Subject: Cancer Studies Are Seen Lagging For Poor Women 
Date: Published: 5/19/92 (66 lines)
Source: Wall Street Journal. Copyright Dow Jones & Co. Inc.

    Technology:
    Cancer Studies
    Are Seen Lagging
    For Poor Women
    ----
    By Marilyn Chase
    Staff Reporter of The Wall Street Journal

    SAN DIEGO -- Benefits of experimental cancer treatment and
 prevention studies aren't reaching poor and minority women
 most at risk, researchers said.
    The findings, discussed at the American Society of
 Clinical Oncology meeting here, have sober implications for
 the massive breast cancer trial of tamoxifen, which is now
 recruiting 16,000 women for what may become a model of future
 prevention studies.
    To ensure equal access to African-American, Hispanic and
 poor women, "you need more resources, but it's hard to get
 resources to do the trials in the first place," said Rowan T. 
 Chlebowski of the University of California's Harbor-UCLA
 Medical Center in Torrance, Calif.
    Because the female relatives of breast cancer patients are
 at high risk of contracting the disease, Dr. Chlebowski
 designed a "mock recruitment" program to see how effectively
 such women were being reached in underserved areas.
    Barriers to patient contact were formidable, he found.
 More than a third of the women lacked a working telephone.
 Even within families, communication was poor, with more than
 one-fifth of the cancer patients witholding the news of their
 diagnosis from their mothers.  Almost eight out of 10 women
 were uninsured, with the remainder receiving some form of
 federal health insurance.
    After screening 126 patients and making more than 300
 phone calls to find relatives, Dr. Chlebowski found only
 three women who were willing to participate in a cancer
 prevention study.  In part, he said, the message isn't
 penetrating because women didn't understand the distinction
 between early diagnosis of cancer and its prevention.  Other
 women thought the study had to do with AIDS.  
    Victor G. Vogel of the M. D. Anderson Cancer Center in
 Houston agreed that the more affluent and educated a woman
 is, the more likely she is to participate in clinical trials.
 Only 8% of his study participants were women of color, he
 said, adding:  "we need to do more" to increase their
 representation.
    Separately, a European study reanimated the discussion
 over whether tamoxifen -- now being evaluated as a breast
 cancer preventative -- may increase the incidence of new
 primary tumors in different organs.
    Rodrigo Ariagada, of the Institut Gustave-Roussy of
 Villejuif, France, said the Swedish-French study looked at
 more than 2,300 breast cancer patients.  Those on tamoxifen
 had fewer recurrences of breast cancer than their untreated
 counterparts.
    However, 8% of the tamoxifen patients developed new
 primary tumors, including cancers of the uterus and
 gastrointestinal tract, against 5% of the control group -- in
 a difference described as statistically insignificant.

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