Evaluation of Hispanic ethnicity as an independent risk factor in the diagnosis of type I endometrial cancer in the premenopausal patient

Abstract

<h3>Objectives:</h3> Our goal was to evaluate if Hispanic ethnicity is a risk factor for developing Type I Endometrial Cancer (EC) at an earlier age than Non-Hispanic White women. <h3>Methods:</h3> Patients diagnosed with Type I endometrial cancer based on surgical pathology at University Hospital between 2008-2018 were included in this study. The variables we examined were age, race, insurance status, race and ethnicity, stage, grade, and year of diagnosis. Fisher's exact t-test, chi-square analysis, and relative risk calculations were used to determine the association between Hispanic ethnicity and age of diagnosis, body mass index, and stage. <h3>Results:</h3> We identified 548 patients that were diagnosed with Type I Endometrial cancer based on surgical pathology. Overall, 62% (N=340) of these patients were Hispanic, 33.5% (N=184) were Non-Hispanic White, 3.2% (N=18) were Non-Hispanic Black, 0.4% (N=2) were Asian American, and 0.7% (N=4) were unknown ethnicity. The mean age of diagnosis for Hispanic patients was 52.2 years (95% CI 50.9-53.5) and 56.8 years (95% CI 55-58.6) (<i>P</i><0.01) in Non-Hispanic White patients. The mean body mass index (BMI) was 40.9 kg/m² in Hispanic patients (95% CI 39.7-42.1 kg/m²) and 39.4 kg/m² (95% CI 38-40.8 kg/m²) (<i>P</i>=0.153) in Non-Hispanic White patients. A chi-square analysis of premenopausal patients (age < 50) and postmenopausal patients (age ≥50), stratified by Hispanic and Non-Hispanic White, showed a statistically significant difference in cases of EC in premenopausal Hispanic women (<i>x2=</i> 9.8, DF 1, <i>P</i>=0.001). We also calculated the relative risk of being diagnosed with EC at a premenopausal age in Hispanic patients. The RR 1.56 (95% CI 1.16 to 2.092, p=0.002). <h3>Conclusions:</h3> Hispanic women were likely to be significantly younger when diagnosed with Type I Endometrial Cancer and more likely to be premenopausal. However, there was no significant difference in mean body mass index between the two groups. Hispanic race should be considered a risk factor for Type I Endometrial cancer, specifically in premenopausal patients.