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Does Race Affect Cancer Survival?

Breast Cancer Deaths Higher for Black Women Despite Equal Treatment
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Survival Poorer for Black Women With Breast Cancer

Black women are more likely than white women to have estrogen receptor (ER)-negative breast cancers, which are more deadly than ER-positive tumors.

But this biologic difference did not explain the survival advantage among white patients in either the Albain study or new research from the NCI.

Both studies appear in the July 15 issue of the Journal of the National Cancer Institute.     

NCI researchers analyzed outcomes for nearly 250,000 breast cancer patients diagnosed between 1990 and 2004.

Black women were significantly more likely than white women to die of their disease, especially in the years immediately following diagnosis, regardless of their estrogen-receptor status.

“We believe this is mostly due to poorer access to care, but you can’t rule out the possibility that biology plays a role,” lead researcher Idan Menashe, PhD, tells WebMD.

American Cancer Society chief medical officer Otis Brawley, MD, tells WebMD that the Albain study is not the first to suggest that poorer access does not completely explain the higher death rate among black patients for sex-related cancers.

Factors Influencing Cancer Survival

But he does not accept Albain’s assertion that there must be genetic or biologic differences between black and white cancer patients that affect cancer survival.

He points out that death rates from breast cancer were the same for black patients and white patients until about 1980.

“In the late 1970s, we started learning how to treat breast cancer,” he says. “Before this time, poverty and access to care would not have had a big impact on survival.”

This is also about the time when obesity began to be a problem in the United States, with the black population affected more than the white population.

In an editorial examining the two studies, Brawley writes that even biologically driven differences in survival between black and white cancer patients may still be influenced by factors such as culture and poverty.

He cites a 2001 study from Scotland that found that poor Scottish women were more likely to have more aggressive estrogen-receptor negative tumors than middle-class or upper-class Scottish women.

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