Death rates for certain cancers remain higher for African Americans
(18 July 2009: VIDYYA MEDICAL NEWS SERVICE) -- Although breast cancer death rates in the United States have declined substantially during the last 15 years, the trend has been less favorable for African American women, according to a study published online July 7 in the Journal of the National Cancer Institute (JNCI).
Using SEER data, Dr. Idan Menashe and his colleagues from NCI’s Division of Cancer Epidemiology and Genetics (DCEG) calculated ratios of mortality, incidence, hazard of death, and incidence-based mortality for nearly 250,000 women diagnosed with breast cancer from January 1990 through December 2003. They found a statistically significant higher hazard of death in African American women diagnosed with breast cancer compared with Caucasian women, especially during the first few years after breast cancer diagnosis. These results suggest that the widening black-to-white disparity in breast cancer mortality rates in the United States is largely driven by the consistently higher hazard of death among African American women, irrespective of tumor estrogen-receptor (ER) expression at diagnosis.
The authors noted that various biological and non-biological factors could have caused the differential hazard rate patterns among African Americans and Caucasians within each ER category, including response to innovations in breast cancer treatment and access to these treatments. “Hence, greater emphasis should be placed on identifying the reasons for these increased hazards among black women, especially during the initial years following diagnosis, and on developing new therapeutic approaches to address the disparity,” they wrote.
In a second study in JNCI, Dr. Kathy Albain of Loyola University Medical Center and her colleagues analyzed records from more than 19,000 patients who participated in phase III cancer clinical trials conducted by the Southwest Oncology Group. Their analysis showed that even when African American patients received the same cancer treatment as all other patients, their overall survival rates were lower following treatment for breast, prostate, and ovarian cancers, but were equivalent after treatment for all other major cancers.
These two articles “help bring some focus to [racial disparities in cancer incidence and mortality] and help better define the questions that should be asked,” wrote American Cancer Society Chief Medical Officer Dr. Otis Brawley in an accompanying editorial. “It is only through clearly defining the problem that we can most appropriately address it and develop the interventions that may overcome these disparities.”
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