Source: nytimes.com
Author: Roni Caryn Rabin

African-American patients with head and neck cancers die earlier than whites, and researchers say they have made a breakthrough in understanding the underlying reasons for the racial gap.

After scientists at the University of Maryland noticed that whites treated at their hospital for squamous cell head and neck cancers lived more than twice as long as black patients who received the same care at their hospital, they took a closer look. Further analysis revealed that the gap was almost entirely due to differences in survival among patients with cancer of the throat and tonsils, or oropharyngeal cancer.

The scientists were also involved in analyzing specimens of head and neck tumors taken from participants in a treatment trial called the TAX 324 study, to see how many tumors were linked to the human papillomavirus, the same HPV-16 virus that has been linked to cervical cancer.

The results were striking: they found that patients whose tumors were HPV-positive did much better after treatment than patients who were negative for the virus. Yet while half of the throat cancer patients had HPV-positive tumors, 98 percent of the positive tumors were from white patients, while a vast majority of black patients had HPV-negative tumors.

“There was no difference in the survival between black and white patients in the TAX 324 trials, if you subtracted out the HPV-positive patients,” said Dr. Kevin Cullen, the senior author of a paper published online by the journal Cancer Prevention Research. White patients who were HPV-negative fared as poorly as the HPV-negative blacks, he said.

Experts say the challenge for doctors now is to explore new treatments for HPV-negative patients, whether black or white.