Survival disparities for black patients with ovarian, colon, and breast cancer and childhood ALL suggest a need for efforts toward improved screening and treatment adherence in this population.
Researchers at the U.S. Centers for Disease Control and Prevention (CDC) report persisting racial disparities in Americans’ cancer survival rates. The findings from the CONCORD-2 global cancer surveillance study were published in Cancer, detailing survival disparities for ovarian, colon, and breast cancer. Disparities in survival among children diagnosed with acute lymphoblastic leukemia were also reported, particularly after the first year of diagnosis.
“Cancer may soon become the leading cause of death in the United states,” the researchers concluded. Survival disparities remain “large, consistent, and persistent.”
The CONCORD program was created to assess global disparities and trends in cancer survival, using regional and national tumor registry data. CDC researchers analyzed data from the CONCORD-2 study, which tracked patients’ survival rates in 67 countries following cancer diagnoses between 1995 and 2009.
The 5-year colon cancer survival rate climbed from 63.7% to 64.6% between 2001-2003 and 2004-2009. Although survival rates improved for blacks and whites, rates were persistently lower for black patients, who were 15 to 20 years behind the rates seen for white patients. A larger proportion of black patients were diagnosed with distant spread (21.5% vs. 17.2% for 2004-2009, for example).
“These findings suggest a need for more targeted efforts to improve screening and to ensure timely, appropriate treatment, especially for blacks,” the authors concluded.
Breast cancer survival was high overall (88.2%) but was persistently 10% higher among white women compared with black women (89.6% vs. 78.4%, respectively, during 2004-2009). Reducing that disparity will require “broad, coordinated efforts at the federal, state, and local levels,” the authors noted.
Survival disparities were also pronounced among white and black women diagnosed with ovarian cancer. In patients diagnosed with ovarian cancer between 2001 and 2009, half were diagnosed with distant metastasis. The overall 5-year survival rate was 39.6% during 2001-2004 and 41% during 2004-2009. But black women survived at markedly lower rates than white women (29.6% and 31.1% during the two periods, respectively). The disparity is not due to differences in tumor stage at diagnosis; all-races stage-specific survival rates during 2004-2009 were 86% for localized ovarian cancers, 61% for regional stage, and 27% for distant disease, the researchers reported.
“Clinical and public health efforts that ensure all women who are diagnosed with ovarian cancer receive appropriate, guidelines-based treatment may help to decrease these disparities,” they argued.