Mortality Rates After Cancer Surgery Decrease, but Racial Disparities Remain

Using national Medicare data, researchers examined the trends in mortality rates from 2007–2016 in 870,929 Black and White patients who had undergone surgery for colorectal, bladder, esophageal, kidney, liver, ovarian, pancreatic, lung, or prostate cancer. They found that survival rates improved by 0.12% and 0.14% per year in Black and White patients, respectively.

However, prior studies have demonstrated that mortality rates are higher among Blacks than Whites, so the researchers said that the equal decline in rates for both groups meant the racial gap in outcomes did not shrink.

“These findings offer mixed news for policymakers regarding possible reductions in racial disparities following cancer surgery,” the researchers said (https://doi.org/10.1001/jamanetworkopen.2020.27415). “Even though policies designed to improve cancer surgery outcomes are working better for all patients, none of them have been specific enough to close the gap in mortality between Blacks and Whites. It’s possible that part of the gap may be due to upstream and/or downstream issues from the surgery itself, such as late referrals which may lead to late presentation at time of surgery, fragmented follow-up after discharge, and limited resources in the community, and that different policies and interventions may be needed to address disparities in cancer surgery.”