The inclusion of ethnic minorities in cancer prevention studies is a scientific, logistic, cultural, and ethical issue. A great deal has yet to be learned about cancer in these populations. Many questions remain unanswered, such as why some ethnic minorities are more likely to get certain cancers, be diagnosed at later stages, and die of their disease. Further, there is a great need to be more successful in the recruitment of ethnic minorities to cancer prevention research trials. It is unclear why their participation in many clinical studies remains low. The answer to these questions, we argue, lies in an a deeper understanding of the meaning of ethnicity. Definitions of ethnicity are inconsistent and unclear; researchers employ the concept to measure every important indicator associated with inequality or difference: socioeconomic status, cultural lifestyles and values, and genetic predispositions are all being measured by the ethnicity variable. A discussion of the multifactorial elements, implicit or explicit, in the use of the terms race, ethnicity, and culture can be used to point out the elements that are fundamental to these terms and that may influence health behaviors and outcomes. The concept of ethnicity is more useful for understanding health than are the concepts of race or culture because it has, since the origins of the term, focused on the role of traditions while acknowledging that genetics are involved. Ethnicity is best understood when we adopt the interactionist view that specifies that both genes and environmental factors interact in human development and play a role in health and illness. By taking an interactionist view, more successful cancer prevention interventions and research trials can be developed.
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