ArticleJournal of the National Cancer Institute2023
Racial disparities in diagnostic evaluation of uterine cancer among Medicaid beneficiaries.
Article in Journal of the National Cancer Institute, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 18 citations in OpenAlex.
- Pre-diagnosis symptoms reported among endometrial cancer survivors.Gynecologic oncology reports · 2026Article
- Postmenopausal bleeding: Association of initial place of care with stage at diagnosis for uterine cancer.Gynecologic oncology · 2025Article
- Traditional and New Views on MSI-H/dMMR Endometrial Cancer.Biomolecules · 2025Review
- Article
- Geographic Variation of Racial and Ethnic Differences in Uterine Cancer Survival.JAMA network open · 2025Article
- Epigenetic mechanisms underlying endometrial cancer outcomes: race-specific patterns of DNA methylation associated with molecular subtypes and survival.Carcinogenesis · 2025Article
- Challenges in Providing Gynecological Procedures in Primary Care: A Survey of Canadian Academic Family Physicians.Women's health reports (New Rochelle, N.Y.) · 2025Article
- Diagnostic experiences of Black and White patients with uterine cancer: A qualitative study.Gynecologic oncology · 2024Article
- Racioethnic Disparities in Endometrial Cancer Outcomes.Diagnostics (Basel, Switzerland) · 2024Review
- Timeliness of diagnostic evaluation for postmenopausal bleeding: A retrospective cohort study using claims data.PloS one · 2023Article
- Cancer statistics, 2026.CA: a cancer journal for cliniciansArticle
- Cancer statistics, 2025.CA: a cancer journal for cliniciansArticle
- Disparities in Gynecologic Cancers.Cancer journal (Sudbury, Mass.)Review
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundTo inform reasons contributing to Black-White disparity in early diagnosis of uterine cancer, we compared the quality of diagnostic evaluation received by Black vs White patients with abnormal uterine bleeding (AUB) ultimately diagnosed with uterine cancer.
methodsUsing 2008-2019 MarketScan Multi-State Medicaid Database, we identified Black (n = 858) and White (n = 1749) patients with uterine cancer presenting with AUB. Quality of diagnostic evaluation was measured by delayed diagnosis (>1 year after AUB reporting), not receiving guideline-recommended diagnostic procedures, delayed time to first diagnostic procedure (>2 months after AUB reporting), number of diagnostic procedures received, and number of evaluation and management visits for AUB. The association between race and quality indicators was examined by multivariable regressions adjusting for patient characteristics.
resultsBlack patients were more likely than White patients to experience delayed diagnosis (11.3% vs 8.3%, P = .01; adjusted odds ratio [OR] = 1.71, 95% confidence interval [CI] = 1.27 to 2.29) or to not receive guideline-recommended diagnostic procedures (10.1% vs 5.0%, P < .001; adjusted OR = 1.94, 95% CI = 1.40 to 2.68). Even when they did receive recommended diagnostic procedures, Black patients were more likely than White patients to experience delay in time to the first diagnostic procedure (adjusted OR = 1.46, 95% CI = 1.09 to 1.97). In addition, Black patients underwent more evaluation and management visits for AUB before getting diagnosed compared with White patients (adjusted mean ratio = 1.13, 95% CI = 1.04 to 1.23).
conclusionsBlack and White patients with uterine cancer differed in the quality of diagnostic evaluation received. Improving equity in this area may help reduce Black-White disparity in stage at diagnosis.
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