Abstract
Discussion Forum (0)
Background:
Non-Hispanic Blacks (NHBs) with endometrial cancer have worse survival than Non-Hispanic Whites (NHWs) with the largest disparity in endometrioid vs. non-endometrioid cancer. Mixed endometrial cancers (MEC) with grade (G1/G2) endometrioid and mucinous cancer are type I vs. type II with non-endometrioid components (G3). This study investigated racial disparity in these rare MEC.
METHODS:
NHBs and NHWs diagnosed between 2004-2014 with stage I-IV MEC in the National Cancer Database were eligible. Racial differences in clinical characteristics at diagnosis were evaluated using Chi-square test. Survival was evaluated before and after propensity score weighting was applied sequentially to balance racial differences in demographics, comorbidity score, neighborhood income, insurance status, grade, stage, and treatment.
RESULTS:
There were 1,257 NHBs and 8,963 NHWs with MEC. NHBs were more likely to have grade 3 (73% vs. 51%) and stage III/IV disease (40% vs. 29%), as well as comorbid conditions, lower neighborhood income, no or Medicaid insurance, and worse survival (each P<0.0001). The HR (95% CI) for death in NHB vs. NHW patients was 1.89 (1.72-2.09) in the unadjusted model and an insignificant 1.13 (0.96-1.32) in the fully balanced model. Comorbidity score, neighborhood income, insurance, grade, stage, and treatment each accounted for 4.7%, 14.0%, 7.0%, 42.1%, 14.1%, and 3.5% of the total excess relative risk of death in the NHB vs. NHW patients, respectively, with 14.6% remained to be explained.
CONCLUSIONS:
Grade was the largest contributor to survival disparities between NHBs and NHWs with MEC followed by the modifiable factors: neighborhood income, insurance, and comorbidity score.
Non-Hispanic Blacks (NHBs) with endometrial cancer have worse survival than Non-Hispanic Whites (NHWs) with the largest disparity in endometrioid vs. non-endometrioid cancer. Mixed endometrial cancers (MEC) with grade (G1/G2) endometrioid and mucinous cancer are type I vs. type II with non-endometrioid components (G3). This study investigated racial disparity in these rare MEC.
METHODS:
NHBs and NHWs diagnosed between 2004-2014 with stage I-IV MEC in the National Cancer Database were eligible. Racial differences in clinical characteristics at diagnosis were evaluated using Chi-square test. Survival was evaluated before and after propensity score weighting was applied sequentially to balance racial differences in demographics, comorbidity score, neighborhood income, insurance status, grade, stage, and treatment.
RESULTS:
There were 1,257 NHBs and 8,963 NHWs with MEC. NHBs were more likely to have grade 3 (73% vs. 51%) and stage III/IV disease (40% vs. 29%), as well as comorbid conditions, lower neighborhood income, no or Medicaid insurance, and worse survival (each P<0.0001). The HR (95% CI) for death in NHB vs. NHW patients was 1.89 (1.72-2.09) in the unadjusted model and an insignificant 1.13 (0.96-1.32) in the fully balanced model. Comorbidity score, neighborhood income, insurance, grade, stage, and treatment each accounted for 4.7%, 14.0%, 7.0%, 42.1%, 14.1%, and 3.5% of the total excess relative risk of death in the NHB vs. NHW patients, respectively, with 14.6% remained to be explained.
CONCLUSIONS:
Grade was the largest contributor to survival disparities between NHBs and NHWs with MEC followed by the modifiable factors: neighborhood income, insurance, and comorbidity score.
Background:
Non-Hispanic Blacks (NHBs) with endometrial cancer have worse survival than Non-Hispanic Whites (NHWs) with the largest disparity in endometrioid vs. non-endometrioid cancer. Mixed endometrial cancers (MEC) with grade (G1/G2) endometrioid and mucinous cancer are type I vs. type II with non-endometrioid components (G3). This study investigated racial disparity in these rare MEC.
METHODS:
NHBs and NHWs diagnosed between 2004-2014 with stage I-IV MEC in the National Cancer Database were eligible. Racial differences in clinical characteristics at diagnosis were evaluated using Chi-square test. Survival was evaluated before and after propensity score weighting was applied sequentially to balance racial differences in demographics, comorbidity score, neighborhood income, insurance status, grade, stage, and treatment.
RESULTS:
There were 1,257 NHBs and 8,963 NHWs with MEC. NHBs were more likely to have grade 3 (73% vs. 51%) and stage III/IV disease (40% vs. 29%), as well as comorbid conditions, lower neighborhood income, no or Medicaid insurance, and worse survival (each P<0.0001). The HR (95% CI) for death in NHB vs. NHW patients was 1.89 (1.72-2.09) in the unadjusted model and an insignificant 1.13 (0.96-1.32) in the fully balanced model. Comorbidity score, neighborhood income, insurance, grade, stage, and treatment each accounted for 4.7%, 14.0%, 7.0%, 42.1%, 14.1%, and 3.5% of the total excess relative risk of death in the NHB vs. NHW patients, respectively, with 14.6% remained to be explained.
