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Outcomes similar between blacks, whites treated at specialized cancer centers
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Black Medicare patients with lung, breast, colorectal and prostate cancers had higher mortality than white patients with the same cancers; yet, no significant differences existed between blacks and whites who were treated at National Cancer Institute cancer centers.
Researchers conducted a retrospective study of cancer-specific mortality for 201,305 Medicare patients (8.9% black) to determine whether place of service was linked to differences in mortality between blacks and whites. A greater proportion of blacks (11.1%) attended NCI cancer centers than whites (6.9%).
At one year, the overall cancer-specific mortality was 18% for blacks vs. 14.7% for whites. At three years, the rate was 25% for blacks and 20% for whites.
Among those who attended NCI cancer centers, there were no differences in mortality based on race. At one year, the mortality rate was 12.3% for blacks and 12.4% for whites. At three years, the rate was 19.9% for blacks and 20% for whites.
When measuring risk for mortality while accounting for important patient differences, such as age, cancer site and cancer stage, these same patterns held true: Overall, blacks were more likely than whites to have died at one and three years, except among cancer patients attending NCI cancer centers.
When stratified by those who attended and those who did not attend an NCI cancer center, excess risk for blacks no longer remained. The adjusted OR for cancer-specific mortality at one year was 0.95 (95% CI, 0.76-1.19) for those who attended an NCI cancer center and 1.14 (95% CI, 1.08-1.21) for those who did not. At three years, the OR was 1.00 (95% CI, 0.82-1.21) for NCI cancer center attendees and 1.26 (95% CI, 1.20-1.33) for others.
For more information:
- Onega T.Cancer. 2010;doi:10.1002/cncr.25097.