Racial Disparities Prevalent in Survival of Patients With Ovarian, Colon, and Breast Cancer

Findings from 3 analyses shine a spotlight on racial disparities in the survival of patients with ovarian, colon, and breast cancer.

All 3 types of cancer pose a heavy burden to populations worldwide. Ovarian cancer is the eighth most commonly diagnosed and fifth leading cause of cancer death in the US; colon cancer is the third most common cancer diagnosed in men and the second most in women; and breast cancer is the second most common cancer and the fifth leading cause of cancer deaths among females.

“An evaluation of population-based survival trends can help to inform cancer-control efforts by identifying opportunities for improvement in early detection, diagnosis, and treatment,” wrote the authors.

The authors of the analyses, published in CANCER, compiled information from the second CONCORD study, which reported survival for patients who had cancer diagnosed between 1995 and 2009 in 67 countries. The 37 NPCR/SEER state-wide cancer registries that participated in the study covered approximately 80% of the US population.

Patients were grouped by year of diagnosis into 2 calendar periods (2001-2003 and 2004-2009) to reflect changes in methods used by cancer registries to collect data on stage at diagnosis. The authors analyzed survival rates by state, race, and calendar year of diagnosis.

Of the 172,849 ovarian cancer cases, 56,390 women were diagnosed between 2001 and 2003, and 116,459 were diagnosed between 2004 and 2009. Over 85% of the diagnoses were among white women during both time periods and more than half of all the chases were diagnosed at distant stage.

For all races combined, stage-specific survival improved between calendar periods. However, black women had a lower survival rate than white women for each stage at diagnosis. From 2001-2003, the 5-year survival rate was 29.6% for black women and 40.1% for white women; from 2004-2009, survival rate was 31.1% for black women and 41.7% for white women.

Of the 278,382 patients diagnosed with colon cancer between 2001 and 2003, 85.7% were white, and 10.7% were black; of the 534,721 patients diagnosed between 2004 and 2009, 83.7% were white, and 11.9% were black.

Blacks had slightly lower 1-year, 3-year, and 5-year survival than whites during both calendar year periods, but survival among black increased more than among whites. Survival up to 5 years after diagnosis was lower for black than whites in nearly all of states during both calendar periods.

The breast cancer analysis included 1,372,377 US females diagnosed between 2001-2009; 85.1% were white, and 10.4% were black. The 1-year net survival for black women was 92.6% from 2001-2003 and 93.6% from 2004-2009, compared to 96.8% and 97%, respectively, for white women. The 3-year net survival between 2001 and 2003 was 83.1% for black women and 92.5% for white women, and between 2004 and 2009 was 84.3% for black women and 92.9% for white women. The 5-year net survival for black women between 2001 and 2003 was 76.9% and between 2004 and 2009 was 78.4%, compared to 89.1% and 89.6%, respectively, for white women.

“Black/white inequalities in survival suggest differences in access to care and in tumor morphology between the groups,” concluded the authors.