Developing the National Institute for Occupational Safety and Health's Cancer Control Demonstration Projects for Farm Populations

Abstract: Although farmers experience lower overall cancer rates than the U.S. population, they are at increased risk for cancers of certain sites, such as brain, stomach, lymphatic and hematopoietic, lip, prostate, and skin. Little research has been done to determine the extent to which farmers and their families use cancer control services or how their utilization behaviors and cancer survival rates compare to those of nonfarmers in the United States. In 1989, recognizing the occupational uniqueness of farm populations and the limited cancer-related information about them, Congress mandated that the National Institute for Occupational Safety and Health (NIOSH) develop a program to promote cancer control among farming populations. Eight institutions were funded through cooperative agreements to collaborate with NIOSH and each other to develop the demonstration research and intervention projects. The projects are aimed at identifying barriers that prevent farmers, farmworkers, and their families from accessing the full range of cancer control services, and then implementing interventions to mitigate those barriers. This paper illustrates some of the conceptual and methodological issues NIOSH researchers and their collaborators faced while developing the cancer control program.