Reuters Health Information (2011-04-29): Blacks with liver cancer get fewer transplants
Blacks with liver cancer get fewer transplants
Last Updated: 2011-04-29 15:12:17 -0400 (Reuters Health)
NEW YORK (Reuters Health) - African Americans with liver cancer are less likely than whites to get a transplant for the disease, according to U.S. researchers.
And the gap hasn't changed in a decade, they reported March 29th in the journal Cancer.
Although there are probably several reasons for the disparity, Dr. Anthony Robbins of the American Cancer Society told Reuters Health he thinks "the biggest driver is the difference in access to care at the early stages of the disease due to health insurance. And that needs to change."
"This treatment is expensive, high tech and on the rise -- just the kind of perfect storm that leads to a disparity in care," Dr. Robbins, who worked on the new study, told Reuters Health.
For the new study, Dr. Robbins and his colleagues tapped into U.S. hospital records on more than 7,700 patients diagnosed with hepatocellular carcinoma between 1998 and 2007.
Over the first half of the study period, white liver cancer patients had a 30% chance of receiving a new liver, compared to only 15% for blacks.
While the chances climbed somewhat during the next five years, the disparities remained. Taking into account how soon the patients died -- some might have died before they could get a new liver, for instance -- blacks were 36% less likely than whites to undergo the surgery.
They were also 36% more likely to die within five years of their diagnosis. Once transplant centers put black patients on the waiting list for a liver, however, the gap closed and they face the same survival odds as whites.
Dr. Robbins said the medical community has known for years about the inequity in care between blacks and whites.
"After an intense effort to try to fix things and lots of thought and sensitivity to this issue, the disparity hasn't gone away," he said.
The average cost of surgery plus first year medical bills amounts to nearly $450,000.
The study also compared Asians and Hispanics to whites. There was little difference in rates of liver transplants between whites and Hispanics. Asians had only a 19% chance of getting a new liver in the first half of the study, and a 24% chance in the following five years.
While that was much lower than whites, their disease tended to be less devastating and likely did not require a transplant in the first place, the researchers say.
Dr. Andre Dick, a transplant surgeon at Seattle Children's Hospital who was not involved in the study, said the new research is important.
"This makes people aware that it's getting to that waiting list that's important and that's where the real disparities are still showing up," he told Reuters Health. "And how the question is, how do we overcome them?"