GENERAL HEALTH
Study: Blacks Less Likely to Survive Lung Cancer
By Jean F. Gibbs
Black patients may be less likely than their white counterparts to survive lung cancer, suggest a study published in the July 2001 issue of the journal Chest.
Investigators found that black patients with cancer that had not spread beyond the lungs were 24% more likely than whites to die within 5 years. And blacks with cancer that had spread to areas close to the lungs were 14% more likely to die within 5 years.
The reasons for this disparity are not well established. The researchers suggest that the smoking habit seems to be more durable in blacks who more likely become long-term smokers compared with whites. In addition, blacks have been found to be more likely to smoke mentholated cigarettes and cigarettes higher in nicotine and tar.
On the other hand, race may mask social and economic differences that put blacks at greater risk of cancer and death--such as poorer diet, exposure to other environmental pollutants and less access to healthcare.
``Other socioeconomic factors are likely at work that affect the rapidity with which the disease is diagnosed or the type of treatment that patients choose or are offered,'' the study's lead author, Dr. Gregory Kalemkerian of the University of Michigan Medical Center in Ann Arbor, told Reuters Health.
He added that blacks are also more susceptible than whites to many smoking-related conditions such as heart disease, high blood pressure and stroke.
In the study, the researchers analyzed information on more than 48,000 lung cancer patients over a 26 year period. About one quarter of the patients were black.
In other findings, the overall rate of lung cancer among black men was 37% higher than in white men. Among black women, the rate of lung cancer was 9% higher than that of white women.
However, black men saw a greater decline in overall lung cancer diagnoses between 1985 and 1998 than did white men--although the incidence of the disease fell in both groups, the study authors note. Among men younger than 50, whites in fact saw a greater decline in lung cancer incidence.
The research team also found that the rate of distant-stage disease, or cancer that has spread far beyond the initial site, was higher among blacks. Delays in diagnosis due to poorer access to healthcare or greater reluctance to seek care may be to blame, Kalemkerian suggested.
Despite the findings that blacks seem to fare worse than whites when it comes to the diagnosis and survival of lung cancer, Kalemkerian said efforts to reduce or eliminate tobacco use are needed in all groups.
``If you look at the overall survival figures for whites, they are really nothing to cheer about,'' he said. ``The optimal strategy is to stop people from starting to smoke. We are failing at this as the rate of smoking in adolescents in the US is again rising.''
Lung cancer is the leading cause of cancer death among men and women in the US, according to the American Cancer Society (news - web sites). In 2001 alone, about 169,500 people will be diagnosed with lung cancer and about 157,400 people will die of the disease--more than estimates for colon, breast and prostate cancers combined.
SOURCES: Chest 2001;120:55-63; Reuters