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Racial and Ethnic Disparities in Treatment Initiation and Survival Among Patients With Endometrial Cancer
By Omar García‐Rodríguez, KEA TURNER, Yu Chen Lin and 4 others.
Abstract
Objective
To assess the associations of time to treatment initiation and overall survival with race and ethnicity by socioeconomic status (SES) among women with advanced endometrial cancer. We also aimed to evaluate the role of social and clinical determinants in time to treatment initiation and overall survival.
Methods
We conducted a retrospective cohort study using the Flatiron Health Research Database among adult women diagnosed with advanced (stages III-IV) endometrial cancer or who developed recurrence between 2013 and 2022. The main outcomes included delayed treatment initiation (more than 6 weeks) and all-cause mortality. Primary exposures included race and ethnicity and quintiles of area-level SES (Yost Index). We computed adjusted prevalence ratios with 95% CIs using multivariable modified Poisson regressions to assess racial and ethnic disparities in time to treatment initiation, and we computed adjusted hazard ratios (HRs) using Cox proportional hazards models to assess disparities in mortality. All models were adjusted for sociodemographic factors, comorbidities, and cancer and histology characteristics.