Abstract PO-229: Racial/ethnic differences in tumor characteristics among endometrial cancer patients in an equal-access healthcare population
Authors: Desmond Daniel , Arter Zhaohui , Berenberg Jeffrey , Merritt Melissa 
Published: January 2022

Abstract
Introduction: Endometrial cancer is the most prevalent gynecologic malignancy. Compared with White women, endometrial cancer incidence is 30% lower in Black women yet mortality is 80% higher. In retrospective review of young women, [MM1] Black women (&lt;50 years old) presented with more advanced clinical stage and more aggressive histologic subtypes. Multivariable analysis adjusting for these factors showed that risk of mortality[MM2] is 19% higher in Black women than their White counterparts. Native Hawaiian/Pacific Islander race has also been associated with worse survival when compared to their White counterparts. In this retrospective review of endometrial cancer patients treated within the Military Health System we assessed whether there were racial/ethnic disparities in tumor characteristics [MM3] in a system that provides equal access to healthcare and treatment. Methods: The study population included women diagnosed with endometrial cancer among US Department of Defense beneficiaries reported in the Automated Central Tumor Registry (ACTUR) database between 2001-2018. We evaluate differences in tumor characteristics by self-reported racial/ethnic group using the Chi-square test or Fisher test for small sample sizes (a two tailed P&lt;0.05 was considered statistically significant). Results: After excluding women who had non-invasive tumors, non-epithelial histology and those who were not represented in the five major racial/ethnic groups for this study, the study population included 2574 women diagnosed with invasive endometrial cancer (including 1729 Non-Hispanic White[ZA4], 318 Asian, 286 Black, 140 Pacific Islander and 101 Hispanic White women). We observed differences in histology, stage and grade by racial/ethnic group (P&lt;0.001). Specifically, comparing age-standardized endometrial tumor characteristics by racial/ethnic groups we observed that Black women had a lower proportion of endometrioid histology (56%) as compared with other racial/ethnic groups (≥70.6% endometrioid). Black, Hispanic and Pacific Islander women had a higher proportion of distant stage and poorly differentiated (grade 3-4) disease (≥8.9% distant stage; ≥30.5% poorly differentiated) versus (≤5.7% distant stage; ≤23.8% poorly differentiated) in White and Asian women. Conclusions: Endometrial cancer is common and population-wide screening is not recommended which makes it a good case-study for the value of access to care when patients identify concerning symptoms (bleeding, spotting). In our analysis of endometrial cancer cases in an equal-access healthcare environment, there appear to be racial/ethnic disparities among Black, Hispanic and Pacific Islander women. Our review affirms prior data showing more aggressive histology, grade and stage at diagnosis. Further studies will focus on whether these patterns persist among women with endometrioid histology tumors. The views expressed in this abstract are those of the author and do not reflect the official policy of the Department of Army/Navy/Air Force, Department of Defense, or U.S. Government.
Citation Format: Daniel Desmond, Zhaohui Arter, Jeffrey Berenberg, Melissa Merritt. Racial/ethnic differences in tumor characteristics among endometrial cancer patients in an equal-access healthcare population [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-229.