Exploring Outcomes Disparity in Cancer CareOct 20, 2020
Studies have long reported that Black cancer patients have poorer outcomes than their white counterparts, Jessica McDermott, MD, and Sana Karam, MD, PhD, investigated the data further to figure out why and found that outcome disparity was caused not by biology, but simply by differences in access to health care.
Drs. McDermott and Karam examined Medicare data for 13,117 individuals suffering squamous cell cancer of the head and neck in which all patients were diagnosed with their first and only malignant tumor at age 66 or older sometime between 2006 and 2015. The data confirmed what has been widely reported for years – that the Black head and neck cancer patients had worse outcomes than the white cancer patients.
“But then when we controlled for access to care, those differences suddenly disappeared. When you closely examine the data, it becomes clear what is going on.” says Dr. McDermott.
Drs. McDermott and Karam identified two major differences for Black patients: first, they presented at later stages of cancer, and second, they were less likely to receive treatment.
“This is an interesting finding, a lot of the reasons driving the disparate outcomes came down to socially related things – they were less likely to be married, lived in poor areas, had comorbidities [presence of two or more chronic diseases], were less likely to see a primary care provider in the year leading up to the diagnosis, and were more likely to present in the emergency room.” explained Dr. McDermott
A teaching and research hospital like the University of Colorado can lead the way in improving the care of underserved communities. Like many other tertiary care centers, we have a great number of clinical trials, but unfortunately not everyone who could benefit from them enjoys access which is why we need to enhance our ability to deliver more broadly the best and newest trials that can extend life and decrease symptom burden.
Drs. McDermott and Karam are hopeful that their research will catch the attention of those who can help narrow those disparate outcomes.
You can read the full findings in the Journal of the National Comprehensive Cancer Network.