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Disparities: Medicare Credited for Closing Gap

By John O’neil
New York Times, May 20, 2003

Black women die of breast cancer at higher rates than white women with comparable tumors, but the gap disappears among women old enough to qualify for Medicare, according to a study released yesterday.

The study's authors suggested that the findings indicated that access to treatment rather than differences in biology probably played a bigger role in the higher death rate for black women than previous research had found.

The study also found that later-stage breast cancer was more likely to be diagnosed in black women of all ages, leading the researchers to call for greater efforts to increase screening and follow-up.

For the study, which will be published in the June issue of the journal Cancer, the researchers analyzed data collected on more than 110,000 breast cancer cases in 11 states and cities over seven years.

The study's lead researcher, Dr. Kenneth C. Chu of the National Cancer Institute, said that the survival gap between younger women was significant. For Stage 3 tumors — large ones that may have spread to the lymph nodes — 60 percent of white patients were still alive at six years while only 37 percent of black patients were.

He noted that other studies over the last 20 years had found that while survival rates had improved significantly, those gains had been spread unevenly.

Census Bureau figures found that in 2001, nearly 20 percent of black Americans were uninsured, compared with 10 percent of non-Hispanic whites, Dr. Chu said. Because fewer than 1 percent of blacks older than 65 reported being without insurance, he said, the figure for younger blacks had to be higher. The study concluded that "widely available health insurance may help alleviate disparities in treatment."


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