27 Apr Black Patients Less Likely to Be Treated with Proton Beam Therapy Than White Counterparts
MedicalResearch.com Interview with:
Leticia Nogueira, PhD, MPH
Senior Principal Scientist, Health Services Research
American Cancer Society, Inc.
Kennesaw, GA 30144
MedicalResearch.com: What is the background for this study?
Response: Proton Beam Therapy (PBT) can deliver higher dose of radiation to the tumor with less damage to surrounding healthy cells. Therefore, PBT is potentially superior to photon-based radiation therapy to treat tumors with complex anatomy, surrounded by sensitive tissues, or for treating childhood cancer (where long-term side effects of radiation therapy are a main concern). However, PBT can cost twice as much as photon-based radiation therapy.
MedicalResearch.com: What are the main findings?
Response: Black individuals were less likely to be treated with Proton Beam Therapy than their white counterparts, especially for cancers for which PBT is the recommended treatment modality according to the American Society for Radiation Oncology (ASTRO). The racial disparity in receipt of PBT was greatest for the two most common childhood cancers in the US (rhabdomyosarcoma and central nervous system cancers).
Matching on socioeconomic status or health insurance coverage type did not eliminate the disparities.
As the number of facilities offering PBT in the US increased, so did the racial disparity in receipt of PBT. Therefore, increasing availability of therapeutic advances without addressing structural determinants of racial disparities can worsen, instead of ameliorate, racial disparities in receipt of quality cancer treatment.
MedicalResearch.com: What should readers take away from your report?
Response: Black individuals continue to have worse access to quality cancer care in the US. Modifiable factors other than availability of new therapeutic options need to be addressed to eliminate racial disparities in cancer care and outcomes.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Future research should evaluate the contribution of oncology referral patterns, provider intrinsic bias, and institutions’ policies and practices (e.g. provision of transportation services, clinical trial enrollment practices, etc.) to racial disparities in receipt of quality cancer care.
Nogueira LM, Sineshaw HM, Jemal A, Pollack CE, Efstathiou JA, Yabroff KR. Association of Race With Receipt of Proton Beam Therapy for Patients With Newly Diagnosed Cancer in the US, 2004-2018. JAMA Netw Open. 2022;5(4):e228970. doi:10.1001/jamanetworkopen.2022.8970
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