Racial/ethnic disparities in time from diagnosis to surgical treatment for type I and type II endometrial carcinomas

Abstract

Objective

Timeliness of cancer care has been recognized as an indicator of quality of care for numerous cancer sites. Differences in endometrial cancer type may contribute to racial/ethnic disparities in treatment outcomes. This study examines racial/ethnic disparities in time to surgical treatment among type I and type II endometrial cancers.

Methods

We used data from 33,626 women with endometrial cancer in the California Cancer Registry between 2000 and 2019. Descriptive statistics, bivariate analyses, univariate logistic regression models, and multivariate logistic regression models stratified by endometrial cancer type (type I or type II) were performed.

Results

Surgical treatment delays were apparent in 35.3 % (n = 22,487) of type I and 34.6 % (n = 11,139) of type II endometrial cancers; treatment delays varied across racial/ethnic group. Among type I endometrial cancers, multivariable models indicate that American Indian/Alaska Native (odds ratio [OR] 1.47, 95 % CI 1.10–1.97, p < 0.05), Black (OR 1.41, 95 % CI 1.23–1.62, p < 0.001), Hispanic/Latina (OR 1.23, 95 % CI 1.15–1.33, p < 0.001), and Asian or Pacific Islander (OR 1.12, 95 % CI 1.02–1.22, p < 0.01) women had higher odds of experiencing treatment delays compared with White women. Among type II endometrial cancers, multivariable models indicate that Black (OR 1.36, 95 % CI 1.18–1.56, p < 0.001) and Hispanic/Latina (OR 1.15, 95 % CI 1.03–1.28, p < 0.05) women had higher odds of experiencing treatment delays compared with White women.

Conclusions

Targeted interventions are needed to address racial/ethnic disparities in time to surgical treatment for endometrial cancer to ensure equitable access to timely and appropriate cancer care.