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Objective: Delay in initiating cervical cancer treatment may impact outcomes. In a cohort of patients initially treated by surgery, chemoradiation, chemotherapy, or in a clinical trial, we aim to define factors contributing to prolonged time to treatment initiation., Methods: Data from patients initiating treatment for cervical cancer at a single institution was abstracted. Time to treatment initiation was defined as the interval from the date of cancer diagnosis to the date of treatment initiation. Poisson regression model was used for analysis., Results: Of 274 patients studied, the median time to treatment initiation was 60 days (range 0-551). The median times to initiate surgery (54 days, range 3-96) and chemoradiation (58 days, range 4-187) were not significantly different (relative risk (RR) 1.01, 95% CI 0.98 to 1.04, p=0.54). The shortest median initiation time was for chemotherapy (47 days; RR 1.13, 95% CI 1.08 to 1.19, p<0.0001) and the longest was for clinical trial (62 days; RR 1.18, 95% CI 1.12 to 1.24, p<0.0001). Charity care (RR 1.09, 95% CI 1.05 to 1.14, p<0.0001), Medicare or Medicaid (RR 1.10, 95% CI 1.06 to 1.14, p<0.0001), and self-pay (RR 1.38, 95% CI 1.32 to 1.45, p<0.0001) delayed treatment initiation more than private insurance. Hispanic White women (RR 0.69, 95% CI 0.66 to 0.73, p<0.0001) had a shorter treatment initiation time compared with non-Hispanic White patients, while Afro-Caribbean/Afro-Latina women (RR 0.86, 95% CI 0.81 to 0.90, p<0.0001) and African-American patients (RR 1.13, 95% CI 1.07 to 1.19, p<0.0001) had longer initiation times. Spanish speaking patients did not have a prolonged treatment initiation (RR 0.68, 95% CI 0.66 to 0.71, p<0.0001), though Haitian-Creole speaking patients did (RR 1.07, 95% CI 1.01 to 1.13, p<0.002). Diagnosis at an outside institution delayed treatment initiation time (RR 1.24, 95% CI 1.18 to 1.30, p<0.0001) compared with diagnosis at the cancer center., Conclusion: Factors associated with prolonged time to treatment initiation include treatment modality, insurance status, language spoken, and institution of diagnosis. By closely examining each of these factors, barriers to treatment can be identified and modified to shorten treatment initiation time., Competing Interests: Competing interests: None declared., (© IGCS and ESGO 2022. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.)

Background: Minorities have demonstrated an increased risk for type II endometrial cancers, but no data exists about risk among minority subpopulations. Our objective was to evaluate heterogeneity in risk of type II endometrial cancer (EC) histologies across race and Hispanic sub-groups using data from Florida's statewide cancer registry (FCDS)., Methods: FCDS contains data on N=26,416 women diagnosed with EC from 2004 to 2013. Our analysis included women ≥18years of age who were classified as non-Hispanic White (NHW), non-Hispanic Black (NHB) or belonged to one of five Hispanic sub-groups, and had a histology code consistent with type I or type II EC. Binary logistic regression analyses were performed to model risk of type II versus type I ECs across racial and ethnic groups relative to NHW., Results: Relative to NHW, overall odds of being diagnosed with a type II EC were significantly higher in NHB (OR=2.64, 95%CI: 2.38-2.92), Cubans (OR=1.35, 95%CI: 1.08-1.68) and South and Central Americans (SCA) (OR=1.84, 95%CI: 1.40-2.43). Compared to NHW, odds of serous EC were significantly higher in Cubans (OR=2.15, 95% CI: 1.51-3.05) and NHB (OR=2.51, 95% CI: 2.11-2.97); odds of carcinosarcoma (CS) were significantly higher in NHB (OR=2.97, 95% CI: 2.47-3.57) and Puerto Ricans (OR=2.35, 95%CI: 1.32-4.17); and odds of grade III adenocarcinoma (AG3) were significantly higher in NHB (OR=1.60, 95% CI: 1.42-1.81) and SCA (OR=1.76, 95%CI: 1.29-2.40)., Conclusion: Risk of type II EC varies considerably across Hispanic sub-groups, with Cubans, Puerto Ricans and SCA characterized by elevated odds for specific type II histologies., (Copyright © 2017 Elsevier Inc. All rights reserved.)