Race disparities between black and white women in the incidence, treatment, and prognosis of endometrial cancer.
BACKGROUND
Uterine cancer is the most common gynecologic malignancy in the United States, with an estimated 40,100 new cases and 7,470 deaths occurring in 2008. Although the incidence of endometrial cancer is lower among black women compared with white women, the proportion of cancer-related deaths among blacks is higher and has continued to rise over the past two decades.


METHODS
The authors conducted a survey of recent literature published in the English language and have used these articles as the basis for this review.


RESULTS
The etiology for the racial disparity among black women with endometrial cancer is multifactorial and may be the result of barriers that impede access to care, an increased incidence of comorbidities among black women, inequalities in surgical care, adjuvant chemotherapy and radiation treatment, and underlying biological differences associated with more aggressive tumors that often develop in black women.


CONCLUSIONS
Black women with endometrial cancer have a poorer prognosis compared with white women. Factors that contribute to this racial disparity include later diagnosis, treatment disparities, comorbid conditions, and genetic differences in tumors. An improved understanding of the causative factors associated with racial disparities in endometrial cancer outcome is needed to facilitate efforts aimed at correcting this important health care problem and providing individualized care to those at highest risk for poor outcome.
Allard
Jay E
JE
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, Washington, DC 20307, USA.
Maxwell
G Larry
GL
D001741:Black or African American / Q000208:ethnology / Q000235:genetics; D015897:Comorbidity; D016889:Endometrial Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D012959:Socioeconomic Factors; D014481:United States; D044465:White People / Q000208:ethnology / Q000235:genetics