Racial disparities in young women with endometrial cancer

Mukerji, B; Baptiste, Caitlin; Chen, Ling; Tergas, Ana I.; Hou, June Y.; Ananth, Cande V.; Neugut, Alfred I.; Hershman, Dawn L.; Wright, Jason D.

doi:10.1016/j.ygyno.2017.12.032

Cited by 46 publications

(39 citation statements)

References 36 publications

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“…These disparities and uneven distribution of major known clinical prognostic factors of survival (e.g. later stage and higher grade of disease) among Blacks are not unique to Florida and have been described in other studies [ 18 – 20 , 27 , 36 , 37 ]. However, the underlying reasons for these differences remain elusive.…”

Section: Discussionsupporting

confidence: 52%

The role of histology on endometrial cancer survival disparities in diverse Florida

et al. 2020

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Background Endometrial cancer (EC) mortality is particularly high among non-Hispanic Blacks and is twice that of non-Hispanic Whites. However, comparisons of EC survival outcomes by race/ ethnicity are often confounded by histology and grade. Here, we analyze EC survival disparities in multiracial Florida with a focus on EC types (1 and 2) and subtypes, defined according to histology and grade. Methods All 27,809 cases of EC diagnosed during 2005-2016 were obtained from the Florida Cancer Registry. Age-standardized, 5-year cause-specific survival by race/ethnicity and histological type were calculated. Fine and Gray competing risk regression was used to estimate subdistribution hazard ratios (sHRs) for associations between risk of death due to EC and potential predictive factors such as histology/grade, age, stage at diagnosis, and insurance. Results Type 2 EC accounted for only 38.7% of all incident EC-cases but 74.6% of all EC-deaths. Blacks were disproportionately affected by type 2 EC (57.6%) compared to Whites, Hispanics, and Asians (35.6%, 37.7%, and 43.0%, respectively). Age-adjusted 5-year survival for types 1 and 2 were 85.3% and 51.6%, respectively; however, there was wide variation within type 2 subtypes, ranging from 60.2% for mixed cell EC to as low as 30.1% for carcinosarcoma. In the multivariable model, Blacks with type 2 EC had a 23% higher risk of death due to EC (sHR: 1.23, 95%CI: 1.12-1.36) compared to Whites. Conclusions Population-based analyses should consider the histological heterogeneity of EC because the less common type 2 EC drives racial/ethnic survival disparities in EC. Black women have a higher proportion of more aggressive histological types and an overall higher risk of death due to EC than Whites. To the extent that some of these histological types may be

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Section: Discussionsupporting

confidence: 52%

The role of histology on endometrial cancer survival disparities in diverse Florida

et al. 2020

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“…Additionally, a number of studies have shown that both non-White women and underinsured women present with more advanced disease at the time of diagnosis. 26,27 Abbreviations: HR, hazard ratio; ITT, intention to treat.…”

Section: Discussionmentioning

confidence: 99%

Association of Neoadjuvant Chemotherapy With Overall Survival in Women With Metastatic Endometrial Cancer

et al. 2020

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“…For example, in an analysis restricted to EC patients with advanced stage or recurrent disease, Maxwell et al (9) reported significantly worse survival among black as compared to white women. In a study of EC patients < 50 years of age with stage I or II disease, black women had a 24% higher risk of death than white women (10). Apart from a higher prevalence of aggressive tumor characteristics (11), other factors, including lower socioeconomic status (12), presence of comorbidities (13), and receipt of less complete treatment among black EC patients could contribute to racial disparities in EC survival (14).…”

Section: Introductionmentioning

confidence: 99%

Receipt of adjuvant endometrial cancer treatment according to race: an NRG Oncology/Gynecologic Oncology Group 210 Study

Felix

Cohn

Brasky

et al. 2018

American Journal of Obstetrics and Gynecology

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Racial disparities in young women with endometrial cancer

Abstract: Young black women are more likely to present with pathologically aggressive, advanced stage tumors. Even after adjusting for these pathologic differences, young black women with endometrial cancer have higher mortality than white women.

Cited by 46 publications

References 36 publications

The role of histology on endometrial cancer survival disparities in diverse Florida

The role of histology on endometrial cancer survival disparities in diverse Florida

Association of Neoadjuvant Chemotherapy With Overall Survival in Women With Metastatic Endometrial Cancer

Receipt of adjuvant endometrial cancer treatment according to race: an NRG Oncology/Gynecologic Oncology Group 210 Study

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