医学
子宫切除术
子宫内膜癌
比例危险模型
妇科
医疗补助
社会经济地位
生存分析
产科
癌症
内科学
肿瘤科
外科
人口
经济
医疗保健
环境卫生
经济增长
作者
Keith Taylor,Andrew Li,Michael Manuel,B.J. Rimel,Kenneth H. Kim
标识
DOI:10.1016/j.ygyno.2023.06.012
摘要
Objective To determine whether Black race is associated with treatment and survival among women with low-risk endometrial cancer. Methods 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. Results 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. Conclusions 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.
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