Risk factors for delayed diagnosis of endometrial cancer among black individuals: Results from the GUIDE-EC study

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports Pub Date : 2025-08-01 DOI:10.1016/j.gore.2025.101922

Maya E. Gross , Mindy Pike , Julianna Alson , Patrice Williams , Mollie E. Wood , Erica Marsh , Erin Carey , Til Stürmer , Ronit Katz , Whitney R. Robinson , Kemi M. Doll

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引用次数: 0

Abstract

Objective

Black patients with endometrial cancer (EC) experience disproportionately advanced stage at diagnosis. We aimed to identify variables, beyond race and histologic subtype, which increase risk for delayed diagnosis of EC.

Methods

This is a retrospective study of Black individuals with EC in a large academic-affiliated healthcare system from 2014 to 2020. Primary outcome was delayed diagnosis of EC, defined as prolonged time to diagnosis (>28 days to reach diagnosis). We used descriptive statistics, univariate regression, and factor analysis to identify variables associated with delayed diagnosis, achieve data reduction, and calculate odds ratios for delayed diagnosis.

Results

Of 388 patients with EC included for analysis, one fifth (n = 79, 20 %) experienced delayed diagnosis. Ultrasound had the strongest association with delayed diagnosis in univariate regression (OR 4.4, 95 % CI 2.4, 7.8) and factor analysis (OR 2.2, 95 % CI 1.6, 3.0). BMI ≥ 40 (OR 1.9, 95 % CI 1.1, 3.3) was also associated with delayed diagnosis. Age ≥ 50 was associated with decreased odds of delayed diagnosis (OR 0.3, 95 % CI 0.2, 0.7). Presence of an endometrial biopsy was associated with decreased odds of delayed diagnosis on univariate regression (OR 0.4, 95 % CI 0.2, 1.4).

Conclusions

A fifth of Black patients with EC experienced delayed diagnosis, and preoperative ultrasound was most strongly associated with delayed diagnosis. Providers should consider a tissue-sampling-first approach in Black patients at risk for EC.

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黑人子宫内膜癌延迟诊断的危险因素：GUIDE-EC研究结果

目的：黑人子宫内膜癌（EC）患者在诊断时多处于晚期。我们的目的是确定除种族和组织学亚型外，会增加EC延迟诊断风险的变量。方法回顾性研究某大型学术附属医疗系统2014 - 2020年黑人EC患者。主要结局是延迟诊断EC，定义为诊断时间延长（28天达到诊断）。我们使用描述性统计、单变量回归和因子分析来识别与延迟诊断相关的变量，实现数据缩减，并计算延迟诊断的优势比。结果在纳入分析的388例EC患者中，五分之一（n = 79,20 %）出现延迟诊断。单因素回归分析（OR 4.4, 95% CI 2.4, 7.8）和因素分析（OR 2.2, 95% CI 1.6, 3.0）显示，超声与延迟诊断的相关性最强。BMI≥40 （OR 1.9, 95% CI 1.1, 3.3）也与延迟诊断相关。年龄≥50岁与延迟诊断的几率降低相关（OR 0.3, 95% CI 0.2, 0.7）。单因素回归显示，子宫内膜活检与延迟诊断的几率降低相关（OR 0.4, 95% CI 0.2, 1.4）。结论五分之一的黑人EC患者延迟诊断，术前超声与延迟诊断相关性最强。提供者应考虑对有EC风险的黑人患者采用组织取样优先的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gynecologic Oncology Reports OBSTETRICS & GYNECOLOGY-

CiteScore

2.00

自引率

0.00%

发文量

183

审稿时长

41 days

期刊介绍： Gynecologic Oncology Reports is an online-only, open access journal devoted to the rapid publication of narrative review articles, survey articles, case reports, case series, letters to the editor regarding previously published manuscripts and other short communications in the field of gynecologic oncology. The journal will consider papers that concern tumors of the female reproductive tract, with originality, quality, and clarity the chief criteria of acceptance.