Impact of age at diagnosis on racial disparities in endometrial cancer patients

Tarney, Christopher M.; Tian, C.; Dubil, E.A.; Bateman, Nicholas W.; Chan, J.K.; Elshaikh, M.A.; Cote, M.L.; Schildkraut, Joellen M.; Conrads, Thomas P.; Hamilton, Chad A.; Maxwell, George L.; Darcy, Kathleen M.

doi:10.1016/j.ygyno.2018.04.307

Cited by 8 publications

(14 citation statements)

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“…About 41% of uterine corpus cancers are diagnosed at a regional or distant stage in black women, compared with 27% in white women. Agressive histologic subtypes, including uterine serous cancer and uterine carcinosarcoma, are more common in black women than white women, particularly among women aged 50 and older …”

Section: Selected Findingsmentioning

confidence: 99%

Cancer statistics for African Americans, 2019

DeSantis

Miller

Sauer

et al. 2019

CA A Cancer J Clinicians

633

555

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In the United States, African American/black individuals bear a disproportionate share of the cancer burden, having the highest death rate and the lowest survival rate of any racial or ethnic group for most cancers. To monitor progress in reducing these inequalities, every 3 years the American Cancer Society provides the estimated number of new cancer cases and deaths for blacks in the United States and the most recent data on cancer incidence, mortality, survival, screening, and risk factors using data from the National Cancer Institute, the North American Association of Central Cancer Registries, and the National Center for Health Statistics. In 2019, approximately 202,260 new cases of cancer and 73,030 cancer deaths are expected to occur among blacks in the United States. During 2006 through 2015, the overall cancer incidence rate decreased faster in black men than in white men (2.4% vs 1.7% per year), largely due to the more rapid decline in lung cancer. In contrast, the overall cancer incidence rate was stable in black women (compared with a slight increase in white women), reflecting increasing rates for cancers of the breast, uterine corpus, and pancreas juxtaposed with declining trends for cancers of the lung and colorectum. Overall cancer death rates declined faster in blacks than whites among both males (2.6% vs 1.6% per year) and females (1.5% vs 1.3% per year), largely driven by greater declines for cancers of the lung, colorectum, and prostate. Consequently, the excess risk of overall cancer death in blacks compared with whites dropped from 47% in 1990 to 19% in 2016 in men and from 19% in 1990 to 13% in 2016 in women. Moreover, the black‐white cancer disparity has been nearly eliminated in men <50 years and women ≥70 years. Twenty‐five years of continuous declines in the cancer death rate among black individuals translates to more than 462,000 fewer cancer deaths. Continued progress in reducing disparities will require expanding access to high‐quality prevention, early detection, and treatment for all Americans.

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Section: Selected Findingsmentioning

confidence: 99%

Cancer statistics for African Americans, 2019

DeSantis

Miller

Sauer

et al. 2019

CA A Cancer J Clinicians

633

555

View full text Add to dashboard Cite

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“…Additionally, we also looked at the time interval between hysterectomy and the initiation of adjuvant RT, a factor that is reported to be a significant predictor of cancer recurrence [24] in women with EC. As some investigators reported that disparities in outcome between races in women with EC were mostly in younger woman [25], we also incorporated age as a matching requirement between the 2 groups. Finally, we also incorporated the year of hysterectomy as a variable in the matching process to account for recent advances in surgical techniques [26].…”

Section: Discussionmentioning

confidence: 99%

A Matched Analysis on the Prognostic Impact of Race on Survival Endpoints of Women with Early-Stage Endometrial Cancer

Feldman

Chaugle

Burmeister

et al. 2018

Gynecol Obstet Invest

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Objective: To compare survival endpoints between African American (AA) and non-AA (NAA) women with endometrial carcinoma (EC) stage I–II using a robust matching analysis. Methods and Materials: Patients were matched by stage, grade, adjuvant management (surveillance, vaginal brachytherapy or pelvic radiation treatment), age, and year of hysterectomy. Recurrence-free survival (RFS), disease-specific survival (DSS) and overall survival (OS) were calculated. Results: A total of 758 patients were included. Body mass index and Age-Adjusted Charlson comorbidity index was significantly higher in AA compared to NAA women. There were no significant differences between the AA and NAA groups in regard to 5-year RFS (94 vs. 93%), DSS (96 vs. 98%) or 5-year OS (90 vs. 92%). On multivariate analysis of survival endpoints for the entire study cohort, it was found that race (AA vs. NAA) was not a significant predictor of RFS, DSS, or OS. Grade 3 tumors and the presence of lymphovascular space invasion (LVSI) were the only 2 independent predictors of RFS and DSS, while age-adjusted Charlson comorbidity score, grade 3, stage II and the presence of LVSI were independent predictors of shorter OS. Conclusions: When matched based on the tumor stage, grade, adjuvant treatment, age, and year of surgery, our study suggests that there is no statistically significant difference in any survival endpoints between AA and NAA women with early-stage EC. Based on these data, disparities in outcome likely do not stem from uterine cancer-related causes. The increased comorbidity burden in AA women is likely a factor contributing to the racial disparity in endometrial cancer.

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“…Type II tumors represent 10–15% of endometrial cancers, they are high‐grade carcinomas, mainly serous and clear cell histologies and they show a poor prognosis . Type II endometrial cancers are more likely to be diagnosed at older ages and this association is stronger in black patients . Incidence rates for Type II cancers are typically higher among black or African American women and lower among Hispanic women compared to Caucasian .…”

Section: Natural History Of Endometrial Cancermentioning

confidence: 99%

“…Type II endometrial cancers are more likely to be diagnosed at older ages and this association is stronger in black patients . Incidence rates for Type II cancers are typically higher among black or African American women and lower among Hispanic women compared to Caucasian . Consequently, black women with endometrial cancer have higher mortality, and their tumors tend to be enriched with TP53 mutations (see “Molecular alterations in endometrial precursor lesions”).…”

Section: Natural History Of Endometrial Cancermentioning

confidence: 99%

New perspectives on screening and early detection of endometrial cancer

Costas

Frias-Gomez

Guardiola

et al. 2019

Intl Journal of Cancer

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Due to the anatomical continuity of the uterine cavity with the cervix, genomic exploitation of material from routine Pap smears and other noninvasive sampling methods represent a unique opportunity to detect signs of disease using biological material shed from the upper genital tract. Recent research findings offer a promising perspective in the detection of endometrial cancer, but certain questions need to be addressed in order to accelerate the implementation of novel technologies in a routine screening or clinical setting. We discuss here new perspectives on detection of endometrial cancer using genomic and other biomarkers in minimally invasive sampling methods with a special focus on public health classic screening criteria, highlighting current gaps in knowledge.

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Impact of age at diagnosis on racial disparities in endometrial cancer patients

Cited by 8 publications

References 0 publications

Cancer statistics for African Americans, 2019

Cancer statistics for African Americans, 2019

A Matched Analysis on the Prognostic Impact of Race on Survival Endpoints of Women with Early-Stage Endometrial Cancer

New perspectives on screening and early detection of endometrial cancer

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