Black esophageal cancer patients in the United States are half as likely as whites to get surgery that can help them live longer and often do not even see a surgeon, researchers reported Tuesday.
Only 25 percent of black American patients studied underwent surgery that can cure this form of cancer in some cases, compared to 46 percent of white patients, the researchers in the United States and the Netherlands found.
This could explain why blacks are more likely to die of esophageal cancer, they reported in the Journal of Clinical Oncology.
“Our study showed that black patients are less likely to be seen by a surgeon, and if seen, less likely to undergo surgery,” said Ewout Steyerberg of Erasmus medical center in Rotterdam, who led the study.
Esophageal cancer is three times more common in blacks than in whites.
Less likely to receive other treatments
Blacks were also less likely to receive other treatments. The researchers found that 20 percent of African-American patients got radiotherapy and no other treatment, compared to 13 percent of whites. Twenty six percent of blacks received no treatment at all compared to 15 percent of white patients.
Researchers at the Dana Farber Cancer Institute in Boston reviewed the Medicare records of 2,946 white patients and 367 African-American patients, all over the age of 65 with cancer that had not spread elsewhere in the body.
They found that 70 percent of black patients saw a surgeon, compared to 78 percent of white patients. Of the black patients who saw a surgeon, only 35 percent were operated on, compared to 59 percent of white patients.
Two years after diagnosis, 18 percent of African Americans were still alive, compared to 25 percent of white patients. But when blacks got surgery, they were as likely to live as white patients.
“African-American patients need equal opportunities to receive quality cancer care. The time has come for us to move beyond just trying to remove barriers to access to care and actually work to engage vulnerable patients and find ways to facilitate their participation in care,” Steyerberg said.
About 20 percent of patients with esophageal cancer that has not spread usually survive at least five years if they have surgery. In 2004, 14,250 new cases of esophageal cancer were diagnosed in the United States, and 13,300 people died of it.