A study of patients with endometrial cancer showed worse survival in non-Hispanic Black (NHB) patients than in non-Hispanic White (NHW) patients, despite equal access to care.
These results suggest “that factors other than access to care may be related to this racial disparity,” the study authors wrote in Gynecologic Oncology.
The researchers used data from the US Department of Defense’s Automated Central Tumor Registry to look at outcomes in patients diagnosed with endometrial cancer between 1988 and 2013.
The study included 1583 patients, of whom 144 were NHBs and 1439 were NHWs. NHB patients were more likely than NHW patients to have been diagnosed during the later period of the study (2005-2013; 56.3% vs 35.3%), to have high-grade endometrioid endometrial cancer (18.1% vs 10%), and to have nonendometrioid histology (20.8% vs 5.1%).
Results showed that NHB patients had worse survival outcomes than NHW patients (P <.0001).
After controlling for age, diagnosis period, stage, histology/grade, and adjuvant treatment, NHB patients still had an increased risk of death compared with NHW patients (hazard ratio [HR], 1.64; 95% CI, 1.19-2.27; P =.0024).
In a subgroup analysis, significant differences in the risk of death by race were found among patients with:
- Stage I/II disease (HR, 1.81; 95% CI, 1.17-2.79; P =.0076)
- Low-grade endometrioid carcinoma (HR, 2.47; 95% CI, 1.55-3.95; P =.0002)
- Non-endometrioid cancers (HR, 2.05; 95% CI, 1.08-3.90; P =.0277)
- No adjuvant treatment (HR, 2.15; 95% CI, 1.31-3.53; P =.0026).
The researchers suggested that several factors might contribute to the racial disparities observed in this study. These include variations in histologic subtype by racial/ethnic group; differences in molecular features of tumors; differences in treatment timing, intensity, and duration; and the use of all-cause mortality instead of cancer-specific mortality in this study.
Disclosures: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Park AB, Darcy KM, Tian C, et al. Racial disparities in survival among women with endometrial cancer in an equal access system. Gynecol Oncol. Published online July 26, 2021. doi:10.1016/j.ygyno.2021.07.022