U.S. Blacks More Likely to Die of Colon Cancer Than Whites: Study

FRIDAY, Dec. 30 (HealthDay News) — Although colorectal cancer
death rates in the United States have fallen across the board over the
last 20 years, the dip has been smaller among blacks than whites, a new
study indicates.

Specifically, the racial spread in death rate trends appears to be most
notable among patients diagnosed with the most advanced stage of the
disease, according to the results of an investigation by the American
Cancer Society (ACS).

“The widening racial disparity for [advanced]-stage has a
disproportionate impact on overall colorectal cancer mortality disparities
because [advanced]-stage accounts for approximately 60 percent of the
overall black-white mortality disparity,” the study authors explained in
an ACS news release.

The study team, led by Dr. Anthony Robbins, pointed out that up until
1980, black Americans were actually less likely to die from colorectal
cancer overall than whites. Since then, however, the availability of
ever-better screening and treatment options has turned that dynamic on its
head. The result: by 2007, the rate of death among blacks was 44 percent
greater than that among whites.

The reason, the authors suggested, may be that black patients do not
seem to be getting screened or treated as often and as aggressively as
white patients.

The aim of the current ACS study was to find out how exactly racial
differences in plummeting death rates have been playing out with respect
to disease progression: namely, early-stage (in which cancer is
localized); mid-stage (in which cancer has spread to regional lymph
nodes); and late-stage (in which the cancer is made its way throughout the
patient’s body).

To explore that question, the team analyzed two decades of information
that had already been gathered by the U.S. National Cancer Institute’s
Surveillance, Epidemiology, and End Results (SEER) Program database.

The review, released online Dec. 19 in advance of print publication in
the Journal of Clinical Oncology, revealed that while racial
differences in death rate declines were apparent at every stage of
disease, the divide was most stark among late-stage patients.

For example, while early-stage white patients experienced a roughly 30
percent drop in death rates over the last 20 years, their black peers
experienced about a 13 percent decline. Among mid-stage patients, the drop
was almost 49 percent among whites versus 34 percent among blacks.

But for those with the most advanced stage of disease, the gap was even
greater: death rates had dropped by nearly 33 percent among whites
compared with just under 5 percent among blacks, the investigators
found.

The authors noted that black Americans tend to be screened less often,
are less likely to have timely follow-ups when they are screened, and are
generally less well informed when it comes to the latest and best
treatment options. The researchers suggested that to rectify the problem,
an effort should be made to bump up early-stage detection of colorectal
cancer among black patients.

More information

For more on colorectal cancer, visit the U.S. National Cancer Institute.

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