Older black women with breast cancer do not receive beneficial chemotherapy as often as white women
Research Activities, April 2010, No. 356
Older women (65 to 69 years old) with operable breast cancer that has spread to one or more lymph nodes often benefit from receiving chemotherapy to battle their cancer, clinical trials show. However, black women in this age group do not receive chemotherapy as often as white women, a new study finds. Researchers at the University of Texas used data from Medicare, the U.S. Census, and the National Cancer Institute's Surveillance, Epidemiology, and End Results cancer registry. They identified 14,177 white women and 1,277 black women who were diagnosed with operable stage II or IIIA breast cancer with positive lymph nodes between 1991 and 2002.
For the 65-69 age group, 66 percent of white women received chemotherapy within 6 months of being diagnosed compared with 56 percent of black women. However, this racial disparity diminished with age. For instance, after age 74 there were no significant differences between the percentages of white and black women receiving chemotherapy, despite the lack of evidence or guidelines for providing chemotherapy for women 75 and older.
When researchers adjusted the results to include socioeconomic status for women aged 65 to 69, poverty appeared to be at the root of the racial differences in who received chemotherapy. In fact, racial differences in receipt of chemotherapy were mediated by census tract poverty rates. Despite being insured by Medicare, out-of-pocket costs and copayments may be burdensome for women without means, and women who live in poor areas may also have poor health, other health conditions, and employment difficulties. This study was funded in part by the Agency for Healthcare Research and Quality (HS16743).
See "Racial and socioeconomic disparities in adjuvant chemotherapy for older women with lymph node-positive, operable breast cancer," by Alessia Bhargava and Xianglin L. Du, M.D., Ph.D., in Cancer 115(13), pp. 2999-3008, 2009.