Race and neighborhood disadvantage in patients with stage I-III endometrioid endometrial carcinoma treated at a tertiary referral center

Objective

To identify associations between race, neighborhood disadvantage, and outcomes in women with stage I-III endometrioid endometrial cancer (EEC) treated at a tertiary referral center.

Methods

This retrospective tumor registry study included patients with stage I-III EEC between 1/2006 and 12/2022. Progression-free (PFS) and overall survival (OS) were analyzed by race and neighborhood disadvantage, stratified by Area Deprivation Index (ADI; national quartile).

Results

Of 797 patients included, 112 (14 %) resided in the least disadvantaged quartile, 267 (34 %) in the second ADI quartile, 248 (31 %) in the third ADI quartile, and 170 (21 %) in the most disadvantaged quartile. A greater proportion of Black than White patients lived in the most disadvantaged areas (39 % vs 16 %, p < 0.01). In adjusted Cox-proportion model for PFS, older age, higher grade, higher stage and living in the least disadvantaged areas were associated with a higher risk of progression, however, in adjusted model for OS, only higher stage and older age were associated with a higher risk of death. Race was not associated with PFS or OS.

Conclusions

In women with Stage I-III EEC treated at a single tertiary referral center, we did not find differences in outcomes when analyzed by ADI or race. Given previously reported racial disparities in outcomes for women with EEC, our data may reflect increased resources available to patients with access to a tertiary center regardless of residence. Future studies should focus on broader geographic areas and more individual measurements of vulnerability.