University of California, San Francisco School of Medicine, San Francisco, CA, USA.
Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Gynecol Oncol. 2021 May;161(2):470-476. doi: 10.1016/j.ygyno.2021.02.037. Epub 2021 Mar 13.
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 correction. The objective of our study was to evaluate racial disparities in age-adjusted incidence of non-endometrioid uterine cancer in 720,984 patients.
Data were obtained from United States Cancer Statistics using SEER*Stat. We used the Behavioral Risk Factor Surveillance 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.
Of 720,984 patients, 560,131 (77.7%) were White, 72,328 (10.0%) were Black, 56,239 (7.8%) were Hispanic, 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).
Black women have a two to four-fold higher incidence of high-risk uterine cancer subtypes, particularly serous carcinoma, carcinosarcoma, and leiomyosarcoma, compared to White women after correcting for hysterectomy and active pregnancy.
与白人女性相比，患有子宫癌的黑人女性的平均生存结果较差，部分原因是侵袭性、非子宫内膜样亚型的比例较高。然而，缺乏对特定高危亚型发病率趋势的分析，包括那些接受过子宫切除术和活产矫正的患者。本研究的目的是评估 720984 名患者中非子宫内膜样子宫癌的年龄调整发病率的种族差异。
数据来自美国癌症统计数据，使用 SEER*Stat 获得。我们使用行为风险因素监测系统来校正子宫切除术和活产。使用 Joinpoint 回归计算 2001 年至 2016 年的年龄调整、校正后的子宫癌发病率和年百分变化（APC）。
在 720984 名患者中，560131 名（77.7%）为白人，72328 名（10.0%）为黑人，56239 名（7.8%）为西班牙裔，22963 名（3.2%）为亚裔/太平洋岛民。子宫癌的年龄调整发病率从 2001 年的 40.8（每 100000 人）增加到 2016 年的 42.9（APC=0.5，p<0.001）。黑人女性的总体发病率最高，为 49.5（APC=2.3，p<0.001）。与白人女性相比，黑人女性的非子宫内膜样亚型发病率更高，其中浆液性癌（9.1 比 3.0）、癌肉瘤（6.1 比 1.8）和平滑肌肉瘤（1.3 比 0.6）的差异最为明显。特别是，70-74 岁患有浆液性癌的黑人女性的发病率最高（61.3），APC 最高（7.3，p<0.001）。
在校正子宫切除术和活产因素后，与白人女性相比，黑人女性具有高风险的子宫癌亚型（尤其是浆液性癌、癌肉瘤和平滑肌肉瘤）的发病率要高出两到四倍。
