A Call to Action on a Racial Disparity

From the National Comprehensive Cancer Network annual meeting, Hollywood, Fla.

photo by Damian McNamara

photo by Damian McNamara

In contrast to lung cancer deaths, where decreases since the 1970s are experienced about equally by black and white Americans, a striking disparity still exists in death rates from colorectal cancer.

“We have to address how we bring our curative treatments to all of the population, not just those who can afford it,” Dr. Paul F. Engstrom of Fox Chase Cancer Center in Philadelphia said. Dr. Engstrom led 27 other physicians to update the NCCN’s colorectal cancer guidelines, which feature new emphasis on treating recurrent disease, what to do when cancer spreads to the liver, and how to follow survivors over time.

Dr. Paul Engstrom (photo by Damian McNamara)

Dr. Paul Engstrom (photo by Damian McNamara)

In doing the guidelines research, Dr. Engstrom noticed something was missing. “An issue NCCN has not addressed is disparities in colorectal cancer survival and response to therapy in blacks versus whites. Our organization needs to look at this.” 

Interestingly, a potential answer why NCCN has not addressed the black-white disparity came two days later during a presentation on the group’s Oncology Outcomes Database Project. “We do not see disparity in care by race at any of our member institutions, which is good,” Dr. Jane C. Weeks of the Dana-Farber Cancer Institute in Boston said during a Q & A session.  “But we cannot say we’ve solved the racial disparity issue, because we are not the whole picture.” She added that, “Patients seen at one of the 21 leading cancer centers in the NCCN have the ability and resources to be treated at such an institution.

Dr. Jane C. Weeks (photo by Damian McNamara)

Dr. Jane C. Weeks (photo by Damian McNamara)

There is good news. Colorectal cancer death rates can be decreased in all patients through more widespread early screening and treatent, Dr. Engstrom said. Also, the gap between blacks and whites in overall cancer mortality has decreased between the early 1990s to 2004, according to a study (Cancer Epidemiology Biomarkers & Prevention 2008:17:2908-12).

—Damian McNamara

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