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Study: Despite efforts, racial disparities in cancer care continue
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 the 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.
Dr. Cary P. Gross, associate professor of medicine at the 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 since 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,” says Gross, a member of the 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 Dr. Benjamin D. Smith of Wilford Hall Medical Center, Lackland Air Force
Base, San Antonio, Texas.
— By Karen Peart
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