Many U.S. cancer patients are getting delayed or substandard care for their disease and are dying earlier as a consequence, according to several studies released on Sunday.

Doctors treating black women with breast cancer, for instance, wait on average three months longer to test them and begin treatment for their cancer than they do for white women, according to one study.

Another study found that about half of patients with stomach cancer had their tumors and surrounding lymph nodes completely removed - and this varied greatly by region.

And a systematic survey of breast and Colon cancer care found many breast and colon cancer patients do not get the full recommended care.

Sherri Sheinfeld Gorin of Columbia University in New York and colleagues checked the records of nearly 50,000 women over the age of 64 with breast cancer.

Nearly 27 percent of black women had a three-month delay in the time it took to first have a suspect mammogram or lump biopsied for cancer, and then surgery to take it out, compared with 17 percent of Hispanic women and 15 percent of white women, Gorin told a meeting of the American Society of Clinical Oncology.

“A delay of two months can reduce five-year survival by 10 percent to 15 percent,” said society President Dr. David Johnson.

Dr. Beverly Moy of Massachusetts General Hospital in Boston said her study may help explain why. She interviewed 49 women in-depth and found many black women were fatalistic about having breast cancer.

DEATH AS INEVITABLE

“In African-American women, for example, one thing that came out consistently was ‘Why bother with screening because once I have got breast cancer, I’ll probably die,”’ Moy said in an interview. Others felt their health was not a priority.

Hispanic women complained U.S. hospital staff were “cold” and uncaring, so they avoided hospitals, Moy said.

But even when treatment starts, some cancers are not being handled aggressively, other researchers found.

Dr. Natalie Coburn of Princess Margaret Hospital in Toronto, Canada, and colleagues surveyed the records of 10,000 patients with stomach cancer, which affects nearly 22,000 Americans a year and kills more than 11,500.

There are guidelines from specialty cancer societies for treating cancer - gastric cancer patients are supposed to have the entire cancerous area removed and 15 nearby lymph nodes taken out and tested to ensure the cancer has not spread.

On average, doctors checked nine lymph nodes per patient and only 32 percent of patients got the recommended full extent of surgery and lymph node removal.

In the regions where doctors followed the guidelines more closely, patients were 30 percent more likely to survive five years or more after surgery, Coburn found.

Dr. Ezekiel Emanuel of the National Cancer Institute and chair of the society’s task force on quality care surveyed records of 1,700 patients in five cities and found that 86 percent of the time breast cancer patients got all the correct recommended treatments and follow-up, while Colorectal cancer patients did 78 percent of the time.

The percentage of patients with stage 2 or 3 rectal cancer getting lifesaving radiation treatments ranged from 52 percent in one city to 92 percent in another.

Only 29 percent of breast cancer patients got the recommended full schedule of chemotherapy in one city, and the best city scored 79 percent, which Emanuel called “quite distressing.”

“It’s quite clear that we are not doing well enough,” Emanuel told the news conference.