Black Rectal Cancer Patients Less Likely to Receive Recommended Treatment

Despite being referred to specialists at the same rate as whites, African Americans with rectal cancer receive chemotherapy and radiation treatment after surgery less often.

Studying SEER (Surveillance, Epidemiology, and End Results) and Medicare data from 1992 through 1999, researchers found no significant difference in the percentage of patients who were referred to either medical or radiation oncologists.  There were fewer referred to both specialists — 49 percent of blacks saw both a radiation and medical oncologist compared to 59 percent of whites.

However, once referred:

• 54.1 percent of blacks received chemotherapy compared to 70.2 of white patients
• 73.7 percent received radiation treatment compared to 83.4 percent of whites
• 60.6 received combination chemoradiation compared to 76.9 percent of whites.

There seemed to be no connection between either patient or provider characteristics that explains the disparities.  Patient age at diagnosis, sex, marital status, median income, education, other medical conditions, or cancer stage were studied without finding reasons for why African American patients didn’t receive recommended treatments after rectal cancer surgery.

Arden M. Morris, MD, from the Department of Surgery at the University of Michigan wrote:

Racial differences in oncologist consultation rates do not explain disparities in the use of adjuvant treatment for rectal cancer. A better understanding of patient preferences, patient–provider interactions, and potential influences on provider decision making is necessary to develop strategies to increase the use of adjuvant treatment for rectal cancer among black patients.

SOURCE: Morris et al, Journal of the National Cancer Institute, advanced access published online May 13, 2008.