Disparities in cancer-specific and overall survival in black women with endometrial cancer: A Medicare-SEER study
Objectives: To examine overall survival (OS) and cancer-specific survival (CSS) for different racial groups of women with surgically staged endometrial cancer by histologic subtype. Methods: This is a retrospective cohort study of women with stage I-III endometrioid, serous, clear cell, and carcinos...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-04-01
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| Series: | Gynecologic Oncology Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578922000029 |
| _version_ | 1818275094688956416 |
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| author | Daniel H. Saris Anna Jo Bodurtha Smith Colleen Brensinger Sarah H. Kim Ashley F. Haggerty Nawar Latif Lori Cory Robert L. Giuntoli Mark A. Morgan Lilie L. Lin Emily M. Ko |
| author_facet | Daniel H. Saris Anna Jo Bodurtha Smith Colleen Brensinger Sarah H. Kim Ashley F. Haggerty Nawar Latif Lori Cory Robert L. Giuntoli Mark A. Morgan Lilie L. Lin Emily M. Ko |
| author_sort | Daniel H. Saris |
| collection | DOAJ |
| description | Objectives: To examine overall survival (OS) and cancer-specific survival (CSS) for different racial groups of women with surgically staged endometrial cancer by histologic subtype. Methods: This is a retrospective cohort study of women with stage I-III endometrioid, serous, clear cell, and carcinosarcoma who underwent hysterectomy as primary surgical staging in the 2000–2016 SEER-Medicare database. OS and CSS outcomes were stratified by race (defined as White, Black, Other), stage, and histology. Survival was assessed with descriptive analyses, log-rank tests and unadjusted and adjusted multivariable cox regression models. Results: Of the 24,142 women identified, 85.5% were White, 8.5% Black, and 6% other races. Receipt of adjuvant therapy differed only for stage III endometrioid: Black women were less likely to receive adjuvant treatment after hysterectomy (61.2% vs. 70.1% White, p = 0.03). For stage I, Black women had worse CSS for all histologies other than clear cell in unadjusted and adjusted analyses. For stage II, Black women had worse CSS for endometrioid histology in unadjusted analyses and similar OS. For stage III, Black women with endometrioid carcinoma had worse CSS and OS in unadjusted analyses, but no significant difference in CSS in adjusted analyses. “Other” race showed improved OS for Stage I endometrioid adenocarcinoma without significant differences in outcomes when compared to White women. Conclusion: Across histologies other than clear cell, Black women diagnosed with stage I endometrial cancer had consistently worse CSS, despite similar receipt of adjuvant therapy. Differences in CSS and OS at higher stages disappeared once accounting for treatment disparities. |
| first_indexed | 2024-12-12T22:24:17Z |
| format | Article |
| id | doaj.art-9b56877f403f46559c5972e8eef9533b |
| institution | Directory Open Access Journal |
| issn | 2352-5789 |
| language | English |
| last_indexed | 2024-12-12T22:24:17Z |
| publishDate | 2022-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj.art-9b56877f403f46559c5972e8eef9533b2022-12-22T00:09:48ZengElsevierGynecologic Oncology Reports2352-57892022-04-0140100922Disparities in cancer-specific and overall survival in black women with endometrial cancer: A Medicare-SEER studyDaniel H. Saris0Anna Jo Bodurtha Smith1Colleen Brensinger2Sarah H. Kim3Ashley F. Haggerty4Nawar Latif5Lori Cory6Robert L. Giuntoli7Mark A. Morgan8Lilie L. Lin9Emily M. Ko10Department of Obstetrics and Gynecology, University of Pennsylvania Health System, Philadelphia, PA, USA; Corresponding author at: Pennsylvania Hospital, 800 Spruce Street, Philadelphia PA 19107, United States.Department of Obstetrics and Gynecology, University of Pennsylvania Health System, Philadelphia, PA, USA; Penn Center for Cancer Care Innovation, Abramson Cancer Center, University of Pennsylvania, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, USACenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, USADepartment of Obstetrics and Gynecology: Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USADepartment of Obstetrics and Gynecology: Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USADepartment of Obstetrics and Gynecology: Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USADepartment of Obstetrics and Gynecology: Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USADepartment of Obstetrics and Gynecology: Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USADepartment of Obstetrics and Gynecology: Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USADepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, USADepartment of Obstetrics and Gynecology: Division of Gynecologic Oncology, Perelman School of Medicine, University of Pennsylvania, USA; Penn Center for Cancer Care Innovation, Abramson Cancer Center, University of Pennsylvania, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, USAObjectives: To examine overall survival (OS) and cancer-specific survival (CSS) for different racial groups of women with surgically staged endometrial cancer by histologic subtype. Methods: This is a retrospective cohort study of women with stage I-III endometrioid, serous, clear cell, and carcinosarcoma who underwent hysterectomy as primary surgical staging in the 2000–2016 SEER-Medicare database. OS and CSS outcomes were stratified by race (defined as White, Black, Other), stage, and histology. Survival was assessed with descriptive analyses, log-rank tests and unadjusted and adjusted multivariable cox regression models. Results: Of the 24,142 women identified, 85.5% were White, 8.5% Black, and 6% other races. Receipt of adjuvant therapy differed only for stage III endometrioid: Black women were less likely to receive adjuvant treatment after hysterectomy (61.2% vs. 70.1% White, p = 0.03). For stage I, Black women had worse CSS for all histologies other than clear cell in unadjusted and adjusted analyses. For stage II, Black women had worse CSS for endometrioid histology in unadjusted analyses and similar OS. For stage III, Black women with endometrioid carcinoma had worse CSS and OS in unadjusted analyses, but no significant difference in CSS in adjusted analyses. “Other” race showed improved OS for Stage I endometrioid adenocarcinoma without significant differences in outcomes when compared to White women. Conclusion: Across histologies other than clear cell, Black women diagnosed with stage I endometrial cancer had consistently worse CSS, despite similar receipt of adjuvant therapy. Differences in CSS and OS at higher stages disappeared once accounting for treatment disparities.http://www.sciencedirect.com/science/article/pii/S2352578922000029Endometrial CancerSurvivalOutcomesDemographicsDisparitiesSEER Medicare |
| spellingShingle | Daniel H. Saris Anna Jo Bodurtha Smith Colleen Brensinger Sarah H. Kim Ashley F. Haggerty Nawar Latif Lori Cory Robert L. Giuntoli Mark A. Morgan Lilie L. Lin Emily M. Ko Disparities in cancer-specific and overall survival in black women with endometrial cancer: A Medicare-SEER study Gynecologic Oncology Reports Endometrial Cancer Survival Outcomes Demographics Disparities SEER Medicare |
| title | Disparities in cancer-specific and overall survival in black women with endometrial cancer: A Medicare-SEER study |
| title_full | Disparities in cancer-specific and overall survival in black women with endometrial cancer: A Medicare-SEER study |
| title_fullStr | Disparities in cancer-specific and overall survival in black women with endometrial cancer: A Medicare-SEER study |
| title_full_unstemmed | Disparities in cancer-specific and overall survival in black women with endometrial cancer: A Medicare-SEER study |
| title_short | Disparities in cancer-specific and overall survival in black women with endometrial cancer: A Medicare-SEER study |
| title_sort | disparities in cancer specific and overall survival in black women with endometrial cancer a medicare seer study |
| topic | Endometrial Cancer Survival Outcomes Demographics Disparities SEER Medicare |
| url | http://www.sciencedirect.com/science/article/pii/S2352578922000029 |
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