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. 2022 May;165(2):248-256.
doi: 10.1016/j.ygyno.2022.02.021. Epub 2022 Mar 8.

Differences in the microbial profiles of early stage endometrial cancers between Black and White women

Gabrielle M Hawkins  1 , Wesley C Burkett  2 , Amber N McCoy  3 , Hazel B Nichols  4 , Andrew F Olshan  5 , Russell Broaddus  6 , Jason D Merker  7 , Bernard Weissman  8 , Wendy R Brewster  9 , Jeffrey Roach  10 , Temitope O Keku  11 , Victoria Bae-Jump  12
Affiliations

Differences in the microbial profiles of early stage endometrial cancers between Black and White women

Gabrielle M Hawkins et al. Gynecol Oncol. 2022 May.

Abstract

Objective: Black women suffer a higher mortality from endometrial cancer (EC) than White women. Potential biological causes for this disparity include a higher prevalence of obesity and more lethal histologic/molecular subtypes. We hypothesize that another biological factor driving this racial disparity could be the EC microbiome.

Methods: Banked tumor specimens of postmenopausal, Black and White women undergoing hysterectomy for early stage endometrioid EC were identified. The microbiota of the tumors were characterized by bacterial 16S rRNA sequencing. The microbial component of endometrioid ECs in The Cancer Genome Atlas (TCGA) database were assessed for comparison.

Results: 95 early stage ECs were evaluated: 23 Black (24%) and 72 White (76%). Microbial diversity was increased (p < 0.001), and Firmicutes, Cyanobacteria and OD1 phyla abundance was higher in tumors from Black versus White women (p < 0.001). Genus level abundance of Dietzia and Geobacillus were found to be lower in tumors of obese Black versus obese White women (p < 0.001). Analysis of early stage ECs in TCGA found that microbial diversity was higher in ECs from Black versus White women (p < 0.05). When comparing ECs from obese Black versus obese White women, 5 bacteria distributions were distinct, with higher abundance of Lactobacillus acidophilus in ECs from Black women being the most striking difference. Similarly in TCGA, Dietzia and Geobacillus were more common in ECs from White women compared to Black.

Conclusion: Increased microbial diversity and the distinct microbial profiles between ECs of obese Black versus obese White women suggests that intra-tumoral bacteria may contribute to EC disparities and pathogenesis.

Keywords: Endometrial cancer; Race disparities; Uterine microbiome.

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Conflict of interest statement

Declaration of Competing Interest The authors declare no competing financial interest for this manuscript.

Figures

Figure 1:
Figure 1:
Genus-level microbiota abundance (%) between the benign uterus and endometrioid endometrial cancers. (Blue = p and FDR <0.05; Green = p<0.05 and FDR<0.10)
Figure 2:
Figure 2:
Phylum-level microbiota abundance (%) in endometrial cancer tumors of White women by obesity status. (Blue = p and FDR<0.05)
Figure 3:
Figure 3:
Phylum- (A) and genus-level (B) microbiota distribution (%) in endometrial tumors of obese endometrial cancer patients by race. (Blue = p and FDR<0.05; Green = p<0.05 and FDR<0.10)
Figure 3:
Figure 3:
Phylum- (A) and genus-level (B) microbiota distribution (%) in endometrial tumors of obese endometrial cancer patients by race. (Blue = p and FDR<0.05; Green = p<0.05 and FDR<0.10)
Figure 4:
Figure 4:
Bacterial enzymes (A) and pathways (B) that distinguished endometrial cancers from Black versus White women. (Red = p<0.05)
Figure 5:
Figure 5:. Analysis of the microbial component of endometrial cancers in The Cancer Genome Atlas (TCGA) database.
Increased microbial diversity was found when comparing the endometrial cancers of Black versus White women (A). In addition, several bacteria were found to be associated with either Black or White race (B). W scores estimated by ANCOM; additional statistical significance: p-values, q-values, and indications of structural zeros, estimated by ANCOM-BC.
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