Monday, June 15, 2015

Why are African Americans less Likely to Survive Certain Cancers?

Contrary to Prevailing Theory, the Reason isn't Solely Due to Poverty or Inferior Healthcare, Loyola Study Finds

MAYWOOD, Il. -- African Americans are more likely than other races to die from breast, prostate and ovarian cancers, but this disparity is not due to poverty or inferior healthcare, a first-of-its-kind study has found.

Researchers followed more than 19,000 patients who were enrolled in cancer clinical trials conducted by the Southwest Oncology Group, a National Cancer Institute-funded clinical trials national cooperative. Patients of all races received the same advanced treatments by the same doctors.

"It was a level playing field for everyone, with the same quality care," said lead author Dr. Kathy Albain. "So our findings cast doubt on a prevailing theory that African Americans have lower cancer survival rates because of poverty, poor access to quality care or other socioeconomic factors." Albain is a breast and lung cancer specialist at Loyola University Health System's Cardinal Bernardin Cancer Center.

If poverty or other socioeconomic factors were to blame, then the survival gap should exist for all cancers. But the study, published in the Journal of the National Cancer Institute, found there was no statistically significant association between race and survival for lung and colon cancers, leukemia, lymphoma or myeloma.

"The good news for African Americans is that for most common cancers, they have the same survival rates as all other races," Albain said.

The cancers that did show survival gaps -- breast, prostate and ovarian -- are gender-related. The findings therefore suggest that the survival gap is due to a complex interaction of biologic factors in the tumor and inherited variations in common genes that control metabolism of drugs and hormones, Albain said. People with different patterns of these genes metabolize cancer drugs and their own hormones differently, and experience different side effects.

"We are actively conducting new research based on these findings to explore interactions among tumor biology, treatment, sex, race, inherited genes and survival," Albain said.

Dr. Patrick Stiff, director of the Cardinal Bernardin Cancer Center, said: "This groundbreaking study will provide investigators with a road map for future research that will improve outcomes of patients of all races and socioeconomic status."

Researchers identified 19,457 adult cancer patients enrolled in 35 Southwest Oncology Group clinical trials who were followed for at least 10 years after treatment. Twelve percent of the patients were African American. During the course of the study, African Americans were 49 percent more likely than other races to die from early-stage, postmenopausal breast cancer; 41 percent more likely to die from early stage, premenopausal breast cancer; 61 percent more likely to die from advanced-stage ovarian cancer and 21 percent more likely to die from advanced-stage prostate cancer.

Albain is a professor in the Department of Medicine, Division of Hematology/Oncology, Loyola University Chicago Stritch School of Medicine. Her co-authors are Joseph Unger and John Crowley of the Southwest Oncology Group Statistical Center, Dr.Charles Coltman of the University of Texas Health Science Center and Dr. Dawn Hershman of Columbia University College of Physicians and Surgeons.

The study was funded by the National Cancer Institute.

About Loyola University Health System

Loyola University Health System (LUHS) is part of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb Memorial Hospital campus and more than 30 primary and specialty care facilities in Cook, Will and DuPage counties. Loyola University Medical Center’s campus is conveniently located in Maywood, 13 miles west of Chicago’s Loop and 8 miles east of Oak Brook, Ill. At the heart of the medical center campus is a 559-licensed-bed hospital that houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children's Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as Loyola University Chicago Stritch School of Medicine, Loyola University Chicago Marcella Niehoff School of Nursing and the Loyola Center for Fitness. Loyola's Gottlieb campus in Melrose Park includes the 255-licensed-bed community hospital, the Professional Office Building housing 150 private practice clinics, the Adult Day Care, the Gottlieb Center for Fitness, Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.

Trinity Health is a national Catholic health system with an enduring legacy and a steadfast mission to be a transforming and healing presence within the communities we serve. Trinity is committed to being a people-centered health care system that enables better health, better care and lower costs. Trinity Health has 88 hospitals and hundreds of continuing care facilities, home care agencies and outpatient centers in 21 states and 119,000 employees.