1. The association of black race with receipt of hysterectomy and survival in low-risk endometrial cancer.
- Author
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Taylor, Kristin N., Li, Andrew, Manuel, Michael, Rimel, Bobbie Jo, and Kim, Kenneth H.
- Subjects
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RACE , *ENDOMETRIAL cancer , *HYSTERECTOMY , *PROPORTIONAL hazards models , *WHITE women , *ENDOMETRIAL surgery - Abstract
To determine whether Black race is associated with treatment and survival among women with low-risk endometrial cancer. Black and White women with Stage IA grade 1–2 endometrioid endometrial carcinoma diagnosed from 2010 to 2016 in the SEER 18 dataset were identified (n = 23,431), and clinical and socioeconomic attributes obtained. Five-year cancer-specific survival (CSS) and relative survival (RS) were calculated using SEER*Stat 8.3.9. Cox proportional hazards model was used to determine predictors of overall survival (OS) and CSS. There was a significantly higher proportion of Black women who did not have surgery compared to White women (3% vs 1%, respectively; p < 0.0001). Residing in the South, being insured with Medicaid, and residing in a county with low median income were also associated with non-receipt of surgery. Black women remained less likely to undergo hysterectomy on multivariable analysis (OR 0.44, 95% CI 0.32–0.60). Non-receipt of hysterectomy was predictive of decreased CSS (HR 0.14, 95% CI 0.09–0.21) and OS (HR 0.18, 95% 0.14–0.23) on adjusted analysis. Black race was also an independent predictor of increased cancer-specific death (HR 2.07, 95% CI 1.50–2.86) as well as death from any cause (HR 1.74, 95% CI 1.44–2.09) on adjusted analysis. Black women with low-risk endometrial cancer were less likely to undergo hysterectomy and experienced decreased survival relative to White women. Further investigation is warranted to better understand the socioeconomic, geographic, and biologic factors that influence this disparity. • Black race, low socioeconomic status, and residing in the South were associated with non-receipt of cancer-directed surgery. • Five-year cancer-specific and relative survival were lower for Black women compared to White women. • Black race and receipt of hysterectomy were independent predictors of decreased cancer-specific and overall survival. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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