title: The role of racial genetic admixture with endometrial cancer outcomes: An NRG Oncology/Gynecologic Oncology Group study.
abstract: OBJECTIVE
  Racial genetic admixture (RGA), a measure to account for ancestral genetic background that correlates with individual's racial classification, could provide insights on causation of racial disparity in endometrial cancer (EC). Our objective is to evaluate the association of RGA with EC outcomes.
  
  
  METHODS
  EC patients enrolled onto the GOG-210 protocol were eligible. A randomized subcohort stratified by stage and self-reported race/ethnicity of black or white was used. Genotyping was performed using custom-selected Ancestry Informative Markers to calculate individual admixture estimates of African and European ancestral background.
  
  
  RESULTS
  A total of 149 patients were evaluated (self-reported race: 70 black & 79 white). Mean RGA for African ancestry for self-reported black patients was 0.65 (range 0.04-0.86); while mean RGA for European ancestry for self-reported white patients was 0.77 (range 0.12-0.88). Progression-free survival (PFS) analysis using proportional hazards models stratified by stage and race revealed that each 0.10 increase in African ancestry was associated with worse PFS with hazard ratio (HR) of 1.11 (95% CI 0.90-1.37). Each 0.10 increase in European RGA was associated with improved PFS with HR of 0.86 (95% CI 0.69-1.07). Using tertiles of African RGA showed increasing risk of progression of death with increasing African RGA (with 0-5% as reference), HR (95% CIs) for top two tertiles are: 6%-66%: 1.38 (0.64, 2.97), and 67%-86%: 2.27 (0.74, 6.95).
  
  
  CONCLUSIONS
  RGA demonstrated a trend with PFS in self-reported black and white patients with EC. Patients with increased levels of African ancestry showed a trend towards worse survival after stratifying by stage/race.
authors.affiliation: Mitchell Cancer Institute, University Of South Alabama, Mobile, AL, USA. Electronic address: rocconi@health.southalabama.edu.
authors.forename: Rodney P
authors.initials: RP
authors.lastname: Rocconi
authors.affiliation: NRG Oncology/Gynecologic Oncology Group, Buffalo, NY, USA. Electronic address: hlankes@gogstats.org.
authors.forename: Heather A
authors.initials: HA
authors.lastname: Lankes
authors.affiliation: NRG Oncology/Gynecologic Oncology Group, Buffalo, NY, USA. Electronic address: bbrady@gogstats.org.
authors.forename: William E
authors.initials: WE
authors.lastname: Brady
authors.affiliation: Ohio State University, Columbus, OH, USA. Electronic address: paul.goodfellow@osumc.edu.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Goodfellow
authors.affiliation: The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA. Electronic address: nilsa.ramirez@nationwidechildrens.org.
authors.forename: Nilsa C
authors.initials: NC
authors.lastname: Ramirez
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: rdalvarez@aol.com.
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Alvarez
authors.affiliation: Medical University of South Carolina, Charleston, SC, USA. Electronic address: creasman@musc.edu.
authors.forename: William
authors.initials: W
authors.lastname: Creasman
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: jose@uab.edu.
authors.forename: José R
authors.initials: JR
authors.lastname: Fernández
mesh_terms: D000368:Aged; D044383:Black People; D015331:Cohort Studies; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000208:ethnology* / Q000235:genetics*; D005260:Female; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D011379:Prognosis; D044465:White People
keywords: Ancestry informative markers; Endometrial cancer; Genetic admixture; Racial disparity