Underinsured African-Americans With Breast Cancer Fare Worse

Have poorer survival than whites; race not significant factor in survival after adjustment for confounders

THURSDAY, June 24 (HealthDay News) -- Underinsured African-American patients are more likely to experience poorer breast cancer-specific survival than their non-Hispanic white counterparts, though the effect of race on survival is not statistically significant after adjustment for sociodemographic and clinical factors, according to research published online June 23 in the Journal of the National Cancer Institute.

In a retrospective review, Ian K. Komenaka, M.D., of Wishard Memorial Hospital in Indianapolis, and colleagues evaluated the medical records of 574 breast cancer patients (259 non-Hispanic whites and 315 African-Americans) treated from Jan. 1, 1997, to Feb. 28, 2006.

The researchers found that non-Hispanic whites and African-Americans were equally unlikely to have had a screening mammography during the two-year period prior to diagnosis, and 84 percent of patients were underinsured. In addition, the median time from diagnosis to operation, receipt of adequate surgery, and use of all types of adjuvant therapy were similar between non-Hispanic whites and African-Americans. However, African-American race was statistically significantly associated with breast cancer-specific mortality after adjusting for comorbidities, compared to non-Hispanic whites (26.0 versus 17.5 percent). Yet, the effect of race on survival was no longer statistically significant after adjusting for clinical and sociodemographic factors.

"We found no statistically significant difference in breast cancer-free survival between African-American and non-Hispanic white women," the authors write. "However, African-American women had worse overall survival compared with non-Hispanic white women."

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