Racial disparities in uterine and ovarian carcinosarcoma: A population-based analysis of treatment and survival

Rojas, Christine; Tian, Chunqiao; Powell, Matthew A.; Chan, John K.; Bateman, Nicholas W.; Conrads, Thomas P.; Rocconi, Rodney P.; Jones, Nathaniel; Shriver, Craig D.; Hamilton, Chad A.; Maxwell, G. Larry; Casablanca, Yovanni; Darcy, Kathleen M.

doi:10.1016/j.ygyno.2020.01.017

Cited by 17 publications

(10 citation statements)

References 38 publications

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“…Our findings are consistent with Rojas et al , which found increases in UCS incidence from 3.1% to 14.8% in Black women and 1.5% to 6.7% in White women ages 40 to 90 years old. ( Rojas et al, 2020 ) Similar to our findings, Matsuo et al found an increase in UCS incidence in Black women, however, this study found a decrease in UCS incidence in White women. ( Matsuo et al, 2018 ) A prior study evaluating the association between UCS and race found that Black women have an increased risk of developing UCS compared to other racial and ethnic groups.…”

Section: Discussionsupporting

confidence: 91%

Increasing incidence of uterine carcinosarcoma: A United States Cancer Statistics study

Liao

Caesar

Lee

et al. 2022

Gynecologic Oncology Reports

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Section: Discussionsupporting

confidence: 91%

Increasing incidence of uterine carcinosarcoma: A United States Cancer Statistics study

Liao

Caesar

Lee

et al. 2022

Gynecologic Oncology Reports

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“…In 2015, Asian/Pacific Islander women had similar uterine cancer death rates to White women (4 vs 5/100,000). 5 Rojas et al 14 noted similar death rates between Asian/Pacific Islander and White women in patients with uterine carcinosarcoma (HR 1.10, 95% CI 0.93–1.29). Terada et al 22 noted no difference in overall mortality rates for endometrial cancer between Native Hawaiian and other Pacific Islander women compared with other women.…”

Section: Evidence Reviewmentioning

confidence: 89%

“…13 This disparity was also observed in a study using the National Cancer Database looking specifically at uterine carcinosarcoma. 14…”

Section: Evidence Reviewmentioning

confidence: 99%

Health Disparities in Uterine Cancer

Whetstone

Burke

Sheth

et al. 2022

Obstetrics &Amp; Gynecology

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“…Previous studies demonstrated that black women have an increased risk of uterine carcinosarcoma, which may suggest a possible future demographic change in carcinosarcoma because the uterus is the dominant site of carcinosarcoma ( 10 , 25 , 26 ). Another possible explanation for the steep increase in incidence in the black population may be socioeconomic disparities (including low income, insurance status, health services) ( 25 , 27 , 28 ). With the rapid development of health inspection and imaging modalities, the incidence of patients diagnosed with unknown stage declined over the past decades.…”

Section: Discussionmentioning

confidence: 99%

“…The rapid decline in mortality among men may be due in part to reduction in smoking ( 29 ). Thus, while medical advances have slowed the trend of rising mortality, targeted cancer control treatments remain urgent ( 11 , 25 , 27 , 28 , 30 ). Consistent with the overall rising incidence and slowing death trend, the prevalence of carcinosarcoma has increased year-by-year, mainly in women, elderly, blacks, and localized stage.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and prediction model of patients with carcinosarcoma in the United States

Chen

Yang³

et al. 2022

Front. Public Health

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BackgroundCarcinosarcoma is a rare biphasic tumor composed of both carcinoma and sarcoma elements, which occurs at various sites. Most studies are case reports or small population-based studies for a single disease site, so comprehensive evaluations of epidemiology and prognostic factors for carcinosarcoma are needed.MethodsSurveillance, Epidemiology, and End Results (SEER)-8 (1975–2019) provided data for the epidemiological analysis. SEER-17 (2000–2019) provided data on the primary tumor sites, initial treatment, construction, and validation of the nomogram.ResultsThe age-adjusted incidence per 100,000 persons of carcinosarcoma increased significantly from 0.46 to 0.91 [1975–2019; average annual percent change (AAPC): 1.3%, P = 0.006], with localized stage increasing from 0.14 to 0.26 [2005–2015; annual percent change (APC): 4.2%]. The 20-year limited-duration prevalence per 100,000 increased from 0.47 to 3.36 (1999–2018). The mortality per 100,000 increased significantly from 0.16 to 0.51 (1975–2019; AAPC: 1.9%, P < 0.001). The 5-year relative survival was 32.8%. The greatest number of carcinosarcomas were from the uterus (68.7%), ovary (17.8%), lung and bronchus (2.3%). The main treatment is comprehensive treatment based on surgery; however, surgery alone is preferred in older patients. In multivariate analysis (N = 11,424), age, sex, race, year of diagnosis, disease stage, tumor site, and treatment were associated with survival. A nomogram was established to predict 1-, 3-, and 5-year survival, and the C-indexes were 0.732 and 0.748 for the training and testing sets, respectively. The receiver operating characteristic curve demonstrated that the nomogram provided a comprehensive and accurate prediction [1-year area under the curve (AUC): 0.782 vs. 0.796; 3-year AUC: 0.771 vs. 0.798; 5-year AUC: 0.777 vs. 0.810].ConclusionsIn this study, the incidence, prevalence, and mortality of carcinosarcoma have increased over the past decades. There was a rapid rise in the incidence of localized stage in recent years, which reflected improved early detection. The prognosis of carcinosarcoma remains poor, signifying the urgency of exploring targeted cancer control treatments. Explicating distribution and gender disparities of carcinosarcoma may facilitate disease screening and medical surveillance. The nomogram demonstrated good predictive capacity and facilitated clinical decision-making.

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Racial disparities in uterine and ovarian carcinosarcoma: A population-based analysis of treatment and survival

Cited by 17 publications

References 38 publications

Increasing incidence of uterine carcinosarcoma: A United States Cancer Statistics study

Increasing incidence of uterine carcinosarcoma: A United States Cancer Statistics study

Health Disparities in Uterine Cancer

Epidemiology and prediction model of patients with carcinosarcoma in the United States

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