US:Black people with rectal cancer in the US are 23 per cent less likely to get chemotherapy than white people, even when they see a cancer specialist, according to US researchers.
The researchers also found that black people were 12 per cent less likely to get radiation therapy than white people.
The study is the latest to show that black people in the US get less treatment for cancer than white people and are more apt to die from their cancers.
Both blacks and whites in the study saw cancer specialists at about the same rate, suggesting that reasons other than access to a specialist may be playing a role.
The finding came as a surprise to Dr Arden Morris, a surgeon at the University of Michigan medical school in Ann Arbor, who had expected to find that black patients were not being referred to a cancer specialist after surgery as often as white patients.
"I assumed they weren't getting recommendations," said Dr Morris, whose study appears in the Journal of the National Cancer Institute.
Black people are about 20 per cent less likely to survive rectal cancer long term after surgery, and the researchers were trying to see if lack of referrals was a factor.
Dr Morris and her colleagues studied Medicare records from 1992 to 1999 of elderly patients who had undergone surgery for rectal cancer. They collected data on age, gender, race and the use of a follow-up therapy such as radiation or chemotherapy.
They found no significant difference between the two groups in terms of how frequently they had consulted a cancer specialist.
But they did find that white people were more likely to consult both a medical oncologist, who might recommend chemotherapy, and a radiation oncologist, who treats tumours with radiation.
Among people who saw an oncologist, only 54 per cent of black patients received chemotherapy, compared with 70 per cent of white patients. The youngest, healthiest blacks in the study appeared to be least likely to get chemotherapy and blacks were less likely to get radiation therapy.
Use of treatments like chemotherapy or radiation help to boost survival from rectal cancer by as much as 20 per cent.
"Unfortunately we are not getting immediate, concrete answers about what to do differently," Dr Morris said. She said it was possible that black patients were more likely to decline radiation or chemotherapy because they felt a sense of hopelessness, did not trust doctors or were worried about the risks of side effects.
It is also possible that the doctors they see do not have as many resources as white patients and are inadvertently limiting care.
A 2004 study in the New England Journal of Medicine found that 80 per cent of black patients were getting care from just 20 per cent of US health providers.
Dr Morris saw a similar pattern. She found that 80 per cent of black patients were seen in just 36 per cent of US hospitals. "That is a limited slice of hospitals."
Dr Morris plans to interview groups of people who have been treated for rectal cancer to find out what made them follow through with treatment.
The study was funded by the American Cancer Society and the National Cancer Institute.
- (Reuters)