Study Finds Racial Disparities in Survival Rates of Colon Cancer Patients With Health Insurance
Among people with health insurance, blacks have the highest colon cancer mortality rate, according to a study published Thursday in the online edition of the journal Cancer, HealthDay/Forbes reports. For the study, researchers examined data on 10,585 whites, 1,479 blacks, 985 Hispanics and 909 Asians and Pacific Islanders who were diagnosed with colorectal cancer between 1993 and 1998. All of the patients had health insurance. The study found that blacks were 17% more likely to die from colon cancer than whites. Hispanics had a similar colon cancer mortality rate to whites and Asians had the lowest risk of death from the disease, according to the study. Researchers also found that blacks were less likely than whites to undergo surgery. According to the researchers, earlier detection and surgery decreased the risk of dying from colon cancer. Surgery reduced the risk of death from colon cancer among blacks by about 6%, the study found (HealthDay/Forbes, 12/21). Tumor stage and treatment appeared to account for the majority of the racial gap in mortality rates, but the link between race and survival was "complex," according to researchers. The study notes that while all the patients were insured, their out-of-pocket medical expenses and ability to take time off from work for doctor's appointments might have varied (Hitti, CBS, 12/21).
Study author Chyke Doubeni of the University of Massachusetts Medical School and the Meyers Primary Care Institute said that "just having health insurance alone does not eliminate disparities. There need to be systems in place that make sure that everyone is getting services." Doubeni said, "Racism and discrimination is still at play. Most of this occurs at an unconscious level. But there are preconceived ideas and prejudices about patients." Harold Freeman, a senior adviser to the director of the National Cancer Institute and former director of NCI's Center to Reduce Cancer Health Disparities, said, "On the patient's side, there may be patient bias, where patients don't trust the medical care system. Patients can also have belief systems that lead them not to accept treatment." In addition, Freeman said, "It depends on the type of insurance you have," adding, "There are people who are insured, but underinsured for the particular things they need." Durado Brooks, director of colorectal cancer at the American Cancer Society, said, "Treatment differences are playing a significant role in outcomes. But are those treatment differences the result of patient choices, patient inaction, or are they system or provider barriers? If you provide equal levels of treatment, you can go a long way to decreasing these barriers" (HealthDay/Forbes, 12/21).
An abstract of the study is available online.