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Disparities in
Cancer Care reflect Hospital Resources
Newswise — Hospitals that treat more black
cancer patients have worse survival rates on
average for patients with breast and colon
cancer, regardless of race, according to a
new study from the University of Michigan
Comprehensive Cancer Center.
The research helps explain why
African-Americans with breast or colon
cancer are less likely than white patients
to survive the disease.
“This work highlights the importance of how
where a patient receives treatment for
cancer affects survival after cancer
surgery.
"An
important next step will be to determine
which system factors are amenable to
interventions aimed at improving the quality
of cancer care,” says study author Tara M.
Breslin, M.D., assistant professor of
surgery at the U-M Medical School.
The study used five year survival data from
the Surveillance Epidemiology and End
Results–Medicare-linked database, a federal
collection of cancer incidence, survival,
and prevalence.
The researchers analyzed data from 25,571
breast cancer patients, 9.7 percent of whom
were black, and 22,168 colon cancer
patients, 11.8 percent of whom were black.
The patients were treated in 436 hospitals.
The study appears in the Aug. 20 issue of
the Journal of Clinical Oncology.
Survival rates were lower for black patients
than for white patients with both breast and
colon cancer.
But hospitals where more than half the
patients were black had an increased risk of
dying after five years for both black and
white patients, compared to hospitals where
fewer than 10 percent of patients were
black.
All breast cancer patients treated at
predominantly black hospitals had a 32
percent increased risk of death after five
years, compared with those treated at
hospitals that see few black patients.
Similarly, colon cancer patients had a 27
percent higher risk of dying at five years.
The researchers also examined patient
factors, such as age, cancer stage, other
medical conditions and socioeconomic status.
They
found that after accounting for these
factors, black patients still had higher
mortality rates.
“Efforts aimed at increasing early detection
through screening and decreasing incidence
with preventative services are essential for
decreasing racial disparities in mortality,
but where a patient receives care after a
cancer diagnosis may be equally important,”
says senior study author Arden M. Morris,
M.D., M.P.H., assistant professor of surgery
at the U-M Medical School and chief of
general surgery at the VA Ann Arbor
Healthcare System.
The study did not identify what specific
hospital factors were at play, but the
researchers plan further analyses to
determine which hospital systems and aspects
of standard therapy are poorly delivered or
absent in hospitals serving a high
percentage of minority patients.
Cancer statistics: 194,280 Americans will be
diagnosed with breast cancer this year, and
106,100 will be diagnosed with colon cancer,
according to the American Cancer Society.
Additional authors: Niya Gu, Sandra L. Wong,
Emily V. Finlayson, Mousumi Banerjee and
John D. Birkmeyer, all from U-M
Funding: National Cancer Institute
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