Disparities in receipt of care for high-grade endometrial cancer: A National Cancer Data Base analysis

Bregar, Amy; Rauh‐Hain, J. Alejandro; Spencer, Ross L.; Clemmer, Joel; Schorge, John O.; Rice, L.W.; Carmen, M.G. del

doi:10.1016/j.ygyno.2017.03.332

Cited by 6 publications

(11 citation statements)

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“…The adjuvant treatment types in our study varied over time and among races. The aforementioned study by Bregar et al 6 found no significant difference observed in the use of adjuvant treatment between racial and ethnic groups after controlling for various factors, a finding not supported in this analysis. These discordant findings may be accounted for by differences in the study populations.…”

Section: Results In the Context Of What Is Knowncontrasting

confidence: 79%

“…12e14 Our findings were largely consistent with 2 of the largest population-based studies evaluating racial differences in treatment for HGEC on the survival differences among racial groups in the United States. 6,15 A study by Bregar et al 6 found that on multivariate analysis, NHB women had decreased OS compared with NHW women, whereas HS women had improved OS compared with NHW women, but only in early-stage (stage I or II) disease. Rauh-Hain et al 15 found that racial disparities for disease-specific mortality were eliminated when accounting for socioeconomic and geographic factors, but OS remained worse for African American patients with HGEC in the multivariate model.…”

Section: Results In the Context Of What Is Knownmentioning

confidence: 99%

“…This is especially true of NHB patients with HGEC, given that NHB patients in our cohort had significantly higher rates of postoperative medical and surgical complications and were more likely to have !1 perioperative complications than NHW patients (44% vs 50%; P<.001), a finding supported in other populationbased studies. 15,6…”

Section: Discussionmentioning

confidence: 99%

“…When correcting for a history of hysterectomy, Black women developed HGEC at 2 to 4 times the incidence of NHW patients and have lower cancer-specific and all-cause mortality rates than White women. 6,15,21 The causes of this are likely multifactorial, and significant effort must be made across all aspects of patient care to close the racial gap in the survival of patients with HGEC.…”

Section: Research Implicationsmentioning

confidence: 99%

“…4 High-grade endometrial cancers (HGECs) comprise only 7% of newly diagnosed ECs but account for 14% of EC-attributed deaths. 5,6 Non-Hispanic Black (NHB) women seem to be disproportionately affected by higherstage cancers and HGECs than their Hispanic (HS) and Non-Hispanic White (NHW) counterparts. 7 When other variables are considered, contemporary cohorts of NHB women with EC have a 29% increased risk of all-cause mortality compared with NHW women and are twice as likely to not be recommended definitive surgery.…”

Section: Introductionmentioning

confidence: 99%

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Disparities in adjuvant treatment of high-grade endometrial cancer in the Medicare population

Corey

Coté

Ruterbusch

et al. 2022

American Journal of Obstetrics and Gynecology

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Section: Results In the Context Of What Is Knowncontrasting

confidence: 79%

Section: Results In the Context Of What Is Knownmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Research Implicationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Disparities in adjuvant treatment of high-grade endometrial cancer in the Medicare population

Corey

Coté

Ruterbusch

et al. 2022

American Journal of Obstetrics and Gynecology

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Racial–Ethnic and Socioeconomic Disparities in Guideline-Adherent Treatment for Endometrial Cancer

Rodríguez

LeBrón

Chang

et al. 2021

Obstetrics &Amp; Gynecology

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To evaluate the association of raceethnicity and neighborhood socioeconomic status with adherence to National Comprehensive Cancer Network guidelines for endometrial carcinoma.METHODS: Data are from the SEER (Surveillance, Epidemiology, and End Results) cancer registry of women diagnosed with endometrial carcinoma for the years 2006-2015. The sample included 83,883 women after inclusion and exclusion criteria were applied. Descriptive statistics, bivariate analyses, univariate, and multivariate logistic regression models were performed to evaluate the association between race-ethnicity and neighborhood socioeconomic status with adherence to treatment guidelines. RESULTS:After controlling for demographic and clinical covariates, Black (odds ratio [OR] 0.89, P,.001), Latina (OR .92, P,.001), and American Indian or Alaska Native (OR 0.82, P5.034) women had lower odds of receiving adherent treatment and Asian (OR 1.14, P,.001) and Native Hawaiian or Pacific Islander (OR 1.19 P5.012) women had higher odds of receiving adherent treatment compared with White women. After controlling for covariates, there was a gradient by neighborhood socioeconomic status: women in the high-middle (OR 0.89, P,.001), middle (OR 0.84, P,.001), low-middle (OR 0.80, P,.001), and lowest (OR 0.73, P,.001) neighborhood socioeconomic status categories had lower odds of receiving adherent treatment than the those in the highest neighborhood socioeconomic status group.CONCLUSIONS: Findings from this study suggest there are racial-ethnic and neighborhood socioeconomic disparities in National Comprehensive Cancer Network treatment adherence for endometrial cancer. Standard treatment therapies should not differ based on sociodemographics. Interventions are needed to ensure that equitable cancer treatment practices are available for all individuals, regardless of racial-ethnic or socioeconomic background.

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The Impact of Racial Disparities on Outcome in Patients With Stage IIIC Endometrial Carcinoma

Patrich

Wang

Elshaikh³

et al. 2023

American Journal of Clinical Oncology

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Objective: To report the impact of race on clinical outcomes in patients with stage IIIC endometrial carcinoma. Materials and Methods: A retrospective multi-institutional study included 90 black and 568 non-black patients with stage IIIC endometrial carcinoma who received adjuvant chemotherapy and radiation treatments. Overall survival (OS) and recurrence-free survival (RFS) were calculated by the Kaplan-Meier method. Propensity score matching (PSM) was conducted. Statistical analyses were conducted using SPSS version 27. Results: The Median follow-up was 45.3 months. black patients were significantly older, had more nonendometrioid histology, grade 3 tumors, and were more likely to have >1 positive paraaortic lymph nodes compared with non-black patients (all P <0.0001). The 5-year estimated OS and RFS rates were 45% and 47% compared with 77% and 68% for black patients versus non-black patients, respectively (P <0.001). After PSM, the 2 groups were well-balanced for all prognostic covariates. The estimated hazard ratios of black versus non-black patients were 1.613 (P value=0.045) for OS and 1.487 (P value=0.116) for RFS. After PSM, black patients were more likely to receive the “Sandwich” approach and concurrent chemoradiotherapy compared with non-black (P=0.013) patients. Conclusions: Black patients have higher rates of nonendometrioid histology, grade 3 tumors, and number of involved paraaortic lymph nodes, worse OS, and RFS, and were more likely to receive the “Sandwich” approach compared with non-black patients. After PSM, black patients had worse OS with a nonsignificant trend in RFS. Access to care, equitable inclusion on randomized trials, and identification of genomic differences are warranted to help mitigate disparities.

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Disparities in receipt of care for high-grade endometrial cancer: A National Cancer Data Base analysis

Cited by 6 publications

References 0 publications

Disparities in adjuvant treatment of high-grade endometrial cancer in the Medicare population

Disparities in adjuvant treatment of high-grade endometrial cancer in the Medicare population

Racial–Ethnic and Socioeconomic Disparities in Guideline-Adherent Treatment for Endometrial Cancer

The Impact of Racial Disparities on Outcome in Patients With Stage IIIC Endometrial Carcinoma

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