It has long been known that there are disparities in health care between black women and white women, specifically in women with breast cancer. A new study, conducted by researchers at the University of Pennsylvania and published in The Journal of the American Medical Association, investigated the reasons for these differences.
Their study included about 107,000 white women and 7,000 black women with breast cancer diagnoses. All subjects were on Medicare and their information was tracked in the Surveillance Epidemiology and End Results database. The average age of the patients at diagnosis was 76. Researchers found that white women with breast cancer lived three years longer, on average, than black women. In terms of five-year survival rates, 70 percent of white women lived at least five years after diagnosis as compared with only 56 percent of black women.
And these disparities are not explained by more aggressive cancers in black women. Rather, researchers found that black women were less likely to be diagnosed at an earlier and therefore more curable stage of the cancer. This may be attributed to the fact that, overall, black women were less likely to seek any medical care, with significantly fewer black women having seen a primary care doctor within the 6 to 18 months prior to receiving a breast cancer diagnosis. Black women were also less likely to have received screening of any sort for health problems such as cholesterol and colon cancer (as well as breast cancer). Furthermore, even if they had been diagnosed, black patients were twice as likely as white patients to never receive treatment for breast cancer, as well as more likely to have significant delays in treatment.
Dr. Jeffrey H. Silber, a professor at the University of Pennsylvania and the director of the Center for Outcomes Research at the Children s Hospital of Philadelphia says, Something is going wrong. These are huge differences. We are getting there too late. He goes on: These patients have insurance. We need to improve screening for these women and improve their relationships with a primary care provider.
