Blacks get less care for cancer of esophagus

Black esophageal cancer patients in the United States are half as likely as whites to get surgery that can help them live longer and often do not even see a surgeon, researchers have found.

Only 25% of black American patients studied underwent surgery that can cure this form of cancer in some cases, compared with 46% of white patients, said the researchers in the United States and the Netherlands.

This could explain why blacks are more likely to die of esophageal cancer, they reported in the Jan. 20 edition of the Journal of Clinical Oncology.

“Our study showed that black patients are less likely to be seen by a surgeon, and if seen, less likely to undergo surgery,” said Ewout Steyerberg of Erasmus medical center in Rotterdam, who led the study.

Esophageal cancer is three times more common in black people than in white people.

Black patients were also less likely to receive other treatments. The researchers found that 20% of African American patients got radiotherapy and no other treatment, compared with 13% of white patients.

Twenty-six percent of black patients received no treatment compared with 15% of white patients.

Researchers at the Dana Farber Cancer Institute in Boston reviewed the Medicare records of 2,946 white patients and 367 African American patients, all over the age of 65 with esophageal cancer that had not spread elsewhere in the body. They found that 70% of black patients saw a surgeon, compared with 78% of white patients. Of the black patients who saw a surgeon, only 35% were operated on, compared with 59% of white patients.

Two years after diagnosis, 18% of African Americans were still alive, compared with 25% of white patients. But when blacks got surgery, they were as likely to live as white patients.