Patients who received recommended care did better, regardless of race, study found
MONDAY, Jan. 19 (HealthDay News) -- Survival disparities between white and black patients with early-stage lung cancer disappear when black patients receive optimal therapy, according to a U.S. study that included nearly 18,000 patients.
Surgery to remove a portion of the lung (pulmonary resection) provides the best chance of a cure for patients with early-stage lung cancer.
"Black patients with early-stage lung cancer have lower five-year survival rates than white patients, and this difference in outcome has been attributed to lower rates of resection among black patients," wrote Dr. Farhood Farjah, of the University of Washington, Seattle, and colleagues. "Several potential factors underlying racial differences in the receipt of surgical therapy include differences in pulmonary function, access to care, refusal of surgery, beliefs about tumor spread on air exposure at the time of operation and the possibility of cure without surgery, distrust of the health care system and physicians, suboptimal patterns of patient and physician communication and health care system and provider biases."
Access to care is often considered the most important of the factors that affect racial disparities among lung cancer patients.
The study looked at nearly 18,000 patients (89 percent white and 6 percent black) who were diagnosed with lung cancer between 1992 and 2002 and recommended for pulmonary resection.
The researchers found that 69 percent of black patients had surgery, compared with 83 percent of white patients. Five-year survival rates were similar among both black and white patients who had surgery.
"Although these findings do not refute the likely roles of health care system and provider biases and patient characteristics as important causal factors underlying health disparities, the findings do suggest that other factors (i.e., distrust, perceptions and beliefs about lung cancer and its treatment and limited access to subspecialty care) may have a more dominant role in causing disparities than previously recognized," the study authors wrote.
"The implication of these findings is that interventions designed to narrow gaps in health care should target structured aspects of care, providers and patients and communities at risk for lung cancer and suboptimal care," the team added.
The researchers suggested that referral of all patients with potentially curable lung cancer for consideration of lung resection may help reduce racial disparities in survival.
The study was published in the January issue of the journal Archives of Surgery.
The U.S. National Cancer Institute has more about lung cancer.
-- Robert Preidt
SOURCE: JAMA/Archives journals, news release, Jan. 19, 2009
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