Socioeconomics don't explain racial disparity in breast Ca: poor outcomes.(News)

SAN ANTONIO -- African Americans undergoing adjuvant therapy for breast cancer have greater than 40% worse survival than women of other races--even after adjusting for differences in socioeconomic factors, baseline disease, and treatment variables, according to a major new study.

What this means is that poor outcomes in African American breast cancer patients cannot simply be blamed on lack of access to health care, poverty, or racism. There is something intrinsically different about the nature of breast cancer as it occurs in African Americans, something perhaps involving racial differences in tumor biology, the pharmacogenetics of drug metabolism, or hormonal effects, Dr. Kathy S. Albain said at a breast cancer symposium sponsored by the Cancer Therapy and Research Center.

She reported on 6,676 women, roughly 10% African American, who enrolled in Southwest Oncology Group (SWOG) breast cancer adjuvant therapy trials during 1975-1995. The analysis was restricted to women in SWOG studies because participants in these clinical trials gain access to state-of-the-art comprehensive cancer care.

Ten year overall survival in the 2,360 patients with premenopausal breast cancer was 68% for African Americans and 77% for all others. Among the 4,316 women with postmenopausal breast cancer, median survival was also significantly shorter in the African Americans, said Dr. Albain, professor of hematology/oncology at Loyola University, Chicago.

Marked racial differences in socioeconomic status were evident among the women. For example, only 26% of post menopausal African American patients lived in high-education zip codes, compared with 67% of non African Americans. Similar ...