In the 1970’s, increased attention to civil rights led to concern about inequality in health care. This concern was especially based on the observation that black Americans had higher rates of death as a result of certain cancers compared with white Americans.[1]
Following the signing of The National Cancer Act of 1971, the Surveillance, Epidemiology, and End Results (SEER) program within the National Cancer Institute (NCI) was established. The program was designed to collect incidence, mortality, and survival data by race and greatly improved documentation of differences in outcomes and analyzed them through its black?white studies. These studies especially demonstrated differences in treatment patterns, and confirmed a higher proportion of blacks receiving inappropriate cancer care compared with whites.[1]
Today, the SEER data encompasses differences in outcomes for a number of racial and
ethnic groups, as well as for cohorts defined by age, sex, socioeconomic status, and other social determinants of health.[1]
Today, the field of cancer health disparities has evolved into a complex science and an established multidisciplinary field of cancer research. With a potential crisis in the racial disparities in cancer treatment and care, this research focuses on cancer incidence and mortality disparities that affects minorities and the medically undeserved.[1]
Ongoing Studies
Three new articles present trends in survival for patients with ovarian, colon, and breast cancer in the United States by race and stage. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings reveal large, consistent, and persistent racial disparities in survival. [2][3][4]
For the analyses, a team led by investigators at the Centers for Disease Control and Prevention used information from the second CONCORD study, which reported survival for patients who had cancer diagnosed between 1995 and 2009 in 67 countries and enabled the comparison of survival of patients in the United States with other countries.
Recorded during the 2017 annual meeting of the American Association for Cancer Research | AACR, Peter Hofland and Sonia Portillo sat down with Michael A. Caligiuri, MD, the current president of the American Association for Cancer Research | AACR, and ask him about health disparities in cancer that represent a major public health problem in our country, one of his main concerns. By promoting the exchange of novel ideas and information between the AACR and a wide range of professionals from academia, industry, government, and the community, Caligiuri hopes to drive a movement to help eliminate the disparities and harness the potential and maximize the many opportunities for bringing research on health disparities from bench to bedside or community, and back again. [Click here to listen].
In the analysis of ovarian cancer data, researchers found that among the 172,849 ovarian cancers diagnosed from 2001?2009, more than one-half were diagnosed at a distant stage. Five-year net survival was 39.6% in 2001?2003 and 41% in 2004?2009. Black women had consistently worse survival compared with white women (29.6% from 2001?2003 and 31.1% from 2004?2009), despite similar stage distributions.
Stage-specific survival for all races combined between 2004 and 2009 was 86.4% for localized stage, 60.9% for regional stage, and 27.4% for distant stage.
Colon Cancer
Concerning colon cancer, the five-year net survival increased 0.9% from 63.7% during 2001?2003 to 64.6% for 2004?2009. Survival improved for both blacks and whites, but the five-year net survival among blacks diagnosed during 2004?2009 had still not reached the level of survival of whites diagnosed during 1990?1994, some 15?20 years earlier. Also, more black than white patients were diagnosed at distant stage in 2001?2003 (21.5% versus 17.2%, respectively), and in 2004?2009 (23.3% versus 18.8%).
Breast Cancer
In the analysis of breast cancer data, five-year net survival was very high (88.2%), but survival was more than 10 percentage points lower for black women than for white women?a difference that persisted over time. From 2001?2003, survival was 89.1 percent for white women and 76.9% for black women. From 2004?2009, survival was 89.6% for white women and 78.4% for black women.
Last Editorial Review: December 5, 2017
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