Abstract

This study analyzed Surveillance, Epidemiology and End Results (SEER) data to assess if socio- economic factors (SEFs) impact on endometrial cancer survival. Endometrial cancer patients treated from 2004-2007 were included in this study. SEER cause specific survival (CSS) data were used as end points. The areas under the receiver operating characteristic (ROC) curve were computed for predictors. Time to event data were analyzed with Kaplan-Meier method. Univariate and multivariate analyses were used to identify independent risk factors. This study included 64,710 patients. The mean follow up time (S.D.) was 28.2 (20.8) months. SEER staging (ROC area of 0.81) was the best pretreatment predictor of CSS. Histology, grade, race/ethnicity and county level family income were also significant pretreatment predictors. African American race and low income neighborhoods decreased the CSS by 20% and 3% respectively at 5 years. This study has found significant endometrial survival disparities due to SEFs. Future studies should focus on eliminating socio-economic barriers to good outcomes.

Highlights

  • Endometrial cancers are the most common gynecologic cancers of United States (U.S.), with over 35000 cases diagnosed each year (Duong et al, 2011)

  • This study analyzed Surveillance, Epidemiology and End Results (SEER) data to assess if socioeconomic factors (SEFs) impact on endometrial cancer survival

  • The mean follow up time 6' ZDV PRQWKV6((5VWDJLQJ 52&DUHDRI ZDVWKHEHVWSUHWUHDWPHQWSUHGLFWRURI&66 +LVWRORJ\JUDGHUDFHHWKQLFLW\DQGFRXQW\OHYHOIDPLO\LQFRPHZHUHDOVRVLJQLÀFDQWSUHWUHDWPHQWSUHGLFWRUV $IULFDQ$PHULFDQUDFHDQGORZLQFRPHQHLJKERUKRRGVGHFUHDVHGWKH&66E\DQGUHVSHFWLYHO\DW years. &RQFOXVLRQV7KLVVWXG\KDVIRXQGVLJQLÀFDQWHQGRPHWULDOVXUYLYDOGLVSDULWLHVGXHWR6()V)XWXUHVWXGLHV should focus on eliminating socio-economic barriers to good outcomes

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Summary

Introduction

Endometrial cancers are the most common gynecologic cancers of United States (U.S.), with over 35000 cases diagnosed each year (Duong et al, 2011). Current management includes surgery alone for early endometrial cancers and additional post-operative radiotherapy (Patel et al, 2012) (Koskas et al, 2011) and chemotherapy (Wright et al, 2012) for more advanced cases. Endometrial cancers have excellent outcomes (Wright et al, 2012) with FDXVHVSHFLÀFVXUYLYDORYHUIRUHDUOLHUVWDJHV6RPH studies have shown that race is shown to be associated with endometrial outcome (Olson et al, 2012). The nature of the socio-economic barriers in good outcome for endometrial cancer has not been well characterized. The Surveillance Epidemiology and End Results (SEER) cancer registry data have been extensively used to build prognostic models for endometrial cancer (Berrington et al, 2011; Felix et al, 2011). This study analyzed SEER data to assess if socio-economic factors (SEFs) impacted on endometrial cancer survival

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