Racial disparities in histopathologic characteristics of uterine cancer are present in older, not younger blacks in an equal-access environment

Abstract

Objective: We sought to determine whether racial disparities in tumor characteristics among uterine cancer patients persisted, and varied by age, in an equal-access healthcare population.

Methods: The distributions of tumor histology, stage and grade by race were compared for uterine cancers diagnosed from 1990 to 2003 using data from the U.S. Department of Defense's Automated Central Tumor Registry. Comparisons were conducted overall and stratified by age (<50, ≥50) using the Chi-square test.

Results: Of 2582 uterine tumors identified, 2057 (79.7%) were diagnosed among White women and 183 (7.1%) among Black women. Among all women analyzed, Blacks were more likely than Whites to present with non-endometrioid tumors (47.7% vs 23.5%, p<0.01), non-localized tumors (31.8% vs 24.5%, p=0.02), and poorly differentiated tumors (20.5% vs 15.0%, p<0.01). Among women 50 years and older, similar significant racial disparities were observed. However, no significant racial differences were observed among young patients. When comparisons were restricted to endometrioid histology adenocarcinomas, trends in age-specific disparities for older women were observed.

Conclusions: Our study suggests that racial disparities in uterine cancers persist between Blacks and Whites in an equal-access population. Blacks endure higher stage and grade tumors, and more aggressive histologies. This disparity in clinicopathologic factors is confined to women older than 50 years. Multiple factors such as racial variation in age-related health knowledge/behavior and estrogen metabolism may be related to the racial disparity.