Poor Breast Cancer Survival in Blacks May Not Be Due to Race

Underinsured black breast cancer patients have worse survival outcomes than underinsured white patients, a new U.S. study has found.

Researchers analyzed the records of 574 breast cancer patients treated at Wishard Memorial Hospital in Indianapolis between Jan. 1, 1997 and Feb. 28, 2006, and found that 84 percent of these patients were underinsured.

The study authors noted that black patients had more advanced breast cancer at diagnosis and poorer cancer-specific survival outcomes than whites. But after adjusting for age, cancer stage and other factors, they found that race was no longer significantly associated with breast cancer-related death.

In addition, contrary to previous study findings, black women were as likely as white women to opt for breast-conserving procedures and "adjuvant" therapy, which is therapy given after the completion of the initial treatment -- such as chemotherapy, radiation or hormone therapy -- to lower the risk of cancer recurrence.

"Despite the similar surgical care and adjuvant therapy, African American women in this study had lower overall and breast cancer-specific survival compared with non-Hispanic white women. After adjustment for competing causes of death, the survival disparity between African American and non-Hispanic white women appears to be attributable in part to differences in clinical and socio-demographic factors between the groups," Dr. Ian K. Komenaka of Wishard Memorial Hospital and colleagues concluded in their report, published online June 23 in the Journal of the National Cancer Institute.

Socio-demographic factors include variables such as income, education level and access to health care, they explained.

"The point of the study is that many factors are important: surgery, adjuvant therapy, biologic and clinical factors, and socio-demographic variables," Komenaka said in a news release from the journal's publisher.