CONCLUSIONS:
Grade was the largest contributor to survival disparities between NHBs and NHWs with MEC followed by the modifiable factors: neighborhood income, insurance, and comorbidity score.
Non-Hispanic Blacks (NHBs) with endometrial cancer have worse survival than Non-Hispanic Whites (NHWs) with the largest disparity in endometrioid vs. non-endometrioid cancer. Mixed endometrial cancers (MEC) with grade (G1/G2) endometrioid and mucinous cancer are type I vs. type II with non-endometrioid components (G3). This study investigated racial disparity in these rare MEC.
METHODS:
NHBs and NHWs diagnosed between 2004-2014 with stage I-IV MEC in the National Cancer Database were eligible. Racial differences in clinical characteristics at diagnosis were evaluated using Chi-square test. Survival was evaluated before and after propensity score weighting was applied sequentially to balance racial differences in demographics, comorbidity score, neighborhood income, insurance status, grade, stage, and treatment.
RESULTS:
There were 1,257 NHBs and 8,963 NHWs with MEC. NHBs were more likely to have grade 3 (73% vs. 51%) and stage III/IV disease (40% vs. 29%), as well as comorbid conditions, lower neighborhood income, no or Medicaid insurance, and worse survival (each P<0.0001). The HR (95% CI) for death in NHB vs. NHW patients was 1.89 (1.72-2.09) in the unadjusted model and an insignificant 1.13 (0.96-1.32) in the fully balanced model. Comorbidity score, neighborhood income, insurance, grade, stage, and treatment each accounted for 4.7%, 14.0%, 7.0%, 42.1%, 14.1%, and 3.5% of the total excess relative risk of death in the NHB vs. NHW patients, respectively, with 14.6% remained to be explained.
CONCLUSIONS:
Grade was the largest contributor to survival disparities between NHBs and NHWs with MEC followed by the modifiable factors: neighborhood income, insurance, and comorbidity score.
Importance of Tumor Grade on Survival Disparities between Non-Hispanic Black and Non-Hispanic White Women with Mixed Endometrial Cancer
Dr. Suzanne Jokajtys
Abstract
Discussion Forum (0)
Background:
Non-Hispanic Blacks (NHBs) with endometrial cancer have worse survival than Non-Hispanic Whites (NHWs) with the largest disparity in endometrioid vs. non-endometrioid cancer. Mixed endometrial cancers (MEC) with grade (G1/G2) endometrioid and mucinous cancer are type I vs. type II with non-endometrioid components (G3). This study investigated racial disparity in these rare MEC.
METHODS:
NHBs and NHWs diagnosed between 2004-2014 with stage I-IV MEC in the National Cancer Database were eligible. Racial differences in clinical characteristics at diagnosis were evaluated using Chi-square test. Survival was evaluated before and after propensity score weighting was applied sequentially to balance racial differences in demographics, comorbidity score, neighborhood income, insurance status, grade, stage, and treatment.
RESULTS:
There were 1,257 NHBs and 8,963 NHWs with MEC. NHBs were more likely to have grade 3 (73% vs. 51%) and stage III/IV disease (40% vs. 29%), as well as comorbid conditions, lower neighborhood income, no or Medicaid insurance, and worse survival (each P<0.0001). The HR (95% CI) for death in NHB vs. NHW patients was 1.89 (1.72-2.09) in the unadjusted model and an insignificant 1.13 (0.96-1.32) in the fully balanced model. Comorbidity score, neighborhood income, insurance, grade, stage, and treatment each accounted for 4.7%, 14.0%, 7.0%, 42.1%, 14.1%, and 3.5% of the total excess relative risk of death in the NHB vs. NHW patients, respectively, with 14.6% remained to be explained.
CONCLUSIONS:
Grade was the largest contributor to survival disparities between NHBs and NHWs with MEC followed by the modifiable factors: neighborhood income, insurance, and comorbidity score.
Non-Hispanic Blacks (NHBs) with endometrial cancer have worse survival than Non-Hispanic Whites (NHWs) with the largest disparity in endometrioid vs. non-endometrioid cancer. Mixed endometrial cancers (MEC) with grade (G1/G2) endometrioid and mucinous cancer are type I vs. type II with non-endometrioid components (G3). This study investigated racial disparity in these rare MEC.
