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African Americans half as likely to receive surgery for esophageal cancer

Alexandria, VA-- African Americans with esophageal cancer are half as likely as whites to be seen by a surgeon and to receive life-prolonging surgery, a new study shows. The study, which examined racial disparities in access to surgical evaluation, receipt of surgery, and survival among older patients with esophageal cancer, found that only 25% of African-American patients received potentially curative surgery, compared to 46% of white patients. The study will be published in the January 20 issue of the Journal of Clinical Oncology (JCO).

"Our study showed that black patients are less likely to be seen by a surgeon, and if seen, less likely to undergo surgery," said Ewout W. Steyerberg, PhD, Center for Clinical Decision Sciences, Department of Public Health, Erasmus MC, Rotterdam, The Netherlands, and lead author of the study. "We were particularly surprised by the two-fold difference in rate of surgery, which may explain why African Americans experience a lower rate of survival."

Researchers reported that African Americans were generally undertreated for their disease. Twenty percent of African-American patients received radiotherapy as their only treatment and 26% received no therapy at all, compared to 13% and 15% of white patients, respectively.

Surgery is the most common form of treatment for esophageal cancer. Although the disease typically has a poor prognosis, almost 20% of patients with locoregional esophageal cancer survive at least five years after surgery. In 2004, approximately 14,250 new cases of esophageal cancer were diagnosed in the United States, and an estimated 13,300 people died of the disease. Esophageal cancer is nearly three times more common among men than women, and three times more prevalent among blacks than whites. The overall five-year relative survival rate of people with esophageal cancer is 14%.

Researchers at the Dana Farber Cancer Institute in Boston reviewed the Medicare records of 2,946 non-Hispa
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