Records were examined from over 200,000 Medicare beneficiaries treated for cancer between 1998 and 2002, in this comparison of mortality among African-American and Caucasian cancer patients and evaluation of the influence of attendance at a National Cancer Institute (NCI)-designated comprehensive or clinical cancer centre. Across all cancer care settings within the study population, the likelihood of 1-year all-cause and cancer-specific mortality was 13% higher for African Americans than for Caucasians; at 3 years, the risk had increased to 23%. By cancer site, cancer-specific mortality was higher among African Americans at 1 year for breast and colorectal cancers and for all cancers at 3 years. However, NCI cancer centre attendance was associated with significantly lower odds of mortality for African Americans (1-year OR 0.63; 3-year OR 0.71). Notably, there were no significant differences in mortality by race among those who attended NCI cancer centres.
