ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2026
Measurement of Treatment Adequacy Influences Racial Disparities Estimates in Endometrial Cancer Care.
Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundGuideline-concordant treatment (GCT) is a key indicator of cancer care quality, yet most studies rely on cancer registry data, which incompletely capture treatment adequacy and vary in population composition. As a result, estimates of racial and ethnic disparities in GCT may differ depending on treatment measurement and populations represented in the data.
methodsWe conducted analyses using Surveillance, Epidemiology, and End Results (SEER)-17, the National Cancer Database (NCDB), and SEER-Medicare to evaluate how treatment measurement and population composition influence disparities in guideline-concordant endometrial cancer treatment. GCT was defined according to National Comprehensive Cancer Network recommendations. Primary analyses used adequacy-based definitions incorporating treatment receipt, timing, amount, and duration, when available, while sensitivity analyses used receipt-based definitions based only on documented receipt. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) for associations between race/ethnicity and GCT within each data source. Additional sensitivity analyses evaluated influences of differences in underlying study populations.
resultsUsing adequacy-based definitions of GCT, Black patients had lower GCT odds than White patients (SEER OR=0.84, 95% CI=0.79-0.90; NCDB OR=0.75, 95% CI=0.73-0.77; SEER-Medicare OR=0.73, 95% CI=0.62-0.85). Within both NCDB and SEER-Medicare, adequacy-based definitions of GCT yielded larger racial and ethnic disparities than receipt-based definitions.
conclusionsThe estimated magnitude of racial disparities in guideline-concordant endometrial cancer treatment are sensitive to treatment measurement and patient selection; sources capturing treatment adequacy show larger disparities. IMPACT: Measuring treatment adequacy provides a more comprehensive assessment of inequities in endometrial cancer care and may improve cancer disparities research, quality measurement, and policy.
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