Treatment Disparity Blamed for Poorer Survival in Black Mesothelioma Patients

A new report contains some good news and some bad news for African Americans on the subject of malignant pleural mesothelioma. According to a team of New York-based researchers, mesothelioma occurs about half as often in black Americans as it does in whites. That is the good news.The bad news is that, due to disparities in treatments, black patients who do get mesothelioma have worse survival rates.

The research was completed at the Hofstra North Shore-LIJ School of Medicine and Mount Sinai Medical Center. Using data from the Surveillance, Epidemiology, and End Results (SEER) database, researchers identified 13,046 white mesothelioma patients and 688 black mesothelioma patients. Patients were separated by race and then categorized by age, sex, diagnosis year, stage, cancer-directed surgery, radiation and vital status. The results revealed disturbing racial differences in the way black and white mesothelioma patients are managed.

“Black patients were more likely to be female, younger, and with advanced stage and less likely to undergo cancer-directed surgery than whites, after adjustment by stage,” writes Emanuela Taioli, of the Hofstra North Shore-LIJ School of Medicine.

Multiple studies have found better survival odds for female mesothelioma patients than males. In the current study, although white women with mesothelioma did tend to live longer than their male counterparts, the same was not true of black women with mesothelioma, who had survival rates similar to men. Being younger at the time of diagnosis and having surgery were associated with longer survival in both black and white patients, but, since the black mesothelioma patients tended to be diagnosed later and were less likely to have surgery, most did not experience longer survival.

While the researchers did not address the reason for the disparities, they did conclude that more surgical intervention could improve survival among African American mesothelioma patients. Mesothelioma affects an estimated 2,500 people in the US each year. Most were inadvertently exposed to asbestos on the job decades earlier, often because of inadequate protective gear or training.

Source:

Taioli, E, et al, “Frequency of Surgery in Black Patients with Malignant Pleural Mesothelioma”, April 30, 2015, Epub ahead of print, Disease Markers