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Cancer / Oncology News
Article Date: 27 Sep 2006 - 22:00pm (PDT)
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African-American women with uterine cancer have worse
survival rates than Caucasian women who received similar
treatment even though they had similar prognostic
factors, according to a new review of four clinical
trials. Published in the November 1, 2006 issue of
CANCER (cancer-newsroom),
a peer-reviewed journal of the American Cancer Society,
the review found significant racial disparities in
survival and clinical presentation of advanced/recurrent
endometrial cancer. African-Americans presented with
worse disease, but even after controlling for clinical
features and treatment, African-Americans survived
significantly fewer months than Caucasians, suggesting
that other factors, such as socioeconomic, biologic, and
cultural issues may have a strong influence on this
disease outcome.
Ethnic and racial differences are observed in many
cancers, such as breast and colon cancers.
Population-based studies have also demonstrated clear
racial disparities in the presentation, course and
outcome of endometrial cancer. These studies clearly
show that African-Americans present with more advanced
disease and have lower survival rates than other racial
groups. Analysis suggests that the cause is
multifactorial and may be related to inequality of
access to healthcare, cultural variations in response to
disease, and differences in disease stage at
presentation. Etiology, however, is difficult to discern
due to methodological shortcomings in many studies, such
as too few patients.
To further characterize the cause of outcome differences
between African-Americans and Caucasians, G. Larry
Maxwell, M.D. of the Department of Obstetrics and
Gynecology at the Walter Reed Army Medical Center in
Washington, DC and investigators analyzed demographic
and clinical data from 1,151 patients who were enrolled
in any of four randomized, control treatment trials with
stage III, IV or recurrent endometrial cancer.
The authors identified racial disparities in outcome,
even after controlling for presentation and treatment.
African-Americans were at 26 percent greater risk of
death from uterine cancer than Caucasians, even if they
had similar diseases and treatments. "When response to
treatment was analyzed, Blacks appeared to have lower
tumor response to each of the chemotherapy regimens
employed in the trials," the authors observe.
Analyzed by time, Africans-Americans survived a median
10.6 months compared to 12.2 months among Caucasians. At
presentation, African-Americans were more likely than
Caucasians to present with more serious disease,
including papillary serous histology, stage IV disease,
and higher tumor grade.
"While the causes of this survival difference remain to
be elucidated, socioeconomic, biologic and cultural
etiologies may be involved," conclude the authors.
###
Article: "Racial Disparity in Survival among Patients
with Advanced/Recurrent Endometrial Adenocarcinoma: A
Gynecologic Oncology Group Study," G. Larry Maxwell,
Chunqiao Tian, John Risinger, Carol L. Brown, G. Scott
Rose, J. Tate Thigpen, Gini F. Fleming, Holly H. Gallion,
Wendy R. Brewster, CANCER; Published Online:
September 25, 2006 (DOI: 10.1002/cncr.22232); Print
Issue Date: November 1, 2006.
Contact: David Greenberg
John Wiley & Sons, Inc.
