title: Comorbidities and endometrial cancer survival in Hispanics and non-Hispanic whites.
abstract: OBJECTIVE
  We investigated comorbidities and endometrial cancer survival by ethnicity because Hispanic whites (HWs) have worse survival than non-Hispanic whites (NHWs).
  
  
  METHODS
  An endometrial cancer cohort (1992-2004) established with the Surveillance, Epidemiology and End Results-Medicare-linked database (n = 3,286) was followed through 2007. Endometrial cancer-specific and other cause mortality were evaluated with multivariate hazard ratios (mHRs).
  
  
  RESULTS
  HWs were more likely than NHWs to have regional/distant disease (31.7 vs. 24.8 %), diabetes (31.7 vs. 11.0 %), and hypertension (49.4 vs. 37.6 %). HWs had poorer endometrial cancer-specific survival than NHWs (age-adjusted HR = 1.28; 95% CI 1.01-1.61), but not after adjustment for tumor characteristics and treatment (mHR = 1.02; 95% CI 0.81-1.29). In contrast, even after adjustment for cancer-related factors, other cause mortality in HWs was elevated (mHR = 1.27; 95% CI 1.01-1.59), but not after further adjustment for comorbid conditions (mHR = 1.07; 95% CI 0.85-1.35).
  
  
  CONCLUSIONS
  Comorbidities, particularly diabetes, were more common in HWs than in NHWs and impacted other cause mortality. Improving diabetes management may be an effective means of improving other cause mortality. This may be particularly true for HWs, given their particularly high prevalence of diabetes.
authors.affiliation: Division of Epidemiology and Biostatistics, Department of Internal Medicine and UNM Cancer Research and Treatment Center, University of New Mexico, Albuquerque, NM 87131-0001, USA. lcook@salud.unm.edu
authors.forename: Linda S
authors.initials: LS
authors.lastname: Cook
authors.forename: Harold E
authors.initials: HE
authors.lastname: Nelson
authors.forename: Myles
authors.initials: M
authors.lastname: Cockburn
authors.forename: Sara H
authors.initials: SH
authors.lastname: Olson
authors.forename: Carolyn Y
authors.initials: CY
authors.lastname: Muller
authors.forename: Charles L
authors.initials: CL
authors.lastname: Wiggins
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018269:Carcinoma, Endometrioid / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality*; D015331:Cohort Studies; D015897:Comorbidity; D016889:Endometrial Neoplasms / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D018426:SEER Program / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013534:Survival / Q000502:physiology; D017741:Survivors / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*