Lower survival rates of blacks with lung cancer may be explained by access to care

New research suggests that the lower survival rates of blacks with lung cancer may be explained by access to care. The study, by Wake Forest University Baptist Medical Center researchers and colleagues is reported in the January issue of the Journal of Clinical Oncology.

"The results were intriguing," said principal investigator A. William Blackstock, M.D., "When offered equivalent therapy, the outcome for black patients was the same as that of non-blacks."

Historically, studies have shown that, across all stages of the disease, survival for black patients lags behind that of non-blacks. A number of potential explanations have been proposed, including later stage at diagnosis, differences in treatment, and differences in the biologic aggressiveness of the disease.

Among the most controversial of these issues is whether race is an independent factor in survival.

Researchers evaluated, retrospectively, data from 995 patients with advanced small cell lung cancer who participated in one of four Cancer and Leukemia Group B (CALGB) studies. The patients were treated between 1990 and 2002 at 41 centers.

"From our analysis, we concluded that equal treatment in patients with advanced lung cancer yields equal outcome among patients with the same stage of disease regardless of race or ethnicity," said Blackstock. "Although other factors may be important, perhaps the most relevant is access to standard cancer care."

Differences in access to care, the quality of care received, and the impact of other health risks may explain the lower survival among African Americans. Continued efforts are needed to encourage disease awareness, promote early detection, implement prompt and appropriate treatment and increase minority participation in clinical trials, the researchers said.

Lung cancer remains the leading cause of cancer death in the United States. Approximately 172,000 Americans were diagnosed with lung cancer in 2005 and 20 percent of those had small-cell lung cancer. Although the incidence of advanced-stage lung cancer has increased in most racial/ethnic groups, the rate of increase has been greatest for African American patients.

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