February 18, 2008

More Findings on Healthcare Disparities

Several recently published studies have noted that racial disparities persist in healthcare, and have specifically looked at the divide in cancer diagnosis and care.

As noted in today’s New York Times, a study is being published in the journal Lancet Oncology that reportedly finds that “the uninsured and those covered by Medicaid are more likely than those with private insurance to receive a diagnosis of cancer in late stages, often diminishing their chances of survival,” and that “blacks had a higher risk of late diagnosis, even after accounting for their disproportionately high rates of being uninsured and underinsured.” This study is not yet available to me via my subscription, but may be worth a read.

Another study published in the journal Cancer examines racial disparities in cancer therapy, attempting to determine whether racial gaps in care have narrowed from 1992 to 2002 in elderly adults with colorectal, breast, lung, or prostate cancer. The authors report that black patients were significantly less likely than white patients to receive radiation after lumpectomy, resection for lung cancer, adjuvant therapy for colon and rectal cancers, and definitive therapy for prostate cancer. Interestingly, there was no disparity found for adjuvant chemotherapy in breast cancer patients. Black patients were also significantly more likely to have Medicare coverage and to have had no visits to a physician prior to their cancer diagnosis. In general, there was no notable decrease in disparities over the 10-year period.

A third study, also in Cancer, looks at racial differences in cervical cancer survival in the Detroit area. The authors found that black women were more likely to be older at diagnosis, to be diagnosed at a later stage of disease, to have larger tumors, and to live in neighborhoods classified as “working poor” than white women. The authors conclude that race by itself does not have an impact on survival, but that the lower cervical cancer survival rate of black women may be due to socioeconomic factors that affect access to care.

Relatedly, the Agency for Healthcare Research and Quality publishes reports on the state of disparities in healthcare that encompass more than just black and white – the most recent, from 2006, is available here.


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