Abstract
To assess differences in the receipt of preventive health services by race/ethnicity among older women with endometrial cancer enrolled in Medicare, we conducted a retrospective population‐based cohort study of women diagnosed with endometrial cancer from 2001 to 2011 in the Surveillance Epidemiology and End Results (SEER)‐Medicare database. Women with stage I or II endometrial cancer of epithelial origin were included. The exposure was race/ethnicity (Non‐Hispanic [NH] White, NH Black, Hispanic, and NH Asian/Pacific Islander [PI]). The services examined were receipt of influenza vaccination and screening tests for diabetes mellitus, hyperlipidemia, and breast cancer. We used multivariate logistic regression to estimate odds ratios with 95% confidence intervals (CI) adjusted for age, region, and year of diagnosis. A total of 13,054 women were included. In the 2 years after diagnosis, receipt of any influenza vaccine ranged from 45% among NH Black women to 67% among NH White women; receipt of a mammogram ranged from 65% among NH Black women to 74% among NH White women. Relative to NH White women, NH Black women had a lower likelihood of receiving both influenza vaccination (adjusted odds ratio [aOR] 0.40, 95% CI 0.33–0.44) and screening mammography (aOR 0.64, 95% CI 0.52–0.79). Hispanic women also were less likely to receive influenza vaccination than NH White women (aOR 0.61, 95% CI 0.51–0.72). There were no significant differences across racial groups for diabetes or cholesterol screening services. Among older women with early‐stage endometrial cancer, racial disparities exist in the utilization of some preventive services.
Highlights
Endometrial cancer is the most common gynecological malignancy among women in the US, with an anticipated 60,050 incident cases and 10,470 deaths in 2016 [1]
Women with endometrial cancer have a high prevalence of concurrent comorbid conditions, and according to a populationbased study using the Surveillance Epidemiology and End Results (SEER) data, women with lowgrade endometrial cancer are more likely to die from cardiovascular disease than endometrial cancer [3, 4]
We found that receipt of any influenza vaccination varied by race, with 67% of NH White women, 45% of NH Black women, 53% of Hispanic women, and 66% of NH Asian/Pacific Islander (PI) women receiving at least one influenza vaccination in two years (Table 2)
Summary
To assess differences in the receipt of preventive health services by race/ethnicity among older women with endometrial cancer enrolled in Medicare. The services examined were receipt of influenza vaccination and screening tests for diabetes mellitus, hyperlipidemia, and breast cancer. In the two years after diagnosis, receipt of any influenza vaccine ranged from 45% among NH Black women to 67% among NH White women; receipt of any mammogram ranged from 65% among NH Black women to 74% among. Relative to NH White women, NH Black women had a lower likelihood of receiving both influenza vaccination (adjusted odds ratio (aOR) 0.40, 95% CI 0.33-0.44) and screening mammography (aOR 0.64, 95% CI 0.52-0.79). Conclusion: Among older US women with early stage endometrial cancer, racial disparities exist in the utilization of some preventive services
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