Black children enrolled in national clinical trials are three times less likely to receive proton radiotherapy than white children, according to research published August 6 in JAMA Oncology.
A team of researchers led by Dr. Danielle Bitterman of Brigham and Women's Hospital in Boston retrospectively analyzed data from children enrolled in prospective trials from the Children's Oncology Group between 2010 and 2018. Of the 1,240 patients, approximately 85% received photon therapy and 15% received proton radiotherapy.
Even after adjusting for confounding variables such as the location of enrolling institution, distance to radiotherapy facility, and the presence of metastatic disease, the researchers found that Black patients were significantly less likely to receive proton radiotherapy compared with non-Hispanic white patients (odds ratio, 0.35; p = 0.004). Previous studies have shown that proton radiotherapy is just as effective and may have a lowered incidence of long-term side effects compared with other forms of radiation therapy, according to the authors.
"Future research should drill down on whether and how geography contributes to disparities, as this could guide more ethical distribution of high cost technologies," said senior author Dr. Daphne Haas-Kogan in a statement. "And, perhaps most importantly, healthcare provider bias and racism may influence referral and treatment patterns for high cost medical treatments. This needs to be measured, recognized, and addressed in order to narrow the glaring healthcare disparities in our country."