Breast Cancer Survival Disparities Between Blacks and Whites Still Prevalent
Researchers have found from previous studies that African American women tend to have lower survival rates once they are diagnosed with breast cancer in comparison to white women. The disparity between the two races has long been attributed to the fact that African American women tend to seek treatment a lot later when their cancer has already progressed significantly. Although researchers have known for years that access to health care differs greatly between races, now, in a new study, researchers aimed to identify more factors that could be responsible.
The researchers from the University of Pennsylvania evaluated the data of Medicare patients who were monitored through the Surveillance, Epidemiology and End Results. From this database, the researchers had access to 107,273 breast cancer cases with 7,375 of them being black women. The researchers were able to compare factors such as treatment differences and tumor characteristics.
The team discovered that overall, white women had a three year longer survival rate from breast cancer in comparison to black women. In the study, around 70 percent of white female patients lived at least five years post initial diagnosis. For black women, the percentage was only at 56. The researchers found that not only were cases of breast cancer more aggressive in black women, black women were also less likely to be diagnosed at an earlier stage. Being diagnosed with cancer later on makes it more difficult to treat.
"Something is wrong," Dr. Jeffrey H. Silber, a professor at the University and the director of the Center for Outcomes Research at the Children's Hospital of Philadelphia, PA. "These are huge differences. We are getting there too late. That's why we are seeing these differences in survival."
The researchers also found that black women received lower-quality medical treatment for their cancer after diagnosis. The team calculated that 12.6 percent of black cancer patients did not have any evidence of being treated in comparison to 5.9 percent of white patients who were not treated. Between patients who were treated for similar tumors, 5.8 percent of black women were not treated until after three months whereas 2.5 percent of white women were not treated after the same amount of time had elapsed.
The researchers found that the introduction of new drugs, treatments and screening tools did not help close this gap. However, the researchers believe that if black women were diagnosed earlier, they could extend their lifespan by two years. In order to be diagnosed earlier, black women would need to be more willing to seek out medical care. Based from the data, the researchers found that only 23.5 percent of black women were screened six to 18 months before diagnosis. The rate for white women was 35. 7 percent. Furthermore, black women were generally less healthy than white women at the time of diagnosis, which could affect the severity of the cancer.
"These patients have insurance," Silber stated. "We need to improve screening for these women and improve their relationships with a primary care provider."
The findings were published in the Journal of American Medical Association (JAMA).