Added Illnesses May Explain Breast Cancer 'Race Gap'

Higher rates of heart disease, diabetes could lower survival for black patients, study suggests

TUESDAY, Oct. 11, 2005 (HealthDay News) -- Researchers are unraveling the mystery of why black women stricken with breast cancer often have shorter survival times than white women diagnosed with the disease.

According to a new study, black patients are more likely than whites to have other disorders such as high blood pressure and diabetes, and those disorders may help explain their poorer survival, said researcher David Nerenz, acting director of the Center for Health Services Research at the Henry Ford Health System, in Detroit.

His team published the findings in the Oct. 12 issue of the Journal of the American Medical Association.

"For the past 10 or 15 years, researchers have known that black patients do worse with breast cancer when it comes to survival," Nerenz said. Several reasons have been identified, he said, such as a lower socioeconomic status, a lack of access to medical care and inferior treatment.

In their study, the researchers tracked the 10-year post-diagnosis outcomes of more than 900 breast cancer patients -- 264 of whom were black and 642 of whom were white.

They found that nearly 62 percent of black patients died during the follow-up period, compared to 50 percent of whites, and that more black patients than whites died of breast cancer -- nearly 25 percent compared to just over 18 percent of whites.

The researchers also collected information on the presence of other health problems such as diabetes, high blood pressure, respiratory problems and other ailments.

They found that, on average, black patients had about 2.5 additional illnesses, while white patients experienced two additional health problems.

Overall, about 86 percent of black patients faced at least one health problem besides breast cancer, compared to around 66 percent of whites.

In all, 37 percent of blacks died from non-breast cancer causes compared to 32 percent of whites.

Compared with white patients, black patients had shorter overall survival, breast cancer survival and other-causes survival, the researchers found.

"The presence of other health problems accounted for most of the difference in deaths between African-Americans and whites," said Nerenz. "African-Americans were more likely to die of something else other than breast cancer, but also from breast cancer."

"The study is a reminder to us that even with the diagnosis of breast cancer, women are whole human beings and they continue to have other health problems. It's important for us not to lose sight of other health conditions and focus only on the breast cancer," he said.

Elizabeth Ward, director of surveillance research at the American Cancer Society, sees benefits and downsides to the study.

"They are able to look specifically at the effects of other health problems on survival," she said. "Few studies have done this because such information is difficult to get."

However, she worried that the study's' focus on deaths due to illnesses besides breast cancer will take the spotlight away from the early detection and treatment of breast malignancies. "It therefore remains very important to continue to research the gap between black women and white women with respect to breast cancer treatment and survival," Ward said.

Another expert, Dr. Nancy Keating, an assistant professor of medicine and health care policy at Harvard Medical School, called the new report an important study.

"We have long known that there are racial differences in breast cancer survival that aren't explained by the racial differences in stage at diagnosis and treatment," she said. "The study measured numerous comorbid [accompanying] illnesses, including many that are typically not captured in other studies of breast cancer care, and found that these comorbid illnesses help to explain differences in survival."

"Studies examining cancer patients' survival should include information about comorbidity," she said.

More information

To learn more about breast cancer, visit the American Cancer Society.

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