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Review
. 2023 Nov-Dec;29(6):343-353.
doi: 10.1097/PPO.0000000000000678.

Disparities in Gynecologic Cancers

Nita K Lee, Jasmin A Tiro, Kunle Odunsi
Review

Disparities in Gynecologic Cancers

Nita K Lee et al. Cancer J. 2023 Nov-Dec.

Abstract

Gynecologic cancer disparities have different trends by cancer type and by sociodemographic/economic factors. We highlight disparities in the United States arising due to poor delivery of cancer care across the continuum from primary prevention, detection, and diagnosis through treatment and identify opportunities to eliminate/reduce disparities to achieve cancer health equity. Our review documents the persistent racial and ethnic disparities in cervical, ovarian, and uterine cancer outcomes, with Black patients experiencing the worst outcomes, and notes literature investigating social determinants of health, particularly access to care. Although timely delivery of screening and diagnostic evaluation is of paramount importance for cervical cancer, efforts for ovarian and uterine cancer need to focus on timely recognition of symptoms, diagnostic evaluation, and delivery of guideline-concordant cancer treatment, including tumor biomarker and somatic/germline genetic testing.

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Conflict of interest statement

Conflicts of Interest and Source of Funding: K.O. is co-founder of Tactiva Therapeutics. N.K.L. is an educational consultant for the National Ovarian Cancer Coalition. J.A.T. has no significant relationships with, or financial interest in commercial companies pertaining to this article. K.O., J.A.T., and N.K.L. are supported by NCI grant P30CA014599. J.A.T. also receives research support from NCI grants UM1CA221940 and R01CA240375.

Figures

Figure 1.
Figure 1.
Failures in the delivery of the cancer care continuum for gynecologic cancers (cervical, ovarian, and uterine). Adapted from Yabroff et al.
Figure 2:
Figure 2:
Timeline of changes in cervical cancer prevention and control practices in the United States
Figure 3:
Figure 3:
Stage distribution by race and ethnicity in cervical cancer
Figure 4:
Figure 4:
Global cervical cancer disparities. Age-standardized incidence (A) and mortality rates (B) of cervical cancer by country in 2020. Maps as published by Singh et al. as open access under the CC BY-NC-ND license. Copyright ©2023 World Health Organization. Data are from the GLOBOCAN database, collated by the International Agency for Research on Cancer and hosted by the Global Cancer Observatory.
Figure 5:
Figure 5:
Framework for Ovarian Cancer Disparities
Figure 6:
Figure 6:
5-year age-adjusted mortality rates in uterine cancer by race/ethnicity
Figure 7:
Figure 7:
5-yr survival by race and ethnicity for advanced stage uterine cancer
See this image and copyright information in PMC

References

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