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Despite advances in survival rates from colon cancer over the past 20 years thanks to better screening, diagnosis and treatment, a new study shows that there is a disparity in such advances between classes, hitting blacks, indigent, and those without insurance the hardest.
The reasons are two-fold. First, poorer patients are generally not screened early enough. This is the most important factor in determining cancer survival because early stages of cancer are limited to a confined location.
Second, even when poorer patients are screened early, they take a longer time to get on the operating table because they lack insurance or they do not have good social or family support to take them to doctors' appointments or to take them home after surgeries.
For those with early detections, death rates fell 30% for whites and 13% for blacks over the 20-year period. Those with more advanced cancer had death rates fall 48.5% for whites and 34% for blacks. The most advanced cancers showed the greatest disparity: 32.6% for whites and 4.6% for blacks. The study was published by the American Cancer Society in the Journal of Clinical Oncology.
An accompanying editorial suggested several reforms. First is the universalization of colon screening, as it has been adopted in 22 states. Second is a greater emphasis on clinical trials for new cancer drugs, which have generally been withheld from poorer patients. Third is an expanded use of "patient navigators," or cancer-ward concierges, who assist otherwise often-neglected poorer patients.
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