Race-driven survival differential in women diagnosed with endometrial cancers in the USA

2020 ◽  
Vol 30 (12) ◽  
pp. 1893-1901
Author(s):  
Zachary D Horne ◽  
Solomiya R Teterichko ◽  
Scott M Glaser ◽  
Rodney E Wegner ◽  
Shaakir Hasan ◽  
...  
Keyword(s):  
African American ◽  
African American Women ◽  
Type I ◽  
Type Ii ◽  
American Women ◽  
Risk Of Death ◽  
Asian Pacific Islander ◽  
Caucasian Women ◽  
Asian Pacific ◽  
Pacific Islander Women

ObjectiveAfrican American women are increasingly being diagnosed with advanced and type II histology endometrial cancers. Outcomes have been observed to be worse in African American women, but whether or not race itself is a factor is unclear. We sought to evaluate the rates of diagnosis and outcomes on a stage-by-stage basis with respect to race using a large national cancer registry database.MethodsThe National Cancer Data Base was searched for patients with surgically staged non-metastatic endometrial cancer between 2004 and 2015. Women were excluded if surgical stage/histology was unknown, there was no follow-up, or no information on subsequent treatment. Pairwise comparison was used to determine temporal trends and Cox hazards tests with Bonferroni correction were used to determine overall survival.ResultsA total of 286 920 women were diagnosed with endometrial cancer and met the criteria for analysis. Median follow-up was 51 months (IQR 25.7–85.3). In multivariable models, in women with stage I disease, African American women had a higher risk of death than Caucasian women (HR 1.262, 95% CI 1.191 to 1.338, p<0.001) and Asian/Pacific Islander women had a lower risk of death than Caucasian women (HR 0.742, 95% CI 0.689 to 0.801, p<0.001). This held for African American women with stage II type I and type II disease (HR 1.26, 95% CI 1.109 to 1.444, p<0.001 and HR 1.235, 95% CI 1.098 to 1.388, p<0.001) but not for Asian/Pacific Islander women. African American women with stage IIIA–B disease also had a higher risk of death for type I and type II disease versus Caucasian women (HR 1.221, 95% CI 1.045 to 1.422, p=0.010 and HR 1.295, 95% CI 1.155 to 1.452, p<0.001). Asian/Pacific Islander women had a lower risk of death than Caucasian women with type I disease (HR 0.783, 95% CI 0.638 to 0.960, p=0.019) and type II disease (HR 0.790, 95% CI 0.624 to 0.999, p=0.05). African American women with stage IIIC1–2 had a higher risk of death with type I disease (HR 1.343, 95% CI 1.207 to 1.494, p<0.001) and type II disease (HR 1.141, 95% CI 1.055 to 1.233, p=0.001) whereas there was no significant difference between Caucasian women and Asian/Pacific Islander women.ConclusionRace appears to play an independent role in survival from endometrial cancer in the USA, with African American women having worse survival on a stage-for-stage basis compared with Caucasian women.

Mammography screening and detection of early stage breast cancer in Hispanic and African American women at a Minnesota safety net healthcare system.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18074-e18074
Author(s):  
Daniel Fellows Pease ◽  
David T. Gilbertson ◽  
Andres Wiernik
Keyword(s):  
Breast Cancer ◽  
African American ◽  
African American Women ◽  
Healthcare System ◽  
Early Stage ◽  
Screening Mammography ◽  
Advanced Stage ◽  
American Women ◽  
Younger Age ◽  
Caucasian Women

e18074 Background: Approximately 12% of breast cancer cases occur in women younger than 50 years, per SEER data from 2012. Hispanic women are known to present at a younger age and African American women with more advanced stage disease. In this study, we describe the impact of age and race on the initial presentation of breast cancer among minority women treated at the Hennepin Healthcare System (HHS) in the state of Minnesota. Methods: A single-institution retrospective analysis of data from our electronic health record of all breast cancer diagnoses from 2010-2015. Cases were compared by age ( < 50 or > 50 years), race (Caucasian, African American, Hispanic, other), stage (AJCC 7th edition), and method of diagnosis (self-reported mass or screening mammography). Results: A total of 315 breast cancer diagnoses occurred at HHS from 2010-2015. In our cohort, 29% of all breast cancer cases were diagnosed in women < 50yrs. Hispanic and African American women had higher rates of diagnosis at < 50yrs compared to Caucasian women (38.9% vs 37.1% vs 18.1 respectively, p < 0.05). Early stage cancer (stage 0 or I) accounted for most diagnoses in those > 50yrs (54.8%), while advanced stage (stage II-IV) was more prevalent in the < 50yrs age group (59.5%) (p < 0.05). Of all women diagnosed with breast cancer, 63% presented with a self-reported mass and 37% were diagnosed by screening mammography. Hispanics and African American women had a higher rate of presentation with a self-reported mass (74% and 66% respectively) compared to Caucasian women (55%). Women with breast cancer < 50yrs were more likely to present with a self-reported mass than women > 50yrs (80% vs 55%, p < 0.05). 92% of Hispanic and 80% of African American women < 50yrs presented with a self-reported mass, compared to 62% of Caucasian women (p = 0.095). Conclusions: At our institution, Hispanic and African American women are diagnosed at a significantly younger age than Caucasian women, and those diagnosed at a younger age have more advanced disease. Presenting with a self-reported mass is very common for young non-Caucasian women. Whether screening mammography can be better utilized to change these trends requires further study.

