Black Americans Less Likely to Survive Some Cancers - Why?
Dr. Kathy Albain and colleagues wanted to know why black Americans are less likely to survive some cancers. The researchers followed patients enrolled in cancer clinical trials conducted by the Southwest Oncology Group, a National Cancer Institute-funded clinical trials national cooperative. By limiting it to this group, the researchers made sure all 19,457 patients enrolled received the same treatments by the same doctors regardless of race.
The researchers followed the patients enrolled in 35 Southwest Oncology Group clinical trials at least 10 years after treatment. Twelve percent of the patients were African American.
The researchers found that African Americans did not have a survival gap for all cancers, but do for breast, prostate and ovarian cancers. Poverty and inferior healthcare were not issues in this study so did not play a role in the survival gap.
The study published in the Journal of the National Cancer Institute found no statistically significant association between race and survival for lung and colon cancers, leukemia, lymphoma or myeloma.
It was found that Black Americans were 49% more likely than other races to die from early-stage, postmenopausal breast cancer. Black Americans were 41% more likely to die from early stage, premenopausal breast cancer. Black Americans with advanced-stage ovarian cancer were 61% more likely to die. Those with advanced-stage prostate cancer were 21% more likely to die.
The researchers point out that the cancers (breast, prostate, and ovarian) which did show survival gaps are gender-related cancers. Albain and colleagues feel these findings suggest a complex interaction of biologic factors in the tumor and inherited variations in common genes that control metabolism of drugs and hormones.
"We are actively conducting new research based on these findings to explore interactions among tumor biology, treatment, sex, race, inherited genes and survival," Albain said.
Albain et al. Racial Disparities in Cancer Survival Among Randomized Clinical Trials of the Southwest Oncology Group. J Natl Cancer Inst, 2009, 101: 984-992
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