METHODS:
NHBs and NHWs diagnosed between 2004-2014 with stage I-IV MEC in the National Cancer Database were eligible. Racial differences in clinical characteristics at diagnosis were evaluated using Chi-square test. Survival was evaluated before and after propensity score weighting was applied sequentially to balance racial differences in demographics, comorbidity score, neighborhood income, insurance status, grade, stage, and treatment.
RESULTS:
There were 1,257 NHBs and 8,963 NHWs with MEC. NHBs were more likely to have grade 3 (73% vs. 51%) and stage III/IV disease (40% vs. 29%), as well as comorbid conditions, lower neighborhood income, no or Medicaid insurance, and worse survival (each P<0.0001). The HR (95% CI) for death in NHB vs. NHW patients was 1.89 (1.72-2.09) in the unadjusted model and an insignificant 1.13 (0.96-1.32) in the fully balanced model. Comorbidity score, neighborhood income, insurance, grade, stage, and treatment each accounted for 4.7%, 14.0%, 7.0%, 42.1%, 14.1%, and 3.5% of the total excess relative risk of death in the NHB vs. NHW patients, respectively, with 14.6% remained to be explained.
CONCLUSIONS:
Grade was the largest contributor to survival disparities between NHBs and NHWs with MEC followed by the modifiable factors: neighborhood income, insurance, and comorbidity score.
Background:
Non-Hispanic Blacks (NHBs) with endometrial cancer have worse survival than Non-Hispanic Whites (NHWs) with the largest disparity in endometrioid vs. non-endometrioid cancer. Mixed endometrial cancers (MEC) with grade (G1/G2) endometrioid and mucinous cancer are type I vs. type II with non-endometrioid components (G3). This study investigated racial disparity in these rare MEC.
METHODS:
NHBs and NHWs diagnosed between 2004-2014 with stage I-IV MEC in the National Cancer Database were eligible. Racial differences in clinical characteristics at diagnosis were evaluated using Chi-square test. Survival was evaluated before and after propensity score weighting was applied sequentially to balance racial differences in demographics, comorbidity score, neighborhood income, insurance status, grade, stage, and treatment.
RESULTS:
There were 1,257 NHBs and 8,963 NHWs with MEC. NHBs were more likely to have grade 3 (73% vs. 51%) and stage III/IV disease (40% vs. 29%), as well as comorbid conditions, lower neighborhood income, no or Medicaid insurance, and worse survival (each P<0.0001). The HR (95% CI) for death in NHB vs. NHW patients was 1.89 (1.72-2.09) in the unadjusted model and an insignificant 1.13 (0.96-1.32) in the fully balanced model. Comorbidity score, neighborhood income, insurance, grade, stage, and treatment each accounted for 4.7%, 14.0%, 7.0%, 42.1%, 14.1%, and 3.5% of the total excess relative risk of death in the NHB vs. NHW patients, respectively, with 14.6% remained to be explained.
CONCLUSIONS:
Grade was the largest contributor to survival disparities between NHBs and NHWs with MEC followed by the modifiable factors: neighborhood income, insurance, and comorbidity score.
Non-Hispanic Blacks (NHBs) with endometrial cancer have worse survival than Non-Hispanic Whites (NHWs) with the largest disparity in endometrioid vs. non-endometrioid cancer. Mixed endometrial cancers (MEC) with grade (G1/G2) endometrioid and mucinous cancer are type I vs. type II with non-endometrioid components (G3). This study investigated racial disparity in these rare MEC.
METHODS:
NHBs and NHWs diagnosed between 2004-2014 with stage I-IV MEC in the National Cancer Database were eligible. Racial differences in clinical characteristics at diagnosis were evaluated using Chi-square test. Survival was evaluated before and after propensity score weighting was applied sequentially to balance racial differences in demographics, comorbidity score, neighborhood income, insurance status, grade, stage, and treatment.
RESULTS:
There were 1,257 NHBs and 8,963 NHWs with MEC. NHBs were more likely to have grade 3 (73% vs. 51%) and stage III/IV disease (40% vs. 29%), as well as comorbid conditions, lower neighborhood income, no or Medicaid insurance, and worse survival (each P<0.0001). The HR (95% CI) for death in NHB vs. NHW patients was 1.89 (1.72-2.09) in the unadjusted model and an insignificant 1.13 (0.96-1.32) in the fully balanced model. Comorbidity score, neighborhood income, insurance, grade, stage, and treatment each accounted for 4.7%, 14.0%, 7.0%, 42.1%, 14.1%, and 3.5% of the total excess relative risk of death in the NHB vs. NHW patients, respectively, with 14.6% remained to be explained.
CONCLUSIONS:
Grade was the largest contributor to survival disparities between NHBs and NHWs with MEC followed by the modifiable factors: neighborhood income, insurance, and comorbidity score.
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