In April 1984, the District of Columbia Division of the American Cancer Society launched an awareness campaign through the mass media to emphasize the increasing incidence and mortality of cancer among black Americans and motivate the black population to take some action regarding their health.

But some people in the community criticized the campaign. A Washington Post editorial called it "misleading and slightly offensive."

Whatever the feelings about a campaign aimed at the black population's high risk of cancer, the need to do something about that trend is clear.

Statistics show a sharp difference in cancer survival rates between whites and blacks nationwide. For white patients diagnosed with cancer between 1976 and 1981, the survival rate was 50 percent. For black patients, it was only 38 percent.

A study by the Howard University-Georgetown University Comprehensive Cancer Center examined cancer mortality for the District and 10 U.S. Standard Metropolitan Areas comprising 34.5 percent of the total U.S. black population.

The combined cancer mortality rate for both black males and black females in the District was the highest of the areas examined -- 195.4 deaths per 100,000 population. The rate for both white males and white females in the District was among the lowest of the 10 areas in the study -- 132.7 deaths per 100,000 population.

Within the District, cancer mortality rates for black males were 62.5 percent higher than for white males; mortality rates for black females were 22.9 percent higher than for white females. Comparable national data show racial mortality differentials of 21.4 percent among males and 13.2 percent among females.

The Howard-Georgetown study also examined mortality for specific sites of cancer and found that Washington's black population had more cancers of the cervix, colon, esophagus, liver, lung and bronchus, pancreas, prostate, rectum and stomach than the white population. Among the suggested explanations for these high rates are: lack of screening and educational programs, late diagnosis of cancer and less timely or delayed treatment.

In a separate study to further identify high-risk groups within the District, an analysis of the geographic distribution of cancer deaths was undertaken. The study found that cancer risk varies significantly within the District. Two of the areas with the greatest overall risks for both men and women were the eastern corner of the city bordered by Pennsylvania Avenue on the south, the Capitol Hill area with Maryland Avenue to the west and the Anacostia River to the east; and center city north of Massachusetts and Maryland avenues, bounded by 16th Street NW and Bladensburg Road. The lowest risk is associated with those neighborhoods west of Rock Creek Park.

This evidence underscores the necessity for educating the city's black population about prevention and early detection of cancer in order to reduce mortality. Although nothing can guarantee prevention, it is possible to reduce known risk factors for the disease. Cigarette smoking is considered responsible for 83 percent of lung cancer, the leading cancer killer among the District's black males. A study by the National Cancer Institute suggests that high alcohol consumption is responsible for the high mortality from esophageal cancer in the District.

Regular screening examinations can detect potential precancerous conditions such as dysplasia and polyps. The colon and rectal cancer cure rate could be as high as 75 percent if all persons over 50 took advantage of available screening methods. Currently only 47 percent of all black patients diagnosed with colorectal cancer are cured.

An ACS-sponsored national study indicated that blacks believe cancer is the main concern of whites, while high blood pressure and sickle cell anemia are the primary health concerns of blacks. This probably reflects high-visibility programs directed at blacks concerning the latter two health problems, while cancer programs have not been specifically targeted to black audiences.

The local division of the cancer society decided to run this awareness program in accordance with a national American Cancer Society priority for reaching black Americans with cancer information. This national effort began in 1970 with a National Conference on Meeting the Challenge of Cancer Among Black Americans. More than 400 black leaders from 55 civic, religious, fraternal, labor and scientific organizations participated in that conference.

The support of a well-respected Washington advertising agency was sought by the cancer society to develop a public awareness campaign incorporating various mediums to achieve maximum exposure of the targeted population. Television and radio public service announcements, public transportation advertising and other print advertisements incorporated the powerful and compelling message: "If you're black and live in D.C., you're a high cancer risk. Get a checkup. Don't give cancer a chance."

The purpose of this concentrated cancer control program is not only to raise awareness but also to motivate people to take some action regarding their health.

Public response to the awareness effort has been outstanding and has not abated over time. Hundreds of people, 99 percent of them black, have been inspired to call the society for information about prevention, screening and early detection of cancer.

While there is no guarantee that the campaign will lower the number of new cancer cases among blacks, it clearly reached and inspired a large number of people in the black community. It needed to be done.