Ethnic differences in in vitro glyceride synthesis in subcutaneous and omental adipose tissue

2002 ◽  
Vol 283 (5) ◽  
pp. E988-E993 ◽  
Author(s):  
J. F. Bower ◽  
S. Vadlamudi ◽  
H. A. Barakat
Keyword(s):  
Adipose Tissue ◽  
African American ◽  
African American Women ◽  
Ethnic Differences ◽  
American Woman ◽  
Morbidly Obese ◽  
American Women ◽  
Omental Adipose Tissue ◽  
Caucasian Women

Considerable evidence suggests that there are ethnic differences in lipid metabolism between African American and Caucasian women, which may result in increased synthesis of fat in adipose tissue. The purpose of this study was to measure the in vitro rates of [14C]glucose incorporation into the glyceride-glycerol backbone of triglycerides (TG) and diglycerides (DG) in abdominal subcutaneous (SAT) and omental adipose tissue (OAT). Morbidly obese [African American ( n = 15): body mass index (BMI) = 45 ± 2.3; Caucasian ( n = 18): BMI = 51 ± 2.3] and preobese [African American ( n = 7): BMI = 27 ± 1.0; Caucasian ( n = 7): BMI = 25 ± 1.0] women were examined in this study. There were no significant differences in the rates of synthesis of either TG or DG in SAT of either preobese or obese women. On the other hand, both preobese and obese African American women had higher rates of synthesis of TG in OAT compared with their Caucasian counterparts. This increase in TG synthesis in OAT was not due to differences in cell size or rates of reesterification. Thus African American woman have an increased capacity to synthesize TG in OAT compared with Caucasian women, which may contribute to the higher prevalence of obesity in African American women.

Ethnic disparity of treatment initiation in women diagnosed with breast cancer.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 189-189
Author(s):  
M. Omaira ◽  
M. Mozayen ◽  
R. Mushtaq ◽  
K. Katato
Keyword(s):  
Breast Cancer ◽  
African American ◽  
African Americans ◽  
African American Women ◽  
Treatment Initiation ◽  
Age At Diagnosis ◽  
Significant Delay ◽  
American Women ◽  
Caucasian Women ◽  
The Impact

189 Background: Despite the major advances in early detection and treatment of breast cancer (BC), African American women, continued to have a higher mortality rates than Caucasians. Many studies have failed to identify a key factor to explain racial disparities in breast cancer outcome. These disparities persist even after controlling for insurance and socioeconomic settings. Data about delays in treatment initiation are limited and inconclusive. We intend to compare the time from diagnosis to the initiation of treatment between African American and Caucasian women diagnosed with BC in a single community-based cancer registry. Methods: Women aged 18 to 64 years with breast cancer were identified, between 1993 and 2009, using data from the Tumor Registry at Hurley Medical Center in Flint, Michigan. Patient’s characteristics obtained include age at diagnosis, race, stage, date of diagnosis, and date of treatment initiation. All patients were previously insured or became insured after diagnosis. Time from diagnosis to the initiation of treatment was calculated in days and compared between African American and Caucasian women using t-test. Results: A total of 1016 patients have been identified with diagnosis of BC. 23 patients were excluded due to missing data. 993 patients were analyzed. African Americans were 355 (36%), Caucasians 617 (62%), and other ethnicities 21 (2%). Mean age at diagnosis was (48.9) for African Americans versus (51.45) for Caucasians (p = 0.005). African American women were more likely to present with advanced stage (III, IV) than Caucasians (18% versus 12%, p = 0.009). African American women had significant delay in the treatment initiation of BC compared to Caucasians (31.11 versus 21.52 days, p < 0.0001). Conclusions: African American women were diagnosed with breast cancer at younger age and more advanced disease than Caucasians. African American women experienced significant delay in the initiation of therapy after diagnosis compared to Caucasians. However, the impact of an average delay of 10 days in treatment on overall survival is unknown. The exact explanation of this disparity is yet to be determined.

scholarly journals Estrogen Levels Are Higher across the Menstrual Cycle in African-American Women Compared with Caucasian Women

