Black patients are significantly less likely than their white counterparts to receive therapy for various kinds of cancer, despite recent efforts to close gaps in treatment, according to a study by researchers at Yale School of Medicine published in the January 7 online issue of the journal Cancer.
Prior research revealed racial disparities in cancer care in the early 1990s. Cary P. Gross, M.D., associate professor of medicine at Yale School of Medicine, and colleagues studied the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to evaluate whether greater attention and investment in access to care for all individuals have led to any reduction in cancer treatment disparities. They evaluated patients in the SEER database who had been diagnosed with breast, colorectal, lung or prostate cancer between 1992 and 2002.
After identifying therapies for which racial disparities had been previously reported, the investigators determined whether there had been any changes in care for the overall Medicare population or for white and black patients considered separately. The team evaluated 7,775 colon, 1,745 rectal, 11,207 lung, 40,457 breast and 82,238 prostate cancer cases.
The team found that throughout the study period, black patients were significantly less likely than white patients to receive therapy for cancers of the lung, breast, colon and prostate. For both black and white patients, there were little or no improvements in the proportion of patients receiving therapy for most cancers. There was also no decrease in the magnitude of racial disparities between 1992 and 2002. These racial disparities persisted even after limiting the analysis to patients who had access to a physician prior to their cancer diagnosis.
The findings suggest that there has been little improvement in the overall proportion of Medicare beneficiaries receiving cancer care. They also reveal that racial disparities have not lessened.
"Efforts to mitigate cancer care disparities between 1992 and 2002 appear to have been unsuccessful," said Gross, a member of Yale Cancer Center and co-Director of the Center's Office of Eliminating Cancer Disparities. "Future efforts to reduce cancer disparities should be incorporated into a larger framework that encompasses access to high-quality comprehensive care for all patients with cancer."
Other authors on the study included Elizabeth Wolf and Martin Andersen at Yale and Benjamin D. Smith, M.D., of Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, Texas.
Citation: Cancer Vol. 112, No. 4 (Published online January 7, 2008, Print issue date February 15, 2008)