Blacks are less likely than whites to receive lung cancer treatments
Research Activities, October 2009
When it comes to treating nonsmall cell lung cancer, a new study finds a significant gap in the treatment of blacks and whites. Compared with whites, blacks are less likely to receive surgery and chemotherapy. Researchers at the University of Texas in Houston analyzed 83,101 Medicare patients aged 65 and older, who were diagnosed with stages I to IV nonsmall cell lung cancer between 1991 and 2002. About 90 percent of patients were white and 10 percent were black. The researchers placed the patients into one of two groups: early disease (stages I and II) and late disease (stages III and IV). They then looked at who received surgery, chemotherapy, and radiation therapy.
In the early disease group, blacks were 37 percent less likely to receive surgery compared with whites. They were also 42 percent less likely to undergo chemotherapy for their cancer. This disparity was even greater for late disease patients. Blacks in this group were 57 percent less likely to receive chemotherapy compared with whites. Patient characteristics associated with greater treatment disparities included being older, female, and having a lower socioeconomic status.
The researchers offer several explanations for why such disparities still exist. Black patients are less likely to have their cancer appropriately staged and to be recommended for surgery. Even when surgery is indicated, blacks are more likely than whites to refuse it, possibly because the myth that tumors spread when exposed to air remains common in the black community. Other factors include blacks' limited access to health care, reluctance to seek medical attention, treatment at county hospitals, reliance on prayer and spirituality, and a fatalistic attitude toward cancer. The study was supported in part by the Agency for Healthcare Research and Quality (HS16743).
See "Racial disparities and treatment trends in a large cohort of elderly black and white patients with nonsmall cell lung cancer," by Dale Hardy, Ph.D., Chih-Chin Liu, M.S., Rui Xia, M.S., and others, in the May 15, 2009 issue of Cancer 115, pp. 2199-2211.