Greater public welfare spending may improve survival for Black cancer patients in the United States, a new study suggests.
The data showed that greater spending was associated with an increase in 5-year overall survival (OS) for Black patients, and this translated to a decrease in Black-White disparities.
These findings are scheduled to be presented at the 2022 ASCO Annual Meeting and were disclosed in a press briefing in advance of the meeting.
The study included data on adults from 13 states who had a new cancer diagnosis between 2007 and 2016. The data were derived from the SEER-18 database. The researchers also looked at state annual spending data from the US Census Bureau.
The study included more than 2.9 million patients with cancer. The results showed that an increase in public welfare spending did not significantly improve 5-year OS for the overall cohort or for the White patients, but there was a significant improvement in OS for Black patients.
A 10% increase in public welfare spending was associated with an 8.6% improvement in 5-year OS for Black patients, a 2.6% improvement for White patients, and a 2.4% improvement for the overall cohort.
“This translates to a significant narrowing of the Black-White disparity,” said lead study author Justin Michael Barnes, MD, of Washington University School of Medicine in St. Louis, Missouri.
In an adjusted analysis, each 10% increase in spending was associated with a 4.55% narrowing of the 5-year OS disparity between Black and White patients.
Similar findings were seen when the researchers looked at specific cancer types. However, data for testicular cancer, thyroid cancer, kidney and renal pelvis cancer, and Hodgkin lymphoma were not reported because there is no Black-White disparity in OS for these cancers.
“I think these data are thought-provoking, but they’re certainly not the end,” Dr Barnes said. “Some sort of public welfare investment seems to be improving oncologic outcomes for some of our most socioeconomically at-risk patients, but we don’t know the specifics. Future work is needed to determine the specific most influential public welfare expenditures.”
Barnes JM, Johnston KJ, Osazuwa-Peters N. State public welfare spending and racial/ethnic disparities in overall survival among adults with cancer. To be presented at ASCO 2022; June 3-7, 2022. Abstract 6509.