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Cancer More Likely to Recur in Blacks

Cancer More Likely to Recur in Blacks Treated for Head, Neck Cancer  

Black people treated for head and neck cancer have double the risk of cancer recurring elsewhere in the body and thus are far more likely to die within five years than White patients who received the same treatment for the same type of malignancies, University of Florida researchers have found.
The discovery adds to a growing body of scientific discoveries that link race with outcomes for various cancers and draws attention to the need for better identification of patients most at risk and for customized therapies, said Dr. William M. Mendenhall, a professor of radiation oncology at UF’s College of Medicine and a member of the UF Shands Cancer Center. UF researchers reported their findings in the Dec. 1 issue of Cancer, the journal of the American Cancer Society.
In the United States, about 37,000 people are diagnosed as having head and neck cancer each year, a figure that represents about 3 percent of all cancer cases. The cancer is most common in people who use tobacco or are heavy drinkers, but it can occur in individuals who have no such risk factors.
Initially, Mendenhall said he didn’t expect to see any differences in long-term survival in Black versus White patients, because the nearly 700 patients whose medical records UF scientists studied all had tumors that were of similar size and aggressiveness. In addition, all patients received identical treatment: twice-daily radiation therapy for six-and-a-half weeks at Shands at the UF medical center, and surgery when needed. About 8 percent were Black.
Researchers tracked patients for up to seven years and found that cancer was indeed more likely to resurface in Black people, and it usually did so in distant parts of the body, such as the lung, bone or liver.
“I really didn’t think that if you looked at patients with similar stage tumors who were treated the same way that there would be a difference in outcome,” Mendenhall said. It is not really clear why the difference in outcome, said Mendenhall, but the results are important for a number of reasons.
“It tells us we need to do something to modify treatment for those patients to try to reduce their risk of having distant metastasis,” he said. “Because if you develop a distant metastasis, the odds are almost 100 percent you’re going to die from the cancer. So it’s important to try to reduce that risk.”
UF scientists conceded that a drawback of the study was their inability to access reliable information related to study participants’ lifestyles, including tobacco and alcohol use. Similarly, they did not account for potentially important differences in patients’ health before treatment was begun.
Even so, “our data underscore practical implications that are worth consideration,” the authors wrote in the journal.
Mendenhall emphasized that the study calls attention to the importance of evaluating ethnic and racial influences on disease and prognosis, and he recalled the recent defeat of Proposition 54 in California, which sought to remove references to race in medical records and on a variety of state forms.

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