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Decades of social progress fail to render equal ca care

Decades of social progress fail to render equal ca care

What the U.S. is doing wrong in the fight against breast cancer among African Americans continues to elude the medical community.

Research at George Washington University in Washington DC has found that African-American women diagnosed with breast cancer between 2001 and 2003 were significantly more likely to wait for treatment than if they had been diagnosed between 1998 and 2000. And the gap between diagnosis and treatment is getting wider. Those diagnosed between 2004 and 2006 waited longer for treatment than those between 2001 and 2003.

Heather A. Young, PhD, an associate professor of epidemiology, and her colleagues at the university documented this trend but said they can’t explain it. “There is likely something about race that we are still not capturing. Whether it is different patterns of social support, access to transportation, or family burden, something is causing the disparities in care to persist,” Dr. Young said.

She reported that African Americans living with breast cancer in DC are more likely to experience treatment delays regardless of insurance type, socioeconomic status, and cancer characteristics such as stage and grade (2010 AACR Conference on the Science of Cancer Health Disparities abstract B79).

There was reason for hope 20 years ago that the disparity between African Americans and whites could be explained. Researchers reported success in relating the causes of increased cancer morbidity and mortality in African Americans more to poverty and lack of education and access to care than to any inherent racial characteristics.

However, the recently released findings underscored the difficulties in measuring the impact of race and socioeconomic status on health outcomes.

Using data from the DC Cancer Registry, which captured all cancer cases from 1998 to 2006, the researchers found that African-American women were 2.19-fold more likely to wait more than two months longer than white women from the time of diagnosis to treatment. African-American women in the study had a mean time to diagnosis of 26.1 days compared with 14.1 days for white women. This disparity increased over time, as the gap widened from 1998 to 2006. This trend appears to be getting worse and no one knows for sure why, according to Dr. Young.

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