Impact of racial disparities on potential years of life lost due to gynecologic cancer in the United States: trends from 1975 to 2017 based on SEER database

Abstract

<h3>Objectives:</h3> Gynecologic cancer is a major health problem in the United States. We assessed potential years of life lost (PYLL) in women secondary to gynecologic cancer in the United States from 1975 to 2017 using the SEER (Surveillance, Epidemiology and End Results) database. We also report race-adjusted trends in PYLL to highlight racial disparities impacting mortality in gynecologic malignancies. <h3>Methods:</h3> We extracted data from the US National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) 2019 dataset using ICD-O codes for cervix, corpus and uterus, ovary, vulvar, vaginal and other gynecologic cancers. Patients who were diagnosed between 1975-2017 were included. Survival time was estimated by using recorded age of diagnosis and survival data from SEER. Potential years of life lost up to and including age 75 years were calculated after stratifying for tumor site. Statistical analysis was done using One-Way ANOVA test. <h3>Results:</h3> A total of 342159 patients were included in the analysis. Total 1825109 potential years of life were lost due to gynecologic cancers from 1975 to 2017. Uterine followed by ovarian were the two most common gynecologic malignancies with highest number of recorded cases (46.4% and 24.8% respectively). Median PYLL for cervical cancer (12.7 years) was higher than other gynecologic malignancies likely due to early median age of diagnosis (49 years). Across the board, for every subtype of gynecologic malignancy reported, median PYLL for Non-Hispanic White (NHW) population was lower as compared to women from all other racial and ethnic groups. p-value was significiant for every tumor type (Table 1). For NHW females with uterine cancer median PYLL was -0.8 years suggesting likelihood of survival past age of 75 years. <h3>Conclusions:</h3> Analysis of real-world data represents a clear trend pointing towards racial and ethnic disparities in PYLL due to gynecologic malignancies in the United States. Health care policies and efforts need to be focused on improving access to treatment and affordability of medical care for population groups at higher risk of losing quality life years.