Abstract
Black women with endometrial cancer have a 90% higher mortality rate than white women with endometrial cancer. The advanced disease stage at which black women receive a diagnosis of endometrial cancer is a major factor in this disparity and is not explained by differences in health care access. To describe the prediagnostic experiences of symptoms and symptom disclosure among black women with endometrial cancer. This community-engaged qualitative study developed an interview guide to collect data during semistructured interviews among a sample of 15 black women with endometrial cancer in the United States. Interviews were conducted in person or via a secure conferencing platform. An exploratory and descriptive content analysis was performed using iterative rounds of inductive coding, case summaries, and coanalysis with community input to identify emergent themes. Data were collected from October 3, 2017, to April 15, 2019, and the descriptive content analysis was performed from October 11, 2017, to May 6, 2019. Beliefs, interpretations, and experiences of black women with endometrial cancer from symptom onset to diagnostic confirmation of cancer. Participants included 15 women who self-identified as black or African American and ranged in age from 31 to 72 years. Eight participants lived in the Puget Sound region of Washington, 2 participants lived in California, and 1 participant each lived in Alabama, Michigan, Louisiana, Georgia, and New York. Twelve participants were receiving adjuvant therapy during the study, which indicated that they were either in a high-risk group and/or had advanced-stage disease. Thirteen participants had health insurance at the time of symptom onset, and all participants had elected to receive cancer treatment. Participants described knowledge gaps and silence about menopause, misinterpretation of vaginal bleeding, and responses by first-line health care practitioners that were not aligned with the risk of endometrial cancer among black women in the United States. The responses of interviewed black women with endometrial cancer suggest that several mechanisms may be associated with a delay in care before diagnosis among this high-risk population and represent modifiable factors that may be useful in the development of targeted interventions to improve the rates of early diagnosis among black women with endometrial cancer.
Highlights
Racial disparity in endometrial cancer survival rates is substantial and has increased during the past decade.[1]
Participants described knowledge gaps and silence about menopause, misinterpretation of vaginal bleeding, and responses by first-line health care practitioners that were not aligned with the risk of endometrial cancer among black women in the United States
Cancer stage at diagnosis has been reported as a major factor in the mortality gap between black and white women,[6] few studies have focused on identifying modifiable factors.[7,8,9]
Summary
Racial disparity in endometrial cancer survival rates is substantial and has increased during the past decade.[1]. Most cases of endometrial cancer are diagnosed in early stages owing to the early onset of clear symptoms, such as postmenopausal bleeding or markedly abnormal premenopausal bleeding. National guidelines for diagnostic examinations of postmenopausal bleeding exist,[3,4] the guidelines assume that patients promptly report symptoms and that health care practitioners take immediate action. To date, little is known about the ways in which black women recognize, interpret, or experience postmenopausal bleeding.[5] cancer stage at diagnosis has been reported as a major factor in the mortality gap between black and white women,[6] few studies have focused on identifying modifiable factors.[7,8,9] To address this gap, we investigated the beliefs, interpretations, and experiences of symptom onset and diagnosis among black women aged 31 to 72 years with endometrial cancer
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
