Navigation Links
New Clues to Race Gap in Breast Cancer Outcomes
Date:7/7/2009

Studies shed light on why black women more likely to die, but questions remain

TUESDAY, July 7 (HealthDay News) -- The racial gap in breast cancer outcomes, with black women more likely to die from the disease, can't be explained completely by any one factor, new research shows.

For a quarter of a century, researchers have been aware of the so-called race gap in certain cancers. The racial disparity "first emerged about 25 years ago," said Idan Menashe, a postdoctoral fellow at the U.S. National Cancer Institute, who led one of two studies on the topic, both published in the July 15 issue of the Journal of the National Cancer Institute.

Since the mid-1980s, he said, the gap has been widening. "Today is the largest gap we have experienced," he noted.

The two new studies focus on why that may be so, and come to different conclusions. In the first, Menashe and his colleagues compared breast cancer rates for more than 244,000 black and white women, using data from the National Cancer Institute's Surveillance, Epidemiology and End Result (SEER) program.

They looked at the ratios between black and white women when it came to the incidence, mortality and hazard rate -- roughly defined as the probability of dying -- and looked at the tumor's estrogen-receptor status.

Estrogen receptor-negative tumors, or ER-negative, are known to be more aggressive than estrogen receptor-positive tumors, with some experts believing this explained the gap. "What we have shown is, this is not the case," Menashe said.

"We asked what would have happened if black women had the same ER-negative proportion as white women, and we found the mortality disparity would be reduced by only 10 to 20 percent if the proportion of ER-negative tumors were the same in each group," he said.

"We asked what would happen if we equalized the likelihood of dying from the disease. We ruled out that the proportion of ER-negative tumors explains the gap," he said.

They did find that early deaths are driving the disparity between outcomes for white and black women. And, they found that the deaths tend to occur soon after the diagnosis. "Most deaths occur in the two or three years after the diagnosis," he said.

So what drives the disparity?

"We think it's mostly access to care [with black women having less access], but we cannot rule out that the biological differences also contribute to the disparity," Menashe said.

In the second study, Dr. Kathy Albain of Loyola University's Cardinal Bernardin Cancer Center in Maywood, Ill., and her colleagues evaluated nearly 20,000 adult cancer patients with a variety of cancers who were in clinical trials from late 1974 through late 2001, all receiving identical treatments and access to care.

Black patients with breast cancer and other gender-specific cancers had worse survival than white patients, despite identical treatment and follow-up, they noted.

The patients were followed for at least 10 years after treatment. During that time, blacks were 21 percent to 61 percent more likely to die from gender-specific cancers than white patients.

Those findings, the researchers say, cast doubt on the theory that the lower survival rates for certain cancers are due solely to factors such as poverty and poor access to quality health care.

Dr. Mitchell Wong, an associate professor of medicine at the University of California Los Angeles David Geffen School of Medicine, published a study earlier this year on racial differences in cancer death rates.

"These two articles both suggest that something else is going on [in addition to cancer stage, tumor characteristics or treatment] that leads black patients to have a worse prognosis. We can only guess, but it may be due to differences in tumor biology that science does not yet understand. Then the question is: why do blacks have breast cancer with worse prognosis? It's still speculation, but the second article suggests it may be environmental effects. We cannot rule out genetics either."

In an editorial accompanying the studies, Dr. Otis W. Brawley, of the American Cancer Society, took this view: "Taken together, the two studies and others do not suggest that blacks have a different kind of breast cancer, but rather that there are multiple kinds of breast cancer and a higher proportion of black patients with breast cancer have the worst kind."

Both biological differences and access to care could account for the gap, in Menashe's view. The take-home point for breast cancer patients, he said, given the finding that deaths occur soon after diagnosis, is: "Once diagnosed, they should get treatment ASAP.''

More information

To learn more about the racial gap in breast cancer, visit the American Cancer Society.



SOURCES: Mitchell Wong, M.D., Ph.D., associate professor, medicine, David Geffen School of Medicine, University of California, Los Angeles; Idan Menashe, Ph.D., postdoctoral fellow, National Cancer Institute, Bethesda, Md.; July 7, 2009, Journal of the National Cancer Institute, online


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Research Reveals Clues to Breast Cancers Spread
2. Clues to Alzheimers Spotted Earlier in Disease
3. Clues to Muscular Dystrophy Seen in Womb
4. Study gives clues to how adrenal cancer forms
5. Gene Gives Clues to Why Autism More Common in Boys
6. Singing brains offers epilepsy and schizophrenia clues
7. Genes Yield Clues to High Blood Pressure
8. Young Womens Breast Tissue Offers Clues to Cancer Risk
9. Potential lung disease biomarkers yield clues to COX-2 inhibitor side effects
10. Zebrafish offer clues to treatments for motor neurone disease
11. Cat Food-Linked Illness Yields Clues to MS
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
New Clues to Race Gap in Breast Cancer Outcomes
(Date:5/24/2016)... ... ... The Dream Builders Project, a 501(c)3 nonprofit organization based in Los Angeles, ... Mexico on Saturday, May 21st. The volunteers took the children out for the day ... 15 volunteers traveled from Los Angeles to Tijuana, Mexico for the day in the ...
(Date:5/24/2016)... ... 2016 , ... Global Lyme Alliance (GLA), a leading nonprofit ... has named Scott Santarella as its new CEO. , Santarella is former ... San Francisco, where he successfully helped to grow the organization from a regional ...
(Date:5/24/2016)... ... ... PhysicianOne Urgent Care, advocators in helping their patients lead the healthiest lives possible, updates ... spring. , The official tick season kicks off in May across the states ... themselves to their prey while they feed off their blood. Like other similar biting ...
(Date:5/24/2016)... ... May 24, 2016 , ... Applications ... multiplex immunoassays are widely used for cell and protein analysis. Keeping updated on ... quality and efficiency in these areas. , LabRoots introduces a new complementary ...
(Date:5/23/2016)... ... May 23, 2016 , ... On the occasion of his 25th Anniversary of ... weight loss process: , New patients have a consultation and evaluation (done by Dr. ... evaluated. , Body Composition Analysis, There are 15 things that each patient gets checked ...
Breaking Medicine News(10 mins):
(Date:5/19/2016)... Oregon , May 19, 2016 ... titled, World Medical/Diagnostic Imaging Market -Opportunities and Forecasts, 2015 ... reach $45.0 billion by 2022, registering a CAGR of ... expected to continue to be the highest revenue-generating segment ... accounted for around one-third of the market share ...
(Date:5/19/2016)... -- The equities market is never short of ... is without doubt the Healthcare space. ActiveWallSt.com has uncovered four ... Alkermes PLC (NASDAQ: ALKS ), AMAG Pharmaceuticals Inc. ... IDXX ), and Atossa Genetics Inc. (NASDAQ: ... http://www.activewallst.com/ On Wednesday, Alkermes PLC,s ...
(Date:5/19/2016)... 2016 MGB Biopharma, a ... Anti-infectives, Welcomes the Final Instalment of Lord Jim ...   Lord Jim O,Neill,s ... recommendations, providing a comprehensive action plan for the ... rising threat of superbugs - something that could ...
Breaking Medicine Technology: