NCPA - National Center for Policy Analysis


January 26, 2005

Blacks do not have the same access as whites to life-saving cancer treatments, according to a new study in the Journal of Clinical Oncology. The study confirms what other researchers have found: black cancer patients often receive lower-quality care and are more likely to die of their illness.

This new study focused on black patients who had cancer of the esophagus, one of the deadliest cancers. Of the study's 3,300 patients, all were enrolled in Medicare, indicating that blacks did not suffer from a lack of health insurance. The results of the study show:

  • Only 18 percent of black patients survived more than two years compared to 25 percent of white patients.
  • When blacks and whites received the same treatment they were equally likely to survive.

According to Craig Earle, one of the authors of the study, this suggests that the survival gap is caused by differences in care rather than biology.

An early study on blacks and lung cancer surgery helped to provide more insight into the factors behind the discrepancies in cancer care. According to researcher Peter Bach:

  • Blacks and whites often see different doctors because they often live in different neighborhoods.
  • Physicians who treat blacks are less likely to be board-certified in a specialty.
  • Physicians who treat blacks are more likely to say they are unable to provide high-quality care and have less access to critical resources like diagnostic imaging tests.

Researchers agree that the problem is access, not racism. "It's all about access," Earle concludes. "We have to sort out why they're not getting treatment and try to actively increase the quality of care."

Source: Liz Szabo, "New evidence of racial gap in cancer care," USA Today, January 19, 2005; Craig C. Earle et al., "Racial Differences in Surgical Evaluation, Treatment, and Outcome of Locoregional Esophageal Cancer: A Population-Based Analysis of Elderly Patients," Journal of Clinical Oncology, Vol. 23, No 3 (January 20), 2005; and Peter B. Bach et al., "Primary Care Physicians Who Treat Blacks and Whites," New England Journal of Medicine, August 2004.

For Earle study:

For Bach study:


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