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The Making of Medicine

Racial Disparities in Access to Vital Cancer Treatment

New research from our Rajesh Balkrishnan, PhD, shows that minorities with the most common form of lung cancer often face significantly longer waits to access lifesaving radiation therapy compared with white patients.

Professor Balkrishnan and his collaborators examined data collected across the United States from more than 222,700 patients with non-small cell lung cancer. The mean time to radiation initiation for white patients was 60.9 days. But the wait was longer for Black patients, 65.9 days. And the disparity was even worse for Asian patients: 71.9 days.

The differences may not seem huge, but they can be the difference in life and death: A one-week delay in treatment has been associated with a 3.2% and 1.6% increase in the risk of death for patients with stage I and stage II non-small cell lung cancer, respectively.

Professor Balkrishan and his team say there may be multiple factors contributing to the racial disparities. Non-white patients are more likely to be uninsured and often face greater barriers to care, the researchers say. Doctors also may perceive them as being at risk for not following through with their treatment plans. (In general, minorities are more likely to report less satisfaction with their encounters with doctors and other care providers.)

“These findings shed light on the potential presence of and impact of structural racism on patients seeking cancer treatment,” the researchers write in a paper in the scientific journal Health Equity. “Further investigation into the societal determinants that perpetuate disparity in time to radiation therapy, and potential interventions in the clinical setting to improve cultural and racial sensitivity among healthcare professionals, is recommended.”

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