Department of Obstetrics & Gynecology, USA; Sealy Institute for Vaccine Sciences, USA.
Department of Preventive Medicine and Population Health, USA.
Gynecol Oncol. 2021 Jan;160(1):16-23. doi: 10.1016/j.ygyno.2020.10.033. Epub 2020 Nov 19.
While disparities in endometrial hyperplasia and endometrial cancer are well documented in Blacks and Whites, limited information exists for Hispanics. The objective is to describe the patient characteristics associated with endometrial hyperplasia symptoms, endometrial hyperplasia with atypia and endometrial cancer, and assess factors contributing to racial/ethnic differences in disease outcomes.
This single-center, retrospective study included women aged ≥50 years with ≥ two encounters for endometrial hyperplasia symptoms, endometrial hyperplasia with atypia and endometrial cancer between 2012 and 2016. Multivariate logistic regression models evaluated the predictors of endometrial cancer and hyperplasia.
We included 19,865 women (4749 endometrial hyperplasia symptoms, 71 endometrial hyperplasias with atypia, 201 endometrial cancers) with mean age of 60.45 years (SD 9.94). The odds of endometrial hyperplasia symptoms were higher in non-Hispanic Blacks (Odds Ratio [OR] 1.56, 95% Confidence Interval [CI] 1.20-1.72), Hispanics (OR 1.35, 95% CI 1.22-1.49), family history of female cancer (OR 1.25, 95% CI 1.12-1.39), hypertension (OR 1.24, 95% CI 1.14-1.35), and birth control use (OR 1.29, 95% CI 1.15-1.43). Odds of endometrial cancer and atypical hyperplasia increased for ages 60-64 (OR 7.95, 95% CI 3.26-19.37; OR 3.66, 95% 1.01-13.22) and being obese (OR 1.61, 95% CI 1.08-2.41; OR: 6.60, 95% CI 2.32-18.83). Odds of endometrial cancer increased with diabetes (OR 1.68, 95% CI 1.22-2.32).
CONCLUSION(S): Patients with obesity and diabetes had increased odds of endometrial cancer and hyperplasia with atypia. Further study is needed to understand the exogenous estrogen effect contributing to the increased incidence among Hispanics.
尽管黑人和白人之间子宫内膜增生和子宫内膜癌的差异已有充分记录，但关于西班牙裔的信息有限。目的是描述与子宫内膜增生症状、非典型子宫内膜增生和子宫内膜癌相关的患者特征，并评估导致疾病结局种族/民族差异的因素。
这项单中心回顾性研究纳入了 2012 年至 2016 年间年龄≥50 岁且有≥2 次子宫内膜增生症状、非典型子宫内膜增生和子宫内膜癌就诊史的女性。多变量逻辑回归模型评估了子宫内膜癌和增生的预测因素。
我们纳入了 19865 名女性（4749 名子宫内膜增生症状、71 名非典型子宫内膜增生、201 名子宫内膜癌），平均年龄为 60.45 岁（标准差 9.94）。非西班牙裔黑人（优势比 [OR] 1.56，95%置信区间 [CI] 1.20-1.72）、西班牙裔（OR 1.35，95% CI 1.22-1.49）、女性癌症家族史（OR 1.25，95% CI 1.12-1.39）、高血压（OR 1.24，95% CI 1.14-1.35）和使用避孕药具（OR 1.29，95% CI 1.15-1.43）的子宫内膜增生症状发生几率更高。60-64 岁（OR 7.95，95% CI 3.26-19.37；OR 3.66，95% CI 1.01-13.22）和肥胖（OR 1.61，95% CI 1.08-2.41；OR：6.60，95% CI 2.32-18.83）的年龄和肥胖是子宫内膜癌和非典型增生的几率增加。糖尿病（OR 1.68，95% CI 1.22-2.32）患者发生子宫内膜癌的几率增加。
肥胖和糖尿病患者发生子宫内膜癌和非典型增生的几率增加。需要进一步研究以了解导致西班牙裔发病率增加的外源性雌激素的作用。
