Endometrial cancer: Stage at diagnosis and associated factors in black and white patients

Analysis of racial differences in incidence, survival, and mortality for malignant tumors of the uterine corpus

“…Conclusions regarding the relative contributions of clinical and biologic factors to the less favorable outcome experienced by blacks vary. [5][6][7][8][9][10][11][12][13][14][15] Although several studies have found that the symptomatic period before presentation or treatment is similar for blacks and whites, 10,12,20 additional studies evaluating possible racial disparities in health care access, diagnosis, and treatment are needed.…”

“…1,2,4 The higher incidence of endometrioid adenocarcinoma among whites compared with blacks accounts for the higher overall incidence of endometrial carcinoma among whites. Data demonstrating that blacks tend to present with more advanced-stage disease [5][6][7][8][9][10][11][12][13][14] and receive less aggressive treatment 8 than do whites suggest that providing blacks with improved health care could reduce their endometrial cancer mortality. Nonetheless, worse survival for blacks with readily curable forms of endometrial carcinoma may not account entirely for the racial disparity in mortality.…”

“…[7][8][9][10][11][12]15,16 Studies also suggest that the etiology and pathogenesis of some aggressive types of endometrial carcinoma differ from those of the most common type of endometrial carcinoma, endometrioid adenocarcinoma. 4,17 Specifically, pure serous carcinoma appears to develop from atrophic, rather than hyperplastic, epithelium and may not be associated with typical risk factors for endometrial malignancy.…”

Theories of Endometrial Carcinogenesis: A Multidisciplinary Approach

“…Data from the population-based Surveillance and Epidemiology End Results Program indicate that incidence rates are 60% higher among whites, whereas mortality is 30% higher among African Americans (4). It is unclear whether these mortality data reflect interracial differences in diagnosis and treatment or an unexplained tendency for African Americans to develop aggressive tumors that are disproportionately high grade, often contain p53 abnormalities, and frequently are serous or clear cell in type (5)(6)(7)(8). Because population-based screening programs for endometrial carcinoma have not been developed in the United States, our knowledge of the frequency and natural history of endometrial cancer precursors is limited.…”

Racial disparities in histopathologic characteristics of uterine cancer are present in older, not younger blacks in an equal-access environment

“…The American Cancer Society estimated that 43,470 new cases of and 7950 deaths from endometrial cancer would occur during 2010 [1]. While uterine cancer incidence rates are lower among Black women than White women, [2] Blacks are more often diagnosed with aggressive histologic subtypes, advanced tumor stages, and/or higher tumor grades, and they suffer a correspondingly worse prognosis [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Indeed, the disease-specific mortality rate for Black women is nearly double that endured by White women [2].…”