Racial Disparities in Cancer Survival Rates Not Biological, Study Finds
Factors such as coexisting medical conditions, income, insurance and time of diagnosis -- not genetic or biological differences -- are more likely to contribute to the racial disparity in cancer survival rates, according to a new study, Reuters/New York Times reports (Reuters/New York Times, 4/24). Between 1992 and 1997, the overall cancer survival rate five years after diagnosis was 63% for white patients, compared to 52% for black patients. The disparity prompted some researchers to suggest that cancer "behaves differently" in the two groups (Ricks, Newsday, 4/24). To test that theory, researchers at New York-based Memorial Sloan-Kettering Cancer Center reviewed 54 journal articles on cancer survival rates published over the last 35 years. The studies examined a combined 189,877 white cancer patients and 32,004 black cancer patients with 14 different cancers. Their analysis, published in today's Journal of the American Medical Association, found that blacks had a 16% increased risk of death, compared to whites. But when chronic conditions such as hypertension, heart disease and diabetes -- which disproportionately affect blacks -- were taken into account, the overall increased risk of death dropped to 7%. For lung, prostate and colon cancers, the gap was completely eliminated (Cox News/Spokane Spokesman-Review, 4/24). "There is not much evidence that cancer behaves differently in blacks than in whites," Dr. Colin Begg, chair of the department of epidemiology and biostatistics at Memorial Sloan-Kettering, said, adding, "Differences in treatment, stage of disease at presentation and mortality from other diseases -- not biological or genetic differences -- seem to explain most of the disparity. These are the areas that should be the primary targets for future research and public health interventions" (Reuters/New York Times, 4/24).
The study also found that in clinical trials, in which participants have the same stage of cancer and are given the same treatments, almost no racial disparity existed. Dr. Otis Brawley, an oncologist and researcher at Emory University's Winship Cancer Institute and a co-author of the report, said, "Basically, equal access to equal treatment leads to equal outcome" (Cox News/Spokane Spokesman-Review, 4/24).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.