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African-Americans Fare Worse With Some Cancers
Reported July 13, 2009
(Ivanhoe Newswire) — An analysis of almost 20,000 patient records
from the Southwest Oncology Group's database of clinical trials finds that
African-American breast, ovarian, and prostate cancer patients tend to die
earlier than patients of other races, even when they get identical medical
treatment and other socioeconomic factors are controlled. The finding points
to biological or genetic factors as the potential source of the survival
gap.
The study also found that when treatment was uniform and differences in
tumor prognostic factors, demographics, and socioeconomic status were
controlled, there was no significant difference in survival based on race
for a number of other cancers -- lung, colon, lymphoma, leukemia, and
multiple myeloma
"When you look at the dialogue about the issue of race and cancer survival
that's gone on over the years," the paper's lead author, Kathy Albain, M.D.,
a breast and lung cancer specialist at Loyola University's Cardinal
Bernardin Cancer Center is quoted as saying, "it always seems to come down
to general conclusions that African-Americans may in part have poorer access
to quality treatment, may be diagnosed in later stages, and may not have the
same standard of care delivered as Caucasian patients, leading to a
disparity in survival."
"The good news is that for most common cancers," Albain says, "if you get
good treatment, your survival is the same regardless of race. But this is
not the case for breast, ovarian, and prostate cancers."
The urgency of addressing the reasons for racial disparities in outcomes –
both sociological and biological – is amplified by another recent study in
the Journal of Clinical Oncology, which predicts the cancer incidence among
minorities will nearly double in the coming decades, increasing 99 percent
by 2030, compared to an expected 31 percent increase among whites.
This study analyzed records from 35 clinical trials – going back as far as
1974 – that had been conducted by the Southwest Oncology Group, an
NCI-sponsored cooperative group headquartered at the University of Michigan.
Using data from clinical trials, which are already controlled for a range of
potentially confounding factors, helps throw the remaining factors into
sharper relief, according to Frank L. Meyskens, Jr., M.D.
"It's because of the similar way that people are treated on clinical trials
that these differences are even detectable," Meyskens, who is associate
chair for Cancer Control and Prevention for the Southwest Oncology Group and
director of the University of California-Irvine's Chao Family Comprehensive
Cancer Center is quoted as saying.
"The elimination of socioeconomic and healthcare access disparities must be
a priority in the United States," says Lisa Newman, M.D., director of the
Breast Care Center at the University of Michigan Comprehensive Cancer
Center. "However, Dr. Albain's landmark study demonstrates that further
investigation of race- or ethnicity-associated differences in primary tumor
biology is also important."
SOURCE: Journal of the National Cancer Institute (JNCI), July 7, 2009 |
