A University of Toronto study reveals that 71% of Black cancer patients are more likely to experience heart damage after chemotherapy than White patients. Photo by Linda Bartlett/National Cancer Institute
April 14 (UPI) — While racial disparities in healthcare have long been documented, a new study reveals that 71% of Black cancer patients are more likely to experience heart damage after chemotherapy than White patients.
The data from the chemotherapy research was presented at the American College of Cardiology’s Advancing the Cardiovascular Care of the Oncology Patient 2023 conference, which began Friday in Washington, D.C..
Ethnic disparities in healthcare were laid bare during the COVID-19 pandemic, as medical professionals struggled to deal with access. That led to treatment and outcome differences between ethnicities during the height of the crisis.
For the study, scientists performed a systematic search of databases for studies reporting on cardiovascular toxicity in cancer patients of different racial and ethnic backgrounds who received chemotherapy.
In all, researchers screened 7,057 studies and selected 24 that represented 683,749 participants for a final review. In those, the Black race or African ancestry was associated with a 71% increased chance of chemotherapy-associated cardiotoxicity compared to White patients.
Black people also had increased likelihood of a congestive heart failure diagnosis, according to the study’s authors.
“These results may reflect the direct effects of racism, particularly structural racism, which leads to worse determinants of health for Black patients,” Wondewossen Gebeyehu, a medical student at the University of Toronto and lead author of the study, said in a press release.
“It is well-documented that most healthcare settings are not perceived as safe by Black patients, which may increase their vulnerability to disease and decrease opportunities for preventative care, Gebeyehu said.
“Furthermore, decreased representation of Black patients in clinical trials may lead to treatments being developed that are not as effective or that may be riskier for Black patients.”
Chemotherapy can increase the risk of treatment-related heart damage, including heart failure and cerebrovascular disease. Cardiotoxicity is any heart damage stemming from cancer treatment or drugs, including chemotherapy agents and radiation.
Cardiotoxicity can lead to numerous heart problems, including heart failure, cardiomyopathy and irregular heart rhythms.
Certain cancer treatments have a higher risk of causing cardiotoxicity, including anthracyclines, used for treating leukemias, lymphomas, and cancers of the breast, stomach, uterus, ovary and lung.
“In this case, one could have expected that the differences would be minimal since it is the chemotherapy that is injuring the heart, and we would expect the same chemotherapy to be given to Black and non-Black patients with a given cancer,” Gebeyehu said.
“However, this systematic review indicates that the inequalities in health outcomes extend to the odds of cardiotoxicity after cancer treatment,” he said.
“The most important message for patients is that they should not avoid chemotherapy, as the most important thing is making sure they get the best cancer treatment possible, and studies already show Black patients may get less optimal cancer treatments.”
He said healthcare professionals need to understand the disparities to have more conversations around reducing the cardiovascular risk associated with chemotherapy, adding that additional targeted efforts should cater to groups at higher risk.