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African
Americans diagnosed with lung cancer are less likely to see
an oncologist and subsequently less likely to receive chemotherapy,
largely because of their socioeconomic status, according to
researchers at Harvard University.
Researchers
studied 12,015 patients over age 65 who were diagnosed with
metastatic lung cancer between 1991 and 1996 and monitored
by a Survival, Epidemiology, and End Results (SEER) tumor
registry.
Of the
patients who were not treated with chemotherapy, 36 percent
were never assessed by a physician who provided chemotherapy.
Patients living in particular areas, those diagnosed in more
recent years, and patients who received care in a teaching
hospital were all more likely to have seen a cancer specialist,
according to the study published in the Journal of Clinical
Oncology. These factors were not related to subsequent treatment
decisions.
Age and
the presence of other illnesses did not have a significant
effect on whether a patient was seen by an oncologist, but
were linked with the likelihood of their receiving subsequent
chemotherapy.
Investigators
concluded, "Nonmedical factors are important determinants
of whether a lung cancer patient is seen by a physician who
provides chemotherapy. After seeing such a physician, treatment
decisions seem to be mostly explained by appropriate medical
factors. Racial and socioeconomic disparities still exist
at both steps, however."
"Referring
physicians must ensure that biases and barriers to care do
not deprive patients of the opportunity to consider all of
their treatment options," the study advised.
Source:
Medical Week staff,
week of April 7, 2002
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