Headlines and broadcasts trumpet the fact that African Americans have higher cancer rates than whites. It's no wonder that many African Americans develop a fatalistic view of cancer and assume there is no way to mitigate their higher risks.

But these high cancer rates often are directly tied to controllable environmental and lifestyle issues. Higher smoking rates; high-fat, low-fiber diets; sedentary lifestyles; high stress levels; and a greater exposure to cancer-causing (carcinogenic) environments all encourage the cancers that drive the sky-high death rates.

The failure to undergo screenings such as breast self-exams and mammography for breast cancer for women increases the risk as well. This failure means that African Americans' cancers are consistently found at later, harder-to-treat stages. Testicular self-exams, digital rectal exams and prostate screening tests are equally important for men. Physicians recommend that everyone should undergo screenings for colorectal cancer regularly after reaching age 50.

During Breast Cancer Awareness Month in October 1998, the U.S. Department of Health and Human Services, under the leadership of then-Secretary Donna Shalala, announced new efforts to encourage mammography screening. Black women have the nation's highest death rates from breast cancer, and although these rates did decline, the racial disparity did not. Black men have the nation's highest lung cancer death rate, and while this rate also declined sharply in the 1990s, this racial gap also remained constant: The black male death rate remains about twice as high as that of the total population.

However, hope is on the horizon in terms of cancer prevention in African Americans. Surgeon General David Satcher has proposed studying the very low smoking rates in young African American girls for clues about how to keep other American youths of every ethnicity tobacco free.