Black people more likely to exhaust financial resources for cancer therapy than whites: Study

By Dr. Ananya Mandal, MDApr 26 2011

In a new study published online in the journal Cancer, it was said that when faced with life-threatening cancer, minority patients like blacks may be more likely to drain their bank accounts to extend life than whites.

The researchers at the University of Alabama at Birmingham conducted phone interviews with 4,214 patients participating in the Cancer Care Outcomes Research and Surveillance (CanCORS) study. All the participants were newly diagnosed with lung or colon cancer. Researchers asked patients how willing they were to trade personal financial resources for life-prolonging cancer treatment, or would they rather receive treatment that would cost them less but not allow them to live as long.

They found that 80 percent of blacks were willing to exhaust all resources to extend life, compared to 72 percent of Asians, 69 percent of Hispanics and just 54 percent of whites. The biggest difference was between whites and blacks: Blacks were 2.4 times more likely than whites to exhaust personal finances to live longer. Hispanic patients were 1.45 times more likely and Asian patients were 1.59 times more likely to expend all personal financial resources than white patients. The results were adjusted for such variables as income, age, disease stage and expected time left to live.

The study also showed that besides ethnicity there are other factors that made patients more likely to spend more to prolong life. These factors are being younger, having fewer dependents, being divorced or separated, believing that life was in God's hands and having a higher level of social support.

Michelle Martin, the study's lead investigator, adding that, based on her data, she could not say whether the findings extended to other terminal diseases besides lung and colon cancer, “Any speculation as to why this is would be guessing…The reasons behind these preferences are complex, and require further study.”

“As new cancer-treatment options emerge, patients are asked to make complex decisions that often involve trade-offs between quality and quantity of life,” Martin said. “A key tenet of delivering high-quality, patient-centered care is understanding and respecting patients' treatment decisions. Our results highlight the fact that personal finances can influence the decisions patients make about their treatment.”

She cited other studies that showed that minorities receive more aggressive care at the end of life, and suspected that those findings may be consistent with hers. “They may reflect patient preferences,” she said. She added that these findings may help health-care providers better tailor cancer treatment to patients' wishes.

“The next step is to obtain an in-depth understanding of the factors that influence treatment preferences,” she said. “Future work could broaden the factors that we examine, and time spent with cancer patients in conversation about their experience and treatment preferences will help us better deliver cancer care that reflects those,” Martin concluded.