PDF(Pubmed)
Abstract：
Disparities in endometrial cancer has increased during the past decade with Black women more likely to be diagnosed at a later stage and have higher mortality. The majority of research has been focused on cultural barriers, socioeconomic status, lack of access to care, comorbidities, and tumor histology to explain these disparities. Limited studies have been conducted on the disparity in the treatment of endometrial intraepithelial neoplasia(EIN). We sought to analyze the differences in treatment used in the management of postmenopausal women with EIN to evaluate whether race/ethnicity is a contributing factor. An IRB approved retrospective study was conducted amongst women at a single institution diagnosed with EIN. Ethnicity/race was defined as non-Hispanic White, non-Hispanic Black, Hispanic, and Asian. Demographic and clinical data was extracted. Multivariable logistic regression was used to examine the association between ethnicity/race and treatment, adjusted for age, BMI, and underlying medical conditions such as cardiovascular disease and diabetes. In total, 254 patients were analyzed. A significant association between ethnicity/race and treatment with non-Hispanic Black women less likely to be treated with surgical management compared to non-Hispanic White women (OR = 0.326, 95 %CI 0.129-0.827, p = 0.026). Importantly, after adjusting for clinical risk factors(age, BMI, CVD, diabetes), non-Hispanic Black women remained at an increased risk of not undergoing surgical intervention (OR = 0.333, 95 % CI 0.125-0.882, p = 0.027). Future research is imperative to evaluate the root cause of this disparity in the healthcare system.
摘要：
在过去的十年中，子宫内膜癌的差异有所增加，黑人女性更有可能在后期被诊断出来，死亡率更高。大多数研究都集中在文化障碍上，社会经济地位,无法获得护理,合并症,和肿瘤组织学来解释这些差异。关于子宫内膜上皮内瘤变（EIN）治疗差异的研究有限。我们试图分析绝经后女性EIN治疗中使用的治疗差异，以评估种族/民族是否是一个促成因素。IRB批准的回顾性研究是在诊断为EIN的单一机构的女性中进行的。种族/种族被定义为非西班牙裔白人，非西班牙裔黑人,西班牙裔,和亚洲人。提取人口统计学和临床数据。多变量逻辑回归用于检查种族/种族与治疗之间的关联，根据年龄调整，BMI,和潜在的医疗条件，如心血管疾病和糖尿病。总的来说,对254例患者进行分析。与非西班牙裔白人女性相比，种族/种族与非西班牙裔黑人女性不太可能接受手术治疗之间存在显着关联（OR=0.326，95CI0.129-0.827，p=0.026）。重要的是,在调整临床危险因素后(年龄，BMI,CVD,糖尿病)，非西班牙裔黑人女性不接受手术干预的风险仍然增加(OR=0.333,95%CI0.125-0.882,p=0.027).未来的研究必须评估医疗保健系统中这种差异的根本原因。
