Black/White differences in cancer survival persist. Factors shown to be differentiallyrelated to survival, and to differ by race, include the extent of disease present at diagnosis,disease classification or tumor histology, and host vulnerability. It is suggestedthat efforts to reduce this survival differential generally have been unsuccessful due toa failure to accurately identify the sources of this differential. Differences in the extentof disease present at diagnosis, for example, may not be a function of failure to seekphysicians or dollars spent on health care, but may be due to differences in the natureof health care provided. Similarly, differences in socioeconomic status, lifestyle characteristics,and occupational exposures between blacks and whites may be correlatedwith histologic differences and the level of host vulnerability. Differences in relativesurvival rates are viewed as resulting largely from structural sources. Some mecha

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