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Liver cancer patients face racial disparities in survival
A news analysis published in CANCER found that black patients with hepatocellular carcinoma (HCC), or liver cancer, have worse survival than patients of other races, even after receiving comparable treatments.
The disparities have been thought to be due to differences in the cancers themselves, as well as to differences in health care utilization and access to surgical therapy.
To explore the issue, researchers led by Joseph Kim, MD, of City of Hope in Duarte, CA, reviewed data from 20,920 patients in the Surveillance, Epidemiology and End Results (SEER) registry diagnosed with HCC between 1973 and 2004, as well as information from 4,735 patients in the United Network for Organ Sharing (UNOS) who underwent liver transplantation for HCC between 1987 and 2008.
The investigators found that survival from HCC has improved over time for all race, ethnic, and income groups, indicating that all groups have benefited from advances in screening, diagnosis, and treatment.
Among the SEER group, black and low-income patients had the poorest long-term survival. For example, black patients had a 15% increased risk of death compared with whites, while Asian patients had a 13% reduced risk.
It was noted that the reasons for these survival disparities are unclear, but may be related to differences' in patients' underlying disease as well as inconsistencies in access to appropriate care; however, additional analyses showed that black patients continued to do worse even after adjusting for the type of therapy patients received.
Study: costs play role in oncologists' treatment recs
In what was described as the largest survey to date of U.S. oncologists' attitudes about the cost of cancer treatments, researchers at Tufts Medical Center and the University of Michigan found that 84% of oncologists consider their patients' out-of-pocket costs when recommending cancer treatment.
However, fewer than half of the respondents surveyed frequently discuss cost issues with patients.
The survey was published in the January 2010 edition of Health Affairs. It also found support among oncologists for comparative-effectiveness research, which could help doctors make decisions about which treatments are best for different patients.