University of Michigan Researchers Find Cancer Significantly More Deadly for Black Americans
July 5, 2010 — Black Americans are twice as likely to die of cancer than other races in the United States, according to a study in the July 1, 2010, Journal of the American College of Surgeons.
"Black cancer patients don’t fare as well as whites," says study author Arden Morris, M.D., M.P.H., associate professor of surgery at the University of Michigan Medical School. "Their cancers are diagnosed at a later stage, the care they receive is often not as good or they get no care at all."
Dr. Morris added that black patients also tend to trust their physicians less and on average may be more unable to pay for cancer treatments, stated a press release from UMCCC.
Disparities in cancer treatment are greatest for cancers that require the most care. Five-year survival rates varied by 10 percent between blacks and whites with colorectal cancer and 25 percent among patients with uterine cancer.
The authors concluded that the disparities were attributable to three factors: demographics, low use of screening and less efficacious hospital systems. Black Americans are more likely to have comorbidities when their cancers are diagnosed and they are less likely to have physicians who encourage screenings. They also receive less chemotherapy and surgery following a diagnosis, according to the press release.
Morris et al recommended several policy changes, which included expanding public insurance systems to make cancer care more affordable and challenging the "pay-for-performance" programs that reward reaching benchmarks with financial bonuses or withhold funds when a hospital fails.
"Programs that reward better quality with more money need to take into account what that does to hospitals that already have far fewer resources," says Dr. Morris. "Perhaps pay-for-performance could take into account where a hospital is starting from and could be considered as 'pay-for-improvement'."
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