【R7】 DOCTORS HAVE LONG KNOWN THAT LUNG CANCER,WHICH KILLS 160,000 AMERICANS EACH YEAR,TAKES A HEAVIER TOLL AMONG BLACK AMERICANS,PARTICULARLY BLACK MEN,THAN AMONG WHITES. 【R6】______IT ALSO HAS TO DO WITH DIFFERENCES IN INCOME AND ACCESS TO MEDICAL CAR E. BUT THERE HAS ALWAYS BEEN A LINGERING SUSPICION THAT SOME OF THE GAP MIGHT BE DUE TO EITHER OVERT OR SUBCONSCIOUS DISCRIMINATIO N. A STUDY IN LAST WEEK'S NEW ENGLAND JOURNAL OF MEDICINE APPEARS TO SUPPORT THAT DISTURBING CONCLUSIO N. 【R7】______EVEN SO,ABOUT 20% OF LUNG-CANCER PATIENTS ARE FOUND TO HAVE A TUMOR WHOSE BIOLOGICAL CHARACTERISTICS AND SMALL SIZE GIVE THEM A GOOD CHANCE OF BEING CURED IF THE MALIGNANT GROWTH IS SURGICALLY REMOVE D. RESEARCHERS AT THE MEMORIAL SLOAN, KETTERING CANCER CENTER IN NEW YORK CITY LOOKED AT DATA FROM MORE THAN 10,000 WHITE AND BLACK MEDICARE PATIENTS WHOSE TUMORS WERE FOUND EARLY ENOUGH TO MAKE THEM CANDIDATES FOR SURGERY. ABOUT 77% OF THE WHITE PATIENTS UNDERWENT THE PROCEDURE,COMPARED WITH 64% OF BLACKS. THE DIFFERENCE WAS SUFFICIENTLY LARGE TO REDUCE THE OVERALL SURVIVAL RATE FOR BLACK PATIENTS TO 26% AFTER FIVE YEARS,COMPARED WITH 34%FOR WHITES. 【R8】______ 'PEOPLE ARE DYING NEEDLESSLY, 'SAYS DR. PETER BACH OF MEMORIAL SLOAN-KETTERIN G.WHO LED THE STUDY. HE SUSPECTS 'SOME COMBINATION OF THE PROCEDURE NOT BEING OFFERED OR PUSHED BY DOCTORS, AND PATIENTS NOT ACCEPTING IT.' 【R9】______SO GETTING THE WORD OUT THAT THERE IS A PROVEN TREATMENT COULD HELP CLOSE THE GAP. IT'S ALSO VITAL FOR DOCTORS AND PATIENTS TO MAKE SURE THEY UNDERSTAND EACH OTHER. BETTER COMMUNICATION WILL BE EVEN MORE IMPORTANT AS TREATMENTS BECOME MORE COMPLEX. CURRENTLY THERE'S NO SCREENING TEST FOR FINDING LUNG CANCER EARLY.(CHEST X RAYS ALMOST ALWAYS CATCH IT TOO LAT E.)BUT DR. CLAUDIA HENSCHKE OF THE WEILL MEDICAL COLLEGE AT CORNELL UNIVERSITY AND HER COLLEAGUES BELIEVE THEY HAVE FOUND A WAY TO IDENTIFY VERY SMALL TUMORS WITH LOW-DOSE CAT SCANS. 【R10】______.