2011 ◽  
Vol 96 (10) ◽  
pp. 3199-3206 ◽  
Author(s):  
E. E. Marsh ◽  
N. D. Shaw ◽  
K. M. Klingman ◽  
T. O. Tiamfook-Morgan ◽  
M. A. Yialamas ◽  
...  
Keyword(s):  
African American ◽  
Menstrual Cycle ◽  
African American Women ◽  
American Women ◽  
Caucasian Women

scholarly journals Evaluation of Markers of Bone Turnover During Lactation in African-Americans: A Comparison With Caucasian Lactation

2013 ◽  
Vol 98 (2) ◽  
pp. 523-532 ◽  
Author(s):  
Raquel M. Carneiro ◽  
Linda Prebehalla ◽  
Mary Beth Tedesco ◽  
Susan M. Sereika ◽  
Caren M. Gundberg ◽  
...  
Keyword(s):  
African American ◽  
African Americans ◽  
Bone Turnover ◽  
African American Women ◽  
Bottle Feeding ◽  
American Women ◽  
Amino Terminal ◽  
Markers Of Bone Turnover ◽  
Caucasian Women ◽  
Hormonal Milieu

Abstract Context: The African-American skeleton is resistant to PTH; whether it is also resistant to PTHrP and the hormonal milieu of lactation is unknown. Objectives: The objective of the study was to assess bone turnover markers in African-Americans during lactation vs Caucasians. Design and Participants: A prospective cohort study with repeated measures of markers of bone turnover in 60 African-American women (3 groups of 20: lactating, bottle feeding, and healthy controls), compared with historic Caucasian women. Setting: The study was conducted at a university medical center. Outcome Measures: Biochemical markers of bone turnover and calcium metabolism were measured. Results: 25-Hydroxyvitamin D (25-OHD) and PTH were similar among all 3 African-American groups, but 25-OHD was 30%–50% lower and PTH 2-fold higher compared with Caucasians (P &lt; .001, P &lt; .002), with similar 1,25 dihydroxyvitamin D [1,25(OH)2D] values. Formation markers [amino-terminal telopeptide of procollagen-1 (P1NP) and bone-specific alkaline phosphatase (BSAP)] increased significantly (2- to 3-fold) in lactating and bottle-feeding African-American women (P1NP, P &lt; .001; BSAP, P &lt; .001), as did resorption [carboxy-terminal telopeptide of collagen-1 (CTX) and serum amino-terminal telopeptide of collagen 1 (NTX), both P &lt; .001]. P1NP and BSAP were comparable in African-American and Caucasian controls, but CTX and NTX were lower in African-American vs Caucasian controls. African-American lactating mothers displayed quantitatively similar increases in markers of bone formation but slightly lower increases in markers of resorption vs Caucasians (P = .036). Conclusions: Despite reported resistance to PTH, lactating African-American women have a significant increase in markers of bone resorption and formation in response the hormonal milieu of lactation. This response is similar to that reported in Caucasian women despite racial differences in 25-OHD and PTH. Whether this is associated with similar bone loss in African-Americans as in Caucasians during lactation is unknown and requires further study.

scholarly journals Ethnic Identity and Implicit Anti-fat Bias: Similarities and Differences between African American and Caucasian Women

2016 ◽  
Vol 26 (1) ◽  
pp. 69 ◽  
Author(s):  
Erica A. Hart ◽  
Tracy Sbrocco ◽  
Michele M. Carter
Keyword(s):  
African American ◽  
Ethnic Identity ◽  
African American Women ◽  
Well Being ◽  
Weight Stigma ◽  
Self Report ◽  
American Women ◽  
Body Weights ◽  
Prevalence Of Obesity ◽  
Caucasian Women

<p>Research using self-report or explicit measures of body image suggests African American women have a more accepting view of larger figures than non-Hispanic White (NHW) women.  However, increasing research indicates that explicit views may vary from those held at a deeper, implicit level.</p><p>Our study examined whether African American women held an implicit negative bias toward overweight/fat individuals, despite a greater explicit acceptance of larger body size. Additionally, ethnic identity was measured to assess if strength of identity relates to bias. Anti-fat bias was compared within and between ethnic groups using an Implicit Association Test (IAT), which measures the strength of automatic associations between two concepts.  This online IAT measured spontaneous thoughts about figures of various body weights (underweight, overweight, obese) and positive and negative terms (eg, attractive and unattractive or healthy and unhealthy). </p><p>A pervasive anti-fat bias was found in African American as well as NHW women. For both groups this bias was related to ethnic identity when thinking about figure size and health. Specifically, African American women with lower ethnic identity were more negatively biased and NHW women with higher ethnic identity were more negatively biased. </p><p>Findings from this study indicate that implicitly there are few differences in the way these two ethnicities classify heavy figures, and therefore African Americans may not be immune to weight stigma.  Given the prevalence of obesity and the lack of research on weight stigma among African American women, there is need to address this issue and its impact on well-being. <em>Ethn Dis.</em> 2016;26(1):69-76; doi:10.18865/ed.26.1.69</p>

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