Abstract B59: Racial disparities in surgical procedure and survival for endometrial cancer.
Authors: Korenaga Travis-Riley K. , Ward Kristy K. , McHale Michael T. , Saenz Cheryl C. , Plaxe Steven C. 
Published: August 2014

Objective: Hysterectomy is standard of care in the treatment of endometrial cancer. We will determine if endometrial cancer directed hysterectomy varies by race.

Methods: The U.S. Surveillance, Epidemiology, and End Results (SEER) cancer registry was queried to identify 59,994 black and white women diagnosed with localized endometrial cancer from 2000-2009. Frequency of endometrial cancer directed hysterectomy was compared by race (white, black) and adjusted for age (&lt;60 years, 60+) and tumor grade (low = grades I & II, high = grades III & IV). Reason for no hysterectomy was also queried. Five-year relative survival was also calculated using SEER*Stat 7.1.0.

Results: Of the 59,994 women with localized endometrial malignancies in the study, 55,950 were white and 4,044 were black. White females with localized endometrial cancer were significantly more likely to undergo hysterectomy than their black counterparts (95.69% [94.88-96.5%] vs. 86.55% [86.55-92.4%]). Black women 60 and older were significantly less likely to receive hysterectomy than their white counterparts (87.50% vs. 94.96%). In accounting for grade, white women with low grade endometrial cancer were significantly more likely to undergo hysterectomy than black women (96.23% vs. 91.37%). There was no significant difference in hysterectomy in women less than age 60 or among those with high-grade disease. When reason for no hysterectomy was queried, it was found that reason “not recommended” was significantly higher for black women than white women (50.82% [44.28-58.05%] vs. 40.28% [37.79-42.90%]). Furthermore, when accounting for age and grade, black women were still more likely to have no surgery because it was not recommended, but the only statistically significant racial disparity was in women less than 60 years old (41.57% [38.26-44.97%] vs. 54.41% [46.02-62.56%]). Five-year survival for all women with hysterectomy was 98.8% (95% CI = 98.4-99.1%). White subjects that underwent hysterectomy had a significantly higher 5-year survival than black subjects (99.2% [98.7-99.5%] vs. 92.6% [90.6-94.1%]). The significant racial difference in 5-year survival persisted when accounting for age and grade.

Conclusions: We found substantial racial disparities between black and white women with localized endometrial cancer in the frequency of hysterectomy performed and in 5-year survival. This, as yet, unexplained racial disparity merits further study to identify causative factors to ultimately improve health care outcomes for all women with endometrial cancer.

Citation Format: Travis-Riley K. Korenaga, Kristy K. Ward, Michael T. McHale, Cheryl C. Saenz, Steven C. Plaxe. Racial disparities in surgical procedure and survival for endometrial cancer. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr B59.