title: Histopathologic differences account for racial disparity in uterine cancer survival.
abstract: OBJECTIVE
  The incidence for uterine cancers has been reported to be higher among white women, whereas mortality is higher among black women. Reasons for the higher mortality among black women are not completely understood. The aim of our study is to examine the relationship between race/ethnicity, histopathologic subtype, and survival in uterine cancer.
  
  
  METHODS
  We abstracted socio-demographic, treatment, and survival data for all women who were diagnosed with uterine cancer at Montefiore Medical Center from January 1999 through December 2009. Pathology records were reviewed.
  
  
  RESULTS
  984 patients were identified. Racial/ethnic distribution was 382 (39%) white, 308 (31%) black, 232 (24%) Hispanic, and 62 (6.3%) other races, mixed, or unknown. 592 (60%) patients had endometrioid histology. Blacks were much more likely than whites to have non-endometrioid histologies (p<0.001), including papillary serous, carcinosarcoma, and leiomyosarcoma. Blacks and Hispanics were at least as likely as whites to receive either chemotherapy or radiation therapy. The hazard ratio for death for black versus white patients was 1.94 (p<0.001) when all histological subtypes were included. The hazard ratio for Hispanics for death was 1.2 (p=0.32) compared to whites. However, when patients were divided into endometrioid and non-endometrioid histological subtypes, there was no significant difference in survival by race/ethnicity.
  
  
  CONCLUSIONS
  Black patients with uterine cancer are much more likely to die and are much more likely to have non-endometrioid histologies than white patients. There are no differences in survival among white, black, or Hispanic women with uterine cancer, after control for histological subtype.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA. dsmotkin@montefiore.org
authors.forename: David
authors.initials: D
authors.lastname: Smotkin
authors.forename: Nicole S
authors.initials: NS
authors.lastname: Nevadunsky
authors.forename: Kimala
authors.initials: K
authors.lastname: Harris
authors.forename: Mark H
authors.initials: MH
authors.lastname: Einstein
authors.forename: Yiting
authors.initials: Y
authors.lastname: Yu
authors.forename: Gary L
authors.initials: GL
authors.lastname: Goldberg
mesh_terms: D000368:Aged; D044383:Black People; D015992:Body Mass Index; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D016016:Proportional Hazards Models; D018426:SEER Program; D014594:Uterine Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000473:pathology*; D044465:White People