Among men with prostate cancer, African Americans experience longer treatment delays after being diagnosed than Caucasians. That is the finding of an analysis published early online in Cancer, a peer-reviewed journal of the American Cancer Society. The study suggests that efforts are needed to reduce racial disparities in prostate cancer care in order to provide earlier treatment for African Americans.
2. Breast Cancer:
Breast cancer in women between the ages of 15 and 39 years (adolescents and young adults [AYAs]) constitutes 5% to 6% of all breast cancer cases in the United States. Breast cancer in AYA women has a worse prognosis than in older women. Five-year survival rates are lowest for AYA women, and only a few studies have examined the impact of delay in treatment, race/ethnicity, and other socioeconomic factors on survival in AYA women.
CONCLUSIONS AND RELEVANCE: Young women with breast cancer with a longer TDT have significantly decreased survival time compared with those with a shorter TDT. This adverse impact on survival was more pronounced in African American women, those with public or no insurance, and those with low SES.
3. Effects of Health Insurance and Race on Early Detection of Cancer
Our final study population consisted of the 28 237 Florida residents diagnosed with colorectal cancer, breast cancer, melanoma, or prostate cancer in 1994, for whom information was available on both stage and insurance payer (Table 1⇔). Most patients were older than 65 years of age, and Medicare was the most common type of insurance. Table 2⇔ presents the proportion of patients who were diagnosed at a late stage of cancer for each category of insurance payer and race. The insurance payer was statistically significantly associated with stage at diagnosis for each of the four cancers examined. Patients insured by Medicaid and patients who were uninsured were at greater risk for late stage disease. Non-Hispanic African-Americans were at a greater risk of a late stage diagnosis for breast and prostate cancers.
Richard G. Roetzheim,
Naazneen Pal, Colleen Tennant,
John Z. Ayanian,
Annette Schwabe and
Jeffrey P. Krischer
+ Author Affiliations
Affiliations of authors: R. G. Roetzheim, University of South Florida Department of Family Medicine, and Division of Cancer Control, H. Lee Moffitt Cancer Center and Research Institute, Tampa; N. Pal, C. Tennant, University of South Florida Department of Family Medicine; L. Voti, Florida Cancer Data System, Sylvester Comprehensive Cancer Center, University of Miami, FL; J. Z. Ayanian, Division of General Medicine, Department of Medicine, Brigham and Women's Hospital, and Department of Health Care Policy, Harvard Medical School, Boston, MA; A. Schwabe, Department of Chronic Disease Epidemiology, Florida Department of Health, Tallahassee; J. P. Krischer, H. Lee Moffitt Cancer Center and Research Institute.
Correspondence to: Richard G. Roetzheim, M.D., M.S.P.H., University of South Florida Department of Family Medicine, 12901 Bruce B. Downs Blvd., MDC 13, Tampa, FL 33612 (e-mail: firstname.lastname@example.org).