The National Cancer Data Base Report on Endometrial Carcinoma in African-American Women

BACKGROUND, Although the incidence of uterine carcinoma is lower among Afri can-American women compared with white women, the mortality rates are highe r for African-American patients. This report is part of an ongoing series o n gynecologic malignancies in African-American women. METHODS. Hospital registry reports collected by the National Cancer Data Ba se were used to describe some of the differences in case presentation and m anagement characteristics of endometrial carcinoma in these two groups. The cases represented 52,307 Non-Hispanic white and 3226 African-American wome n diagnosed with primary carcinoma of the endometrium between 1988-1994. RESULTS. More African-American patients were diagnosed with less favorable histologies than white patients, at more advanced stages of disease, and wi th less tumor differentiation. Income had no effect on stage or grade. Afri can-American patients were treated less often for their tumor at every stag e of diagnosis compared with white women. Income generally had no effect on whether treatment was provided, but limited income was associated with a l ack of treatment in African-American patients with American Joint Committee on Cancer Stage IV tumors. African-American women were less frequently tre ated surgically and, among surgically treated patients at advanced stages o f disease, they received adjuvant radiotherapy less often and chemotherapy more often than white patients. Five-year survival was poorer for African-A merican women, even for patients with the more favorable Stage I adenocarci noma who were treated surgically. CONCLUSIONS. All patients, regardless of race, should be treated appropriat ely as dictated by medical and prognostic factors and not by race. Although no screening methods currently exist for endometrial carcinoma, the develo pment of procedures for identifying patients at risk for the prognostic fac tors that lead to a poor outcome should be a primary focus. Cancer 1998;83: 2629-37. (C) 1998 American Cancer Society.