Black breast cancer care gaps still an issue

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While the gap between care for Caucasian and ethnic patients has narrowed, it’s still very much a factor, at least for breast cancer patients. That, at least, is the conclusion drawn by a recent study published in the journal CANCER this week.Over time, research has demonstrated that black and Hispanic women are less likely to get recommended breast cancer treatments than white women.  Blacks and Hispanics often see worse outcomes than non-ethnic counterparts, as well.

If you were wondering whether having insurance or a specific socioeconomic status eliminates these disparities, the answer seems to be “no.”

The study, which was done by a team lead by Rachel Freedman, MD, MPH of Boston-based Dana-Farber Cancer Institute,  included information from 662,117 white, black and Hispanic women diagnosed with invasive breast cancer.  The data was drawn between 1998 and 2005 at National Cancer Data Base hospitals.

Researchers conducting the study looked how often women got various forms of therapy, including localized therapy, hormonal therapy, hormone receptor testing and chemotherapy.

Despite factoring out the womens’ socioeconomic and insurance status, clear if modest gaps in care seem to remain between minorities and whites.

It turned out that compared with white women, black women had 0.91 times lower odds of getting recommended local therapy, 0.90 times lower odds of getting hormonal therapy and 0.87 times lower odds of receiving chemotherapy.  Hispanic women were also less likely than white women to receive hormonal therapies.

Dr. Freedman’s conclusion is an unsettling one: “This study suggests that [health insurance] expansion is unlikely to have a major impact on disparities in breast cancer care among black women.”

Surely someone has an idea of how to turn this around?  Readers, do you?  My reading suggests that simply having more black clinicians in place — to increase trust in both directions – would at least be a start.

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