Abstract
Endometrial Cancer (EC) has an inequitable distribution among several high-risk special populations. Utilizing population-based cancer registry data, the current dissertation (1) assessed disparities among cancer survivors who developed EC as a second primary tumor and (2) examined EC disparities by race/ethnicity, with a focus on African descent populations.
The aim of the first study was to characterize the survival experience of women with EC as a second primary. Using Florida's cancer registry, all 45,593 EC cases diagnosed from 2005-2016 were analyzed. Cox Regression was used to analyze EC cause-specific survival. Survival for EC as a second primary was superior to that of a first primary EC after accounting for socio-demographic and tumor characteristics. Second primary ECs following colorectal cancer were of worse prognosis. Chemotherapy for a previous breast cancer did not impact the positive role of chemotherapy for ECs.
For the second study, we evaluated the incidence and trends of EC among US-born Blacks residing in Florida and majority African descent populations in the French Caribbean. We analyzed 34,789 EC cases from Florida (2005-2018), Martinique (2005-2018), and Guadeloupe (2008-2018) Cancer Registries. Age-adjusted incidence rates and rate ratios, and annual percent changes were estimated for US White, US-born Black, and French Caribbean women. The high risk for non-endometrioid tumors was found to be exclusive to US-born Black women. However, a rapid rise in non-endometrioid EC was identified across all race groups in both the US and French Caribbean.
In the third study, the aim was to elucidate the survival disparities for EC among US-born Blacks residing in Florida and the French Caribbean. We analyzed EC cases (n=28,213) from Florida, Martinique, and Guadeloupe. Cox Regression was used to analyze all-cause survival. Intra-racial comparisons uncovered a disproportionately lower survival for women with non-endometrioid EC in the French Caribbean compared to US-born Blacks.