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Racial differences in patients with adenocarcinoma of the endometrium
H S Cronjé1, S Fourie, M J Doman
1Gynecologic Oncology Group, University of the Orange Free State, Bloemfontein, South Africa.
Summary
Endometrial cancer presents more aggressively in Black women compared to White women. Black women were diagnosed at later stages with poorer tumor differentiation, resulting in significantly lower survival rates.
Area of Science:
- Gynecologic Oncology
- Cancer Epidemiology
- Racial Disparities in Health
Background:
- Endometrial cancer, specifically adenocarcinoma, affects women globally.
- Understanding racial differences in disease presentation and outcomes is crucial for targeted interventions.
- Previous research suggests potential disparities in gynecologic cancer care and outcomes among different racial groups.
Purpose of the Study:
- To investigate and compare the clinical presentation and behavior of endometrial adenocarcinoma between White and Black women.
- To identify potential differences in disease staging, tumor characteristics, and treatment outcomes based on race.
Main Methods:
- Retrospective review of medical records for 390 patients diagnosed with endometrial adenocarcinoma in Bloemfontein, South Africa.
- Data included patient demographics (race), FIGO staging, tumor differentiation, treatment protocols, and survival outcomes.
- Survival analysis was conducted using the direct method, with losses to follow-up treated as tumor deaths.
Main Results:
- Black women presented with more advanced disease (FIGO stages II-IV) compared to White women (P = 0.0024).
- Tumor differentiation was more frequently poor in Black patients (P < 0.0001).
- Ten-year survival rates were significantly lower for Black women (28%) compared to White women (67%) (P < 0.0001).
Conclusions:
- Endometrial adenocarcinoma exhibits more aggressive behavior in Black women compared to White women.
- Racial disparities in stage at diagnosis, tumor biology, and survival outcomes highlight the need for further investigation and tailored healthcare strategies.