ABSTRACT: Racial and Ethnic Disparities in the Receipt of Cancer
A disproportionate number of cancer deaths occur among racial/ethnic
minorities, particularly African Americans, who have a 33% higher
risk of dying of cancer than whites.
Although differences in
incidence and stage of disease at diagnosis may contribute to
racial disparities in mortality, evidence of racial disparities
in the receipt of treatment of other chronic diseases raises
questions about the possible role of inequities in the receipt
of cancer treatment.
To evaluate racial/ethnic disparities in
the receipt of cancer treatment, we examined the published literature
that addressed access/use of specific cancer treatment procedures,
trends in patterns of use, or survival studies. We found evidence
of racial disparities in receipt of definitive primary therapy,
conservative therapy, and adjuvant therapy. These treatment differences
could not be completely explained by racial/ethnic variation
in clinically relevant factors.
In many studies, these treatment
differences were associated with an adverse impact on the health
outcomes of racial/ethnic minorities, including more frequent
recurrence, shorter disease-free survival, and higher mortality.
Reducing the influence of nonclinical factors on the receipt
of cancer treatment may, therefore, provide an important means
of reducing racial/ethnic disparities in health.
New data resources
and improved study methodology are needed to better identify
and quantify the full spectrum of nonclinical factors that contribute
to the higher cancer mortality among racial/ethnic minorities
and to develop strategies to facilitate receipt of appropriate
cancer care for all patients.
[30/06/0020; Journal of the National Cancer Institute]
Cancer J, 9/02
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