Researchers compared mortality rates between black and Caucasian patients suffering from one of four major cancers selected for review in the study.
The research suggests that higher mortality rates among black cancer patients can be explained in part by the health care setting, according to lead author Tracy Onega, a Dartmouth Medical School assistant professor of community and family medicine.
Previous research has shown that cancer-related mortality is higher among black patients than white ones, but the cause of this discrepancy had yet to be definitely determined, according to Onega.
In the study, the Dartmouth researchers examined the medical records of over 200,000 Medicare recipients who received treatment for lung, breast, colorectal or prostate cancer between the years of 1998 and 2003.
Their goal was to determine the impact on patient mortality of receiving treatment at comprehensive or clinical cancer centers designated by the National Cancer Institute.
While the researchers found that the cancer-related mortality rate among black Medicare beneficiaries was 20 to 30 percent higher than that of white Medicare recipients, they also determined that there were no significant racial differences in mortality among those who attended NCI cancer centers.
Research institutions can apply to become NCI-designated centers and are awarded the designation by the NCI if they reach a certain threshold in level of cancer research and clinical care provided, Onega said.
"Where you go is an important factor in what kind of treatment you get," Onega said.
The results of the study could be used by cancer care centers to inform patients better about referrals for treatment, Onega said.
"It's a call for patients to think about their own preferences and to know that there are differences in where you go and the outcome," Onega said.
Identifying the important elements of care in NCI centers that increase survival rates could lead to improved care for cancer patients in other facilities, Onega said.
"[The results of the study] suggest that there are probably some components of what goes on in specialized centers that could be translated into other settings," Onega said.
These findings could also affect decisions made by cancer patients in rural regions when choosing where to receive care, according to Onega.
"In our region, where a lot of the people are rural, some patients may have an eight-hour round trip [to a care center]," Onega said. "Is it going to be important to have that travel burden for the outcome of their care?"
By studying Medicare recipients, researchers were able to study a "nationally representative population" as well as focusing on the section of the population most affected by these four cancers, Onega said.
"The median age of [patients with] these cancers is in the 70s, so we are really catching the relevant population," Onega said.
The researchers chose to study lung, breast, colorectal and prostate cancers because these types of cancer have the greatest public health significance and also represent a wide range of expected mortality rates, according to Onega.
Insufficient data prevented the researchers from making comparisons between other races, Onega said.
Other authors of the study were DMS professor and principal investigator David Goodman, DMS research professor Eugene Demidenko, DMS assistant professor Eric Duell and geography professor Xun Shi.
