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Disparity in Breast Cancer Survival Rates Not About Genetics
There's a disparity in the 5-year survival rates of black and white women, but not because of genetics—and the reason goes back to their initial diagnosis, creating a marked difference between the two demographics.
Black women have a 12.9% less chance of surviving 5 years after diagnosis, versus their white counterparts.
According to the a new study released in the July 24/31 issue of JAMA , black women are diagnosed later, in worse health, meaning when the treatment is administered, it is less effective.
The American Cancer Society says that women have a 93 percent 5-year survival rate if their breast cancer is caught at stage 0. That percentage drops to 88 percent if the cancer is at stage I. If the cancer is at stage IV, the 5-year survival rate is 15 percent.
The researchers looked at 7,375 black women aged 65 years and older diagnosed with breast cancer between 1991 and 2005 and compared them to 7,375 white patients. The patients came from 16 U.S. Surveillance, Epidemiology and End Results (SEER) sites in the SEER-Medicare database.
All the patients received follow-up care through December 2009. Each black patient was matched to a white patient in three different categories: demographics (age, year of diagnosis and SEER site), presentation (demographics plus co-existing conditions and tumor characteristics) and treatment (presentation plus aspects of surgery, radiation therapy and chemotherapy).
The researchers found for 5-year survival rates, 69 percent of white women were still alive compared to only 56 percent of black women. Overall, black women had a 12.9 percent less chance of surviving to that 5-year mark. When all categories were factored in, the average survival rate was still 4.4 percent lower for black women.
Around 12.6 percent of black patients did not receive any treatment for their breast cancer, compared to 5.9 percent of whites. The average diagnosis to treatment time for black women was 29.2 days, but for white women it was just 22.5 days. Black women were also less likely to start treatment within three months of diagnosis. They were also more likely to just receive breast-conserving surgery without any additional treatment (like chemotherapy, surgery or radiation) than their white counterparts.
When compared to their counterparts, black women were 8 percent less likely to have at least one primary care visit and were about 12 percent less likely to be screened for breast cancer. They also had significantly lower rates of colon cancer and cholesterol screening.
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