A New Strategy Against Cancer Disparities
How regional collaboration is transforming the fight against cancer health disparities across the United States
In the United States, your zip code can be as important as your genetic code when it comes to your risk of dying from cancer.
Significant disparities in cancer incidence and mortality exist across racial, ethnic, and geographic lines. For instance, African Americans/Blacks face higher age-standardized incidence and mortality rates for colorectal cancer compared to non-Hispanic Whites 2 . These persistent gaps in cancer outcomes have prompted a revolutionary approach from the National Cancer Institute.
Year GMaP program launched by NCI's Center to Reduce Cancer Health Disparities
Regional hubs coordinating cancer disparities efforts across the U.S.
In 2009, the NCI's Center to Reduce Cancer Health Disparities (CRCHD) launched the Geographic Management of Cancer Health Disparities Program (GMaP), an innovative national program designed to address cancer disparities through a region-based "hub" system 1 4 . Unlike traditional research approaches that often work in isolation, GMaP creates collaborative networks that bring together researchers, trainees, community health educators, and community members to collectively tackle the most pressing cancer disparity issues in their regions 1 .
This geographical management approach represents a significant shift in how we combat cancer disparities—acknowledging that solutions must be tailored to local needs while leveraging resources and expertise across institutions.
GMaP operates through a network of regional hubs that serve as coordinating centers for cancer health disparities (CHD) research, training, and outreach. Each hub is based at an NCI-Designated Cancer Center and oversees a specific geographic area 1 . The program aims to enhance capacity in several key areas, including:
The program's structure has evolved since its inception, initially consisting of six regions that were later reorganized. Each region brings together researchers, trainees, students, and community members to identify and prioritize region-specific cancer research, training, and outreach issues 1 5 .
| Region | Hub Institution | States/Territories Served |
|---|---|---|
| Region 1 North | Markey Cancer Center, Lexington, KY | DE, KY, MD, ME, NH, VT, VA, WV, Washington DC 1 |
| Region 1 South | Hollings Cancer Center, Charleston, SC | NC, SC, TN 1 |
| Region 2 | H. Lee Moffitt Cancer Center, Tampa, FL | AL, AR, FL, GA, LA, MS, MO, Puerto Rico 1 |
| Region 3 | University of New Mexico Cancer Center, Albuquerque, NM | AZ, CA, CO, KS, NE, NM, OK, TX 1 |
| Region 4 | Fox Chase Cancer Center, Philadelphia, PA | CT, IA, IL, IN, MA, MI, MN, NJ, NY, OH, PA, RI, WI 1 |
| Region 5 | Fred Hutchinson Cancer Research Center, Seattle, WA | AK, CA, American Samoa, Guam, HI, OR, WA 1 |
| Region 6 | Huntsman Cancer Institute, Salt Lake City, UT | ID, MT, NV, ND, SD, UT, WY 1 |
Visual representation of GMaP regions across the United States
One of the most successful implementations of the GMaP model is the Screen to Save (S2S) Initiative, a colorectal cancer outreach and screening program conducted through CRCHD's National Outreach Network (NON) 2 .
This initiative exemplifies how the GMaP structure enables targeted, culturally-tailored interventions for specific at-risk populations.
Colorectal cancer (CRC) continues to be one of the most commonly diagnosed cancers, ranking as the third most diagnosed cancer among both women and men 2 . Screening can detect cancer and excise premalignant lesions, proven to reduce overall colorectal cancer incidence and mortality rates. However, racial/ethnic minorities and medically underserved populations face increased CRC morbidity and mortality, often due to sociocultural barriers including economic disadvantage, lack of insurance, and longer travel distances to care 2 .
Most diagnosed cancer among both women and men
A key strength of this initiative was its cultural adaptation process. The educational materials went beyond simple translation, employing the Barrera and Castro cultural adaptation model that included five stages: information gathering, preliminary adaptation design, preliminary adaptation tests, adaptation refinement, and final implementation 2 .
The Screen to Save Initiative yielded impressive outcomes that demonstrate the power of the GMaP approach:
All racial/ethnic groups showed an increase in CRC-related knowledge after the educational sessions. Participants strongly agreed that the educational events increased the likelihood they would engage in CRC-related healthful behaviors, such as obtaining CRC screening and increasing physical activity 2 .
In Phase II, the Connections to Care component proved highly effective. Among participants who obtained CRC screening during the 3-month follow-up period, 82% received their screening results, facilitating appropriate follow-up care when needed 2 .
| Outcome Measure | Results | Significance |
|---|---|---|
| Educational Events Conducted | 347 events | Broad reach across diverse communities 2 |
| Participants Surveyed | 3,183 pre/post surveys | Large sample size across multiple demographic groups 2 |
| Knowledge Improvement | Increased across all racial/ethnic groups | Standardized, culturally-tailored education effectively communicates CRC information 2 |
| Screening Result Receipt | 82% of screened participants obtained results | High rate of completion in the screening process chain 2 |
Interactive chart showing CRC knowledge improvement across demographic groups
The GMaP program and its companion initiative, the Minority Biospecimen/Biobanking - Geographic Management of Cancer Health Disparities Program (BMaP), provide researchers with essential resources for conducting cutting-edge cancer disparities research 5 .
World's largest storehouse of natural products with approximately 200,000 extracts from plants, marine organisms, fungi, and bacteria
Screening for potential anti-cancer compounds from diverse natural sources 3
Diverse collection of more than 200,000 synthetic and naturally derived compounds
Preclinical research on potential therapeutic agents 3
Includes cytokines, monoclonal antibodies, and other biologic reagents stored under controlled conditions
Support for preclinical research requiring high-quality biological reagents 3
Low-temperature repository of implantable tumors and tumor cell lines from various species
Cancer biology studies using well-characterized tumor models 3
Infrastructure linking biospecimens with cancer registry data from the Surveillance, Epidemiology, and End Results Program
Population-based cancer research using annotated tissue samples
These resources are particularly valuable for early-stage investigators and researchers in minority-serving institutions, who may not otherwise have access to such extensive research materials.
The GMaP model represents a paradigm shift in how we approach cancer health disparities.
By creating regional networks that leverage local expertise while maintaining national coordination, GMaP has demonstrated that geographical management can effectively address complex health disparities 5 . The program's success in initiatives like Screen to Save shows the power of combining scientific rigor with community engagement.
As research continues, the GMaP/BMaP networks stand as testaments to the power of collaboration—bringing together researchers from basic sciences through community-level research to pool resources across the cancer continuum 5 .
In the fight against cancer disparities, this coordinated, geographical approach offers hope for more equitable outcomes for all communities, regardless of their zip code. As the program moves forward, it serves as a model for how to systematically address health disparities through collaboration, resource-sharing, and capacity-building. The geographical management approach proves that by mapping the problem precisely and engaging the right partners in each region, we can make meaningful progress toward eliminating cancer disparities.