Low-Income Women More Likely to Die from Breast Cancer, Less Likely to Receive Treatment, Study Finds
Low-income women are less likely to be diagnosed early with and treated for breast cancer and are more likely to die from the disease than women with higher incomes, according to a new study published in today's issue of the Journal of the National Cancer Institute, the AP/Baltimore Sun reports. Although several studies have shown that black women are more likely to be diagnosed later and to die from breast cancer than their white counterparts, the new findings indicate that socioeconomic status is more important than race in breast cancer diagnoses and outcomes, according to lead researcher Cathy Bradley (AP/Baltimore Sun, 4/3). In the study, Bradley and her colleagues at Michigan State University used the Detroit cancer registry to identify 5,719 women with breast cancer. Of these women, 593 were insured by Medicaid and had incomes below the federal poverty level. Other women were either uninsured or had private coverage. Nineteen percent of the Medicaid beneficiaries with breast cancer were African-American (Fox, Reuters/Detroit Free Press, 4/3). The researchers compared the medical outcomes of Medicaid beneficiaries with those not in the program. The study found that women on Medicaid were 41% more likely to be diagnosed with breast cancer "at a late stage," 44% less likely to receive radiation treatment and three times more likely to die from breast cancer than women not on Medicaid (AP/Baltimore Sun, 4/3). The Atlanta Journal-Constitution reports that "many factors" may explain the study's findings. Low-income women may not seek prompt medical care because they "hold a deep distrust of the medical system," fear the stigma of being diagnosed with breast cancer or lack transportation and child care (Guthrie, Atlanta Journal-Constitution, 4/3). According to Bradley, many people are ineligible for Medicaid "until they actually develop cancer," and consequently do not seek screening or treatment until the cancer is "so serious that they cannot ignore it." Bradley also suggested that low-income women may be "less able" to follow long-term treatment regimens that require daily hospital visits.
Bradley's study "clashes" with research released last month by the Institute of Medicine that found that minorities receive "less-than-optimal" health care regardless of economic status, Reuters/Detroit Free Press reports (Reuters/Detroit Free Press, 4/3). Bradley contends her study "shows that if a person is poor, whether black or white, they are more likely to have an adverse outcome in cancer care and mortality" (Atlanta Journal-Constitution, 4/3). Dr. Otis Brawley of the Winship Cancer Institute at Emory University wrote in an editorial accompanying the study that "[r]ather than speaking in racial ethnic terms of black and white populations, it is more appropriate to speak in socioeconomic terms of the 'haves' and the 'have nots'" if breast cancer is to be treated effectively. Brawley added, "This focus would rightfully bring other socioeconomically deprived populations that include whites, Hispanics, Native Americans and Asians into the discussion" (AP/Baltimore Sun, 4/3).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.