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Racial Gap in Breast Cancer Care

White Women Living Longer; Survival Rates Among Blacks Unchanged
By
WebMD Health News
Reviewed by Louise Chang, MD

Women Heart Attack Signs

June 5, 2007 (Chicago) -- The racial disparity in the treatment of women with breast cancer appears to be worsening, researchers report.

A two-decade study shows that while white women with advanced breast cancer are living longer than ever, survival rates among black women haven’t changed.

The result: a widening gap between the races, says researcher Sharon Giordano, MD, MPH, an assistant professor of breast medical oncology at the University of Texas M.D. Anderson Cancer Center in Houston.

In 2007, about 180,000 American women will be diagnosed with breast cancer, up to 10% of whom already have metastatic breast cancer that has spread to other parts of the body at the time of diagnosis.

In general, these women can expect to live only 18 to 24 months, she says.

Giordano says a previous study at M.D. Anderson showed that survival rates among women with metastatic breast cancer have improved over the past decade. The new study aimed to look more closely at trends and factors affecting survival in a larger group of women. The study was presented at the annual meeting of the American Society of Clinical Oncology.

Racial Gap in Breast Care Widens

The study included 15,438 women who were newly diagnosed with advanced breast cancer between 1988 and 2003. Information about their age, race, and other factors was obtained from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) database.

To look at trends in survival over time, the women were divided into three groups based on when they were diagnosed: 1988 to 1993, 1994 to 1998, and 1999 to 2003. Overall, the chance of surviving for at least one year increased from 62.9% in the first time period to 64.4% in the second time period and 66.6% in the third period, the analysis showed.

When looked at by race, however, the picture changed. In the 1988 to 1993 time period, 63.2% of white women and 60.4% of black women survived one year. In the second time period, one-year survival rates were 64.9% and 58.1%, respectively. In the last time period, 67.6% and 58.8% of white and black women survived one year, respectively.

“The absolute difference in one-year survival rates between black and white women increased across the three time periods, from a 2.8% to a 6.8% to an 8.8% difference,” Giordano says.

Health Insurance, Distrust May Play Role

Over the study period, the average time a woman lived from diagnosis also rose, from 20 to 21 to 25 months.

For white women, survival times improved from 20 months to 27 months over time. But among black women, survival times remained basically flat at 16 to 17 months.

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