A disproportionate number of cancers in the United States occur among racial and ethnic minorities. When compared with whites, Hispanics have a higher incidence of cervical cancer, Asians have twice the rate of stomach cancer, and African Americans have a higher incidence of prostate, lung, colon, oral, cervical, and stomach cancer.
Increased access to cancer screening services and earlier detection may improve cancer outcomes among minorities; however, differences in cancer survival and mortality between minorities and whites still exist. "This observation suggests that factors other than the stage at diagnosis contribute to the disparate cancer mortality observed among racial/ethnic minority populations," the authors say.
Past studies have suggested that a person's race or ethnicity influences their access and use of noncancer medical services. To determine the role race and ethnicity plays in the receipt of cancer treatments, Shavers and Brown re-examined published data from 87 studies of cancer treatment and survival, focusing on racial and ethnic variations in the treatment of patients with breast, cervical, colorectal, prostate, or lung cancer.
The authors found consistent racial and ethnic differences in the receipt of primary therapy, conservative therapy, and adjuvant therapy. For instance, white patients often received more aggressive therapy than other racial and ethnic groups for lung, prostate, and colorectal cancers. In contrast, whites received less aggressive therapy-such as breast-conserving therapy-when the benefits of that therapy were well established. Racial and ethnic minorities were consistently found to have less frequently received appropriate surgery for lung and colorectal cancers.
Past studies of equal access systems have suggested that equal treatment of a disease leads to similar outcomes between minorities and whites regardless of socioeconomic factors. The authors conclude that, "reducing the influence of non-clinical factors on the receipt of cancer treatment may provide an important means of reducing racial/ethnic disparities in health."
They note, however, that additional studies are needed to determine the influence of access to care, socioeconomic status, and clinical staging, as well as beliefs and attitudes of patients and providers and their influence on racial/ethnic disparities in cancer treatment.
Contact: NCI Press Office, (301) 496-6641
Shavers VL, Brown ML. Racial and Ethnic Disparities in the Receipt of Cancer Treatment. J Natl Cancer Inst 2002;94:334-57.
Attribution to the Journal of the National Cancer Institute is requested in all news coverage.
Journal
JNCI Journal of the National Cancer Institute