Dr. Cary Gross (on the right in photo ) is an internist at the Yale Cancer Center, Yale School of Medicine. He and his team studied the records of more than 140,000 cancer patients from 1992 to 2002, looking at the treatment of black and white patients with four common types of cancer. He is lead author on the article, "Racial Disparities in Cancer Therapy" that appeared in the Jan. 7 issue of the journal Cancer.

Click here to read the study.

"An optimist could think that making our society aware of racial inequities could be enough to start the ball rolling and reduce disparities," he said, "but what we found is that between 1992 and 2002 there was virtually no change in the racial disparities in cancer care."

They studied patients with breast, lung, colorectal and prostate cancer. They found that the level of disparities varied widely, based on the type of cancer.

"For me, this is one of the more important findings of our study," Gross said, because it points the way to possible reduction of those disparities. For example, the study found there was a 15 percent difference between black and white patients when it came to getting surgery for lung cancer, but only a 2 percent racial disparity regarding chemotherapy for breast cancer. Gross said these differences warranted further study.

The researchers included only those patients covered by Medicare and those who had access to a physician before their diagnosis. But Medicaid coverage includes some level of cost-sharing by the patients, which was more affordable for some than for others. "About 50 percent of the costs [of cancer treatment] aren't covered by Medicare," said fellow researcher, Martin Anderson (pictured above with Gross). "That includes the cost of traveling to and from the clinic, then there's a 20 percent co-pay on chemotherapy, and other things.

Click here to hear more about disparities from Gross, such as inability to take time off from work to go for treatment, and living in high-crime, high stress neighborhoods with more toxic pollution.

Gross said their study period ended in 2002, but since then there have been new efforts to reduce disparities, such as the Patient Navigator program that helps patients make their way through the medical system. Such programs are funded by the National Cancer Institute.

Gross agreed that poor communication between doctors and patients can be a problem, along with a lack of trust. "Some members of the minority community may be less likely to trust physicians and trust the health care system. This really could be a self-perpetuating cycle -- that racial disparities exist, and an African American might think, 'Well, I've been reading in the news for 20 years that there are racial disparities. If I go to the doctor, will I get the care I need?' And maybe that will make some people less likely to seek care."

Anderson added, "There's also a legitimate historical concern as well. The Tuskeegee experiment [in which poor black men with syphilis were allowed to die so health researchers could observe the course of the disease] is notorious, and the legacy of that experiment may still persist, in attitudes toward physicians."

Previous studies have shown similar disparities in cancer treatment, but, Anderson added, "It's the first one to look at time trends in those disparities, and the first one to have the benefit of bracketing an important publication by the Institute of Medicine, called The Unequal Burden of Cancer, that came out in 1999."