Researchers from the Dartmouth Medical School have reported that “African-American Medicare beneficiaries with lung, breast, colorectal, and prostate cancers had higher mortality compared with their Caucasian counterparts; however, there were no significant differences in mortality by race among those who attended NCI cancer centers.” The details of this study were published early online in Cancer on March 22, 2010.[1]

Many studies have shown that African Americans have a poorer survival than Caucasian patients following the diagnosis of cancer. It has been unclear as to whether these differences have a biological basis or are related to socioeconomic status or access to appropriate treatments.

The current study used data from Surveillance, Epidemiology, and End Results (SEER) data from 1998 to 2002 concerning outcomes of treatment of Medicare patients with lung, breast, colorectal or prostate cancer. They calculated the likelihood of survival at one and three years after diagnosis: 

• African Americans had a 13% increased risk of all-cause deaths and cancer-specific deaths at one year.
• Cancer-specific mortality was higher in African Americans at three years for all patients and specifically for those with colorectal cancer and breast cancer. 
• African Americans who attended an NCI-designated cancer center had a 37% reduced risk of death at one year and a 29% reduced risk of death at three years.
• African Americans treated at NCI designated cancer centers had the same risk of dying at one and three years as comparable Caucasian patients.

These authors concluded: “The results of this study suggested that place of service may explain some of the cancer mortality excess observed in African Americans.” 

Comments: These observations help explain why African Americans with cancer fare worse than their Caucasian counterparts.

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