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Poorer Patients Have Poorer Survival After Cancer Diagnosis

Less affluent individuals had more advanced disease and were less likely to receive needed treatment

MONDAY, June 23 (HealthDay News) -- Low socioeconomic status increases a cancer patient's risk of dying, say U.S. researchers who analyzed data on almost 14,000 breast, prostate and colorectal patients in seven states.

The study found that cancer patients with low socioeconomic status had more advanced cancers at time of diagnosis, received less aggressive treatment, and had a higher risk of dying within five years of diagnosis.

For example:

  • Poorer women were less likely to receive radiation treatment after a lumpectomy or to receive anti-estrogen therapy when diagnosed with an estrogen receptor-positive (ER+) tumor.
  • Prostate cancer patients who lived in less affluent areas were less likely to have a prostatectomy or receive radiation treatment than men who lived in areas of high socioeconomic status.
  • Colorectal cancer patients of low socioeconomic status were less likely to receive chemotherapy.

While blacks and Hispanic patients were more likely than whites to live in poorer areas, but the link between increased risk of cancer death and low socioeconomic status applied to all racial and ethnic groups.

However, this was not true for patients 65 and older, perhaps because they have more universal access to cancer screening and treatment via Medicare, regardless of socioeconomic status, the researchers said.

"These findings support the need to focus on socioeconomic status as an important underlying factor in cancer disparities by race and ethnicity," wrote Dr. Tim Byers, of the University of Colorado Denver, and colleagues.

"We need better information on how access to health care contributes to differences in cancer outcomes by socioeconomic status in order to address the root causes of racial and ethnic cancer disparities in the United States," they added.

The study is published in the Aug. 1 issue of the journal Cancer.

Another study in the same issue found that initiatives designed to increase awareness and use of breast cancer screening may improve breast cancer survival rates for black American women, who have a higher risk of death from the disease than white women.

Researchers in Atlanta looked at the impact on black women of a program that included public education about the importance of mammography screening, breast self-exams, and seeing a trained health care provider. The program also included breast cancer survivors who supported newly-diagnosed breast cancer patients by encouraging them to follow-up with recommended medical care and helping them access financial, transportation and support services.

Between 2001 and 2004, the program conducted 1,148 community interventions for more than 10,000 participants. During that time, a total of 487 women were diagnosed and treated for breast cancer (89 percent black, 5 percent white, 2 percent Hispanic, and 4 percent other race/ethnicity) at the AVON Comprehensive Breast Center at the Georgia Cancer Center for Excellence at Grady Memorial Hospital in Atlanta.

Over the study period, the proportion of Stage 0 (early) non-invasive breast cancers increased from 12.4 percent to 25.8 percent, and the proportion of Stage IV (late) invasive breast cancers decreased from 16.8 percent to 9.4 percent.

More information

The U.S. Centers for Disease Control and Prevention has more about eliminating disparities in cancer screening and management.

-- Robert Preidt

SOURCE: Cancer, news release, June 23, 2008

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