African-American men with oral and pharyngeal cancer who live in Florida do not live as long as their white counterparts, and they are less likely to undergo the surgery necessary for optimal treatment of the disease, according to a study published in the August issue of the journal Cancer Causes and Control.
To determine how Florida ranked on the issue of racial disparities in treatment and survival of oral cancers, University of Florida researchers examined data gathered by the Florida Cancer Data System on oral and pharyngeal cancer diagnosis, treatment and mortality for more than 27,000 Floridians between 1988 and 1998.
Researchers compared data only on black and white patients. The study’s final sample size of 21,481 people included 19,331 white men and women and 2,150 black men and women.
Data analysis revealed that there were twice as many cases of oral and pharyngeal cancers diagnosed in men as in women. Most cancers occurred in people 51 to 74 years of age, with the median age being 65. Blacks, however, were significantly younger and poorer than whites at the time of diagnosis. The anatomical location of the patients’ cancers differed greatly between whites and blacks. More than one-half of black patients were diagnosed with aggressive pharyngeal cancers, compared with about 39 percent of white patients.
The cancers among blacks were twice as likely to have spread by the time of diagnosis. However, regardless of tumor location or whether the cancer had metastasized, blacks consistently were less likely to undergo surgery than were whites.
Blacks had a median survival time of 360 days compared with 649 days for whites. Although the incidence rate for both black and white men became nearly equal over the study’s 10-year period, the disparity in survival time did not significantly change.
"There is this difference in how people are treated and that contributes to the huge racial disparity in survival," said lead author Dr. Scott L. Tomar. "Unfortunately, we just don’t know why there are those differences. Our next line of investigation is to begin to tease out some of the answers."
