THURSDAY, July 1 (HealthDay News) -- Black cancer patients in
the United States are up to two times more likely to die
prematurely from their disease than patients of other races -- a
disparity linked to factors that include patients, doctors and
hospitals, a new review from the University of Michigan shows.
Racial disparities exist for nearly all types of common cancers,
but are largest for cancers that benefit most from treatment. This
suggests that blacks are less likely to receive lifesaving
treatments, according to researchers at the University of Michigan
(U-M) Comprehensive Cancer Center.
They noted that five-year survival rates varied by 10 percent
between blacks and whites with colorectal cancer and by 25 percent
among patients with uterine cancer. Both types of cancers can be
cured with surgery and medical treatments, but tend to be fatal if
patients don't receive these treatments.
The researchers said three factors appear to play a role in
these disparities: black patients are often diagnosed with more
advanced cancer and are more likely to have other underlying health
problems; black patients are less likely to be advised about cancer
screenings and less likely to receive surgery or chemotherapy; and
hospitals that mostly treat black patients tend to have fewer
resources and offer lower quality care.
"Black cancer patients don't fare as well as whites. Their cancers are diagnosed at a later stage, the care they receive is often not as good -- or they get no care at all. Black patients may trust their doctors less, they may be unable to pay and the hospitals that serve more black patients tend to have fewer resources," study author Dr. Arden Morris, an associate professor of surgery at the U-M Medical School and chief of general surgery at the VA Ann Arbor Healthcare System, said in a U-M news release.
"This is a complex problem and it won't be easy to solve," she added.
Morris and colleagues recommended a number of policy changes,
including expansion of public insurance systems to make cancer care
more affordable for patients and changes to pay-for-performance
programs for hospitals that meet certain standards.
"Programs that reward better quality with more money need to take into account what that does to hospitals that already have far fewer resources. Perhaps pay-for-performance could take into account where a hospital is starting from and could be considered as pay-for-improvement," Morris said.
The study appears in the July issue of the
Journal of the American College of Surgeons.
The U.S. National Cancer Institute has more about
cancer health disparities