Unequal health care increases colorectal cancer mortality in blacks
Black patients die from colorectal cancer at much higher rates than whites do and new research points to unequal health care as the cause.
While deaths from colorectal cancer have declined over the past 40 years, the declines have been uneven, said lead author Samir Soneji, Ph.D., of the Robert Wood Johnson Health and Society Scholars Program at the University of Pennsylvania.
“Colorectal cancer is one of the few cancers that has had advances in detection, treatment and survival over the second half of the twentieth century,” Soneji said. “But despite these advancements, we observed ever-widening racial gaps in overall and stage-specific survival.”
The new study, appearing in the October issue of the American Journal of Public Health, looks at mortality rates from colorectal cancer according to U.S. Mortality Data Files between 1960 and 2005. Researchers also used Surveillance, Epidemiology and End Results (SEER) data to estimate stage-specific survival.
While white women had a 54-percent reduction in deaths during the 40-year span, black women saw only a 14-percent reduction. The most striking disparity, however, occurred with men ? with a 39 percent reduction in deaths for white men, but a 28 percent increase for black men.
Blacks also had worse rates of stage-specific survival and life expectancy than whites. For instance, in the 1970s, the life expectancy for a 60-year-old white man with localized colorectal cancer was 1.01 years greater than that for a black man the same age. However, by the 2000s, the gap between the two groups had widened to 2.7 years.
The researchers attributed the disparities to the differences in the quality of health care received by black patients. Blacks underwent less screening than whites and their cancer was detected at more advanced stages.
“What is needed is funding for targeted programs for black men and other minorities who experience these disparities that have interventions to increase access to screening tests such as the stool blood test and colonoscopy, which have been known to help prevent colorectal cancer as well as detect it early,” said Clement Gwede, Ph.D., assistant director of diversity at the Moffitt Cancer Center in Tampa, Fla.