Cancer Survival Worse in African Americans

Article excerpt

ORLANDO, FLA. -- African Americans with breast or prostate cancer had significantly worse survival rates than patients of other races in several of the major phase III-treatment trials done in the United States.

"The difference in survival persists after adjustment for tumor status, demographics, socioeconomic status, and treatment, Dr. Kathy S. Albain said at the annual meeting of the American Association for Cancer Research.

"We must explore other possible explanations, such as molecular biologic, molecular epidemiologic, pharmacologic, and hormonal causes," said Dr. Albain, who is professor of medicine and director of the breast research program at the Cardinal Bernardin Cancer Center, Loyola University Chicago Medical Center, Maywood, Ill.

Documentation for this racial disparity comes from recent analyses of data collected from trials done during the 1970s-1990s. This included two studies done by the Southwest Oncology Group that involved patients with advanced stage D2 prostate cancer and no prior systemic therapy. Of the 1,843 patients in these two studies, 393 were African American.

In an analysis of survival that adjusted for potential confounders such as age, disease extent, performance status, bone pain, and serum level of prostate-specific antigen, African Americans had a statistically significant 21% higher mortality, compared with all other patients. The significance of this difference persisted after adjustment for income and education level.

Evidence for survival disparities among patients with breast cancer came from data collected by two study groups. The National Surgical Adjuvant Breast and Bowel Project enrolled more than 8,000 women with node-negative cancer and more than 5,000 women with nodepositive cancer.

In an analysis that adjusted for age, treatment, and tumor size, African Americans had about a 20% worse survival rate compared with all other patients, regardless of node status, Dr. …