Black patients with head and neck cancers have twice the death rates of white patients, and a new study suggests race itself underlies those differences.
“What is unique about our study is it strongly supports the conclusion that Black patients seem to respond to therapy differently than white patients,” said study author Dr. Jeffrey Liu. He is an associate professor in the division of head and neck surgery at Fox Chase Cancer Center and the Lewis Katz School of Medicine at Temple University, in Philadelphia.
Past research has found that factors such as economic status and access to health care also contribute to these issues.
For this study, the researchers used data from a clinical trial by the nonprofit Radiation Therapy Oncology Group. Patients in such a trial are by design similar for factors such as age, health status and cancer stage. Once enrolled, they also receive largely the same cancer care, which is not true in the general population where access and quality of care can vary.
For this study, 468 Black head and neck cancer patients were compared with white patients who received the same treatment.
While researchers expected similar outcomes for both groups, in 60% of the matched pairs, white patients had better survival than Black patients, the study found.
“Using self-reported race, we see a difference in how these groups respond to the same treatment,” Liu said in a cancer center news release.
Race is a social construct rather than biological, he noted, so it can be imperfect for grouping patients, but will continue to be used until precision medicine advances to the point where it will be possible to use a patient’s genetic profile in research.
“The bottom line is that people are different,” Liu said. “When you put together groups of patients, however imperfect the grouping, some people may be less responsive to therapy than others. Our next steps are to try to understand why this is the case.”
Jeffrey C Liu et al, Racial Survival Disparities in Head and Neck Cancer Clinical Trials, JNCI: Journal of the National Cancer Institute (2022). DOI: 10.1093/jnci/djac219
The U.S. National Cancer Institute has more on head-and-neck cancers.
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