Racial differences in cancer care still unexplained
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Even though black patients and white patients with rectal cancer are equally likely to consult with an oncologist, blacks are less likely to undergo additional treatment after surgery, according to research findings posted online by the Journal of the National Cancer Institute.
The lower rates of radiation and chemotherapy partially explain why long-term survival after rectal cancer surgery is up to 20 percent lower for black patients than for white patients. Dr. Arden M. Morris, at the University of Michigan in Ann Arbor, and her colleagues hypothesized that blacks may not be referred as often to medical and radiation oncologists.
Using information from a large national database, the researchers identified 2,716 patients 66 years of age or older who had undergone surgery for stage II or III rectal cancer.
There was no significant difference between the 134 black patients and the 2,582 white patients in how frequently they consulted with medical or radiation oncologists.
However, black patients were less likely than white patients to undergo chemotherapy (54 percent vs 70 percent), radiation (74 percent vs 83 percent) or both (61 percent vs 77 percent).
The authors could identify no demographic, clinical, or physician characteristics to account for the differences in treatment.
Until strategies can be developed such as, improving patient and physician communications or distributing resources to settings where black patients are most likely to obtain care, “it is unlikely that racial disparities in the care of rectal and, possibly, other cancers will be improved in a meaningful way,” Morris and her associates conclude.
SOURCE: Journal of the National Cancer Institute, May 13, 2008.
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