemiologist of the Cancer Surveillance Program, Region III of the California Cancer Registry, and Dr. Sergio Aguilar-Gaxiola, director of the Center for Reducing Health Disparities at UC Davis Health System, presented evidence showing that the burden of cancer is heavier among ethnic communities. These include African Americans, Latinos, Asians, Pacific Islanders, Native Americans and new groups of immigrants found in the Slavic community.

Aguilar-Gaxiola, a UC Davis professor of internal medicine, shared how cancer personally affected his own family. “My mother died of leukemia when I was 13, and my dad died of colon cancer later in life,” he said. “Cancer has touched my family in ways that drastically changed our lives. And it touches so many in underserved communities. But it is one of those conditions that can be preventable.”

As founding director of the Center for Reducing Health Disparities, Aguilar-Gaxiola has worked to pinpoint the specific factors associated with health disparities, identify solutions, and implement changes at the patient-provider, institutional and community-wide levels.

He said the growth of ethnic populations in California magnifies the need to resolve health disparities, including that the risk of developing cancer varies considerably by race and ethnicity. The reasons for race and ethnic differences are not well documented or understood, he said, but it is likely that they result from a complex combination of dietary, lifestyle, environmental, occupational and genetic factors.

“Disparities are bad public health policy,” he said. “Often what we see is that resources are allocated to those who need them the least and derive the least benefit. And that is a disparity in itself.”

He challenged participants to “a deeper level of engagement in educating and empowering” those in ethnic communities to help improve greater access to screening and treatment for cancer.

Marlene von Friederichs-Fitzwater, director of the Outreach, Research and Education Program at UC Davis Cancer Center since July 2005 and a cervical cancer survivor, told forum participants that one of the goals of the program is to eliminate health disparities in cancer prevention and control throughout Northern California. The program continues to implement new offerings in the areas of education, support, outreach and survivorship.

The program hopes to reduce health disparities by raising awareness, especially in those communities where access to information and care is limited, said von-Friederichs-Fitzwater.

She is working with two other UC Davis professors to increase awareness of cervical cancer risks and prevention strategies among Latinas in the greater Sacramento area, since Hispanic women face double the lifetime risk of developing cervical cancer compared with non-Hispanic white women.

The Mother’s Wisdom Breast Health Program at the Cancer Center brings together American Indian women from many tribes to develop and deliver culturally sensitive breast health and breast cancer prevention information.

Von-Friederichs-Fitzwater said the Outreach, Research and Education Program also works closely with the Asian American Network for Cancer Awareness Research and Training (AANCART) to reach out to the Asian and Pacific Islander communities. A faith-based program to raise awareness in the African-American community is under way and will be expanding this year.

Two research projects are exploring beliefs and attitudes of newly-immigrated Slavic men and women about cancer prevention and treatment. This research will lead to culturally appropriate outreach programs for this growing population in the greater Sacramento area, she said.

Connie Chan Robison, executive director of the Center for Collaborative Planning in Sacramento, facilitated workgroup discussions among forum participants to gain their insights and ideas about ways to mobilize a community response among diverse communities to control cancer.

Participants acknowledged collectively that access to local data is important and necessary for making appropriate program and policy decisions. Current data collection is limited and more ethnic specific data is needed to “make sure everyone counts,” Chan Robison said.

Beverly Saldivar, health programs manager at the American Cancer Society in Sacramento, said the dialogue was a success and part of a larger ongoing effort to get ethnic and church communities talking about cancer control.

“This is a much-needed collaboration,” said Saldivar, who is a parishioner at the Cathedral of the Blessed Sacrament in Sacramento. “We’re hoping to get more people from parish and church communities involved in helping us with education about strategies to prevent and control cancer.”

For more information about the Diversity Coalition of Greater Sacramento, call Beverly Saldivar at (916) 446-7933 or visit the Web site at www.diversitycoalition-sacramento.com.

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