Racial disparities in high-risk uterine cancer histologic subtypes: A United States Cancer Statistics study
Racial disparities in high-risk uterine cancer histologic subtypes: A United States Cancer Statistics study
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DOI：
10.1016/j.ygyno.2021.02.037
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发表时间：
2021-04-24
影响因子：
4.7
通讯作者：
Chan, John K.
中科院分区：
文献类型：
--
作者：
Abel, Mary Kathryn;Liao, Cheng-, I;Chan, John K.
目标。与白人女性相比，患有子宫癌的黑人女性平均存活率更低，部分原因是侵略性、非子宫内膜样亚型的发病率更高。然而，具体高危亚型的发病率趋势分析缺乏，包括那些子宫切除术和积极妊娠矫正。本研究的目的是评估720,984例非子宫内膜样子宫癌年龄调整发生率的种族差异。方法。数据来自美国癌症统计，使用SEER*Stat。我们使用行为风险因素监测系统来纠正子宫切除术和主动妊娠。结果720,984例患者中，白人560,131例（77.7%），黑人72,328例（10.0%），黑种人56,239例（7.8%），亚裔/太平洋岛民22,963例（3.2%）。子宫癌的年龄调整发病率从2001年的40.8（每10万人）上升到2016年的42.9 （APC = 0.5, p < 0.001）。黑人妇女的总发病率最高，为49.5 （APC = 2.3, p < 0.001）。非子宫内膜样亚型在黑人女性中的发病率高于白人女性，其中浆液性癌（9.1 vs. 3.0）、癌肉瘤（6.1 vs. 1.8）和平滑肌肉瘤（1.3 vs. 0.6）的差异最为明显。特别是70-74岁黑人女性浆液性癌的发病率最高（61.3），APC最高（7.3,p < 0.001）。与白人女性相比，黑人女性在子宫切除术和主动妊娠后患高危子宫癌亚型，特别是浆液性癌、癌肉瘤和平滑肌肉瘤的发生率高2 - 4倍。(c) 2021爱思唯尔公司版权所有。
Objective. Black women with uterine cancer on average have worse survival outcomes compared to White women, in part due to higher rates of aggressive, non-endometrioid subtypes. However, analyses of incidence trends by specific high-risk subtypes are lacking, including those with hysterectomy and active pregnancy cor-rection. The objective of our study was to evaluate racial disparities in age-adjusted incidence of non-endometrioid uterine cancer in 720,984 patients. Methods. Data were obtained from United States Cancer Statistics using SEER*Stat. We used the Behavioral Risk FactorSurveillance System to correct for hysterectomy and active pregnancy. Age-adjusted, corrected incidence of uterine cancer from 2001 to 2016 and annual percent change (APC) were calculated using Joinpoint regression.Results.Of 720,984 patients, 560,131 (77.7%) were White, 72,328 (10.0%) were Black, 56,239 (7.8%) were His-panic, and 22,963 (3.2%) were Asian/Pacific Islander. Age-adjusted incidence of uterine cancer increased from 40.8 (per 100,000) in 2001 to 42.9 in 2016 (APC = 0.5, p < 0.001). Black women had the highest overall incidence at 49.5 (APC = 2.3, p < 0.001). The incidence of non-endometrioid subtypes was higher in Black compared to White women, with the most pronounced differences seen in serous carcinoma (9.1 vs. 3.0), carcinosarcoma (6.1 vs. 1.8), and leiomyosarcoma (1.3 vs. 0.6). In particular, Black women aged 70-74 with serous carcinoma had the highest incidence (61.3) and the highest APC (7.3, p < 0.001).Conclusions. Black women have a two to four-fold higher incidence of high-risk uterine cancer subtypes, par-ticularly serous carcinoma, carcinosarcoma, and leiomyosarcoma, compared to White women after correcting for hysterectomy and active pregnancy.(c) 2021 Elsevier Inc. All rights reserved.