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Geographic Variation of Racial and Ethnic Differences in Uterine Cancer Survival
Caitlin E Meade1, Jennifer A Sinnott2, Tasleem J Padamsee3
1Division of Epidemiology, College of Public Health, The Ohio State University, Columbus.
JAMA Network Open
|April 25, 2025
Summary
Racial and ethnic disparities in uterine cancer survival exist across U.S. geographic regions. Black patients faced worse survival compared to White patients, regardless of regional diversity. Targeted research is needed to address these survival gaps.
Area of Science:
- Oncology
- Health Disparities
- Epidemiology
Background:
- Racial and ethnic disparities in uterine cancer survival are established.
- Limited data exist on how geography and regional diversity influence these survival disparities.
Purpose of the Study:
- To examine the association between race and ethnicity and uterine cancer-specific survival.
- To analyze these associations within different geographic regions and varying levels of regional diversity.
Main Methods:
- Retrospective cohort study of 162,500 uterine cancer patients (2000-2019) from 17 SEER registries.
- Patients categorized by race/ethnicity (Asian, Black, Hispanic, White) and grouped by US location.
- Cox proportional hazards models used to assess survival, stratified by geographic location and Diversity Index (DI).
Main Results:
- Overall, Black patients had worse uterine cancer-specific survival (HR, 1.34) compared to White patients.
- Asian patients had better survival (HR, 0.91), while Hispanic patients showed no significant difference (HR, 1.01) versus White patients.
- Worse survival for Black patients was observed in both high and low Diversity Index locations; Hispanic patients had worse survival in specific regions (Hawaii, Georgia).
Conclusions:
- This study identified significant racial and ethnic disparities in uterine cancer survival within specific geographic areas.
- Survival patterns varied by race/ethnicity and geographic location, highlighting the complex interplay of these factors.
- Targeted research and interventions are crucial to reduce national uterine cancer survival disparities.
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