The impact of race on high-risk types of uterine cancer is modified in non-Hispanic Black and non-Hispanic White women with multiple malignancies

Abstract

Objectives: To investigate racial differences in uterine cancer histology in non-Hispanic Back (NHB) and non-Hispanic White (NHW) women with one or more cancer diagnoses as an extension of prior studies that excluded cases with multiple malignancies. Download : Download high-res image (552KB) Download : Download full-size image Methods: Women in the 18-region Surveillance, Epidemiology and End Results registry with an invasive uterine cancer diagnosed between 1975 and 2015 as a first or second of multiple malignancies relative a single malignancy were evaluated. Median age at diagnosis was compared using Wilcoxon test. Proportions between histologic and racial groups were compared using Chi-square test. Age-adjusted odds ratio (AOR) and 95% confidence interval (CI) for each high-risk uterine cancer histology were calculated for NHBs vs NHWs. Results: There were 237,823 with an invasive uterine cancer including 177,869 as a single diagnosis, 29,594 as a first of multiple malignancies and 30,380 as a second of multiple malignancies. The distribution of NHBs by the setting of the uterine cancer diagnosis was 10.1% as a single malignancy, 6.7% as a first of multiple malignancies and 8.5% as second of multiple malignancies. The median age for the uterine cancer diagnosis in NHBs vs NHWs was 3 vs 5 years younger when identified as a single or first malignancy compared with as a second malignancy, respectively (Table 1). The proportion of both NHBs and NHWs with grade 3 endometrioid cancer, serous cancer and carcinosarcoma was consistently higher in both NHBs and NHWs when diagnosed as a second malignancy compared with a single or first malignancy (P Conclusions: Racial differences in uterine serous cancer, clear cell cancer, carcinosarcoma and leiomyosarcoma but not in grade 3 endometrioid cancer were smaller in women with a prior cancer diagnosis and may reflect the impact of factors including ancestral admixture, germline vs. somatic alterations, genetic modifiers, epigenetic regulators, exposure to prior cancer treatment, cancer screening and social health determinants.