ArticleGynecologic oncology2024
Black-White differences in uterine cancer symptomatology and stage at diagnosis.
Article in Gynecologic oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 9 citations in OpenAlex.
- Postmenopausal bleeding: Association of initial place of care with stage at diagnosis for uterine cancer.Gynecologic oncology · 2025Article
- Beyond Bleeding: An Analysis of Presenting Symptoms Among Black Patients with Endometrial Cancer.Health equity · 2025Article
- Diagnostic experiences of Black and White patients with uterine cancer: A qualitative study.Gynecologic oncology · 2024Article
- Physician Uncertainty, Beliefs, and Practices on Peri- and Postmenopausal Bleeding Evaluation and the Impact on Risks for Black Patients at Risk for Endometrial Cancer.Journal of primary care & community healthArticle
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo examine whether uterine cancer symptoms differ between Black and White patients and how this may influence their stage at diagnosis.
methodsUsing the Surveillance, Epidemiology and End Results-Medicare database, we identified 2328 Black and 21,774 White patients with uterine cancer in 2008-2017. Their symptoms in the 18 months before diagnosis were categorized as postmenopausal bleeding (PMB) alone, PMB together with other symptoms (e.g., abdominal/pelvic pain, bloating), non-PMB symptoms alone, or no symptoms. Stage at diagnosis was dichotomized as advanced (i.e., regional/distant) versus localized. The association between race and stage was analyzed using regression models incrementally adjusting for symptoms and other patient characteristics.
resultsA larger proportion of Black than White patients experienced PMB together with other symptoms (63.1% versus 58.0%) or experienced non-PMB symptoms alone (13.1% versus 9.4%) (p < 0.001). Black patients had a higher risk of advanced-stage diagnosis than White patients (45.0% versus 30.3%, unadjusted RR = 1.52, 95% CI: 1.44-1.59). Adjusting for Black-White differences in symptoms attenuated the RR to 1.46 (95% CI: 1.39-1.53). Compared to PMB symptoms alone, having additional non-PMB symptoms (RR = 1.21, 95% CI: 1.15-1.26) and having non-PMB symptoms alone (RR = 1.99, 95% CI: 1.88-2.10) were associated with increased risk of advanced-stage diagnosis. Further adjusting for histology and other patient characteristics reduced Black-White disparity in advanced-stage diagnosis to 1.08 (95% CI: 1.03-1.14) but symptoms remained significantly associated with stage at diagnosis.
conclusionsHaving non-PMB symptoms was associated with more advanced stage at diagnosis. Non-PMB symptoms were more common among Black than White patients, which might hinder symptom recognition/evaluation.
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