Abstract
Purpose
Endometrial cancer (EC) exhibits striking racial disparities with higher mortality in Blacks compared to Whites. The mortality-to-incidence ratio (MIR) provides a population-based measure of survival which accounts for incidence. The objective of this study was to map EC MIRs by race for eight health regions within South Carolina (SC) and chart EC incidence by race and grade across the four cancer stages.
Methods
Cancer incidence and mortality data were obtained from the SC Community Access Network (SCAN), the online data query system provided by the SC Department of Health and Environmental Control (DHEC). The underlying data for SCAN were generated from the SC Central Cancer Registry and SC DHEC Vital Records and used to construct MIRs. ArcGIS 10.1 was used to map EC MIRs by race for eight health regions within SC. Four categories of MIR were derived using the national MIR for EC among Whites as the reference category.
Results
Blacks had higher levels of poorly differentiated tumors across all stages and higher incidence and mortality rates. In all eight health regions, Blacks were in the highest MIR category. By contrast, the MIRs for Whites were more evenly represented over the four categories.
Conclusions
The MIR proved useful for identifying disparities in EC incidence and mortality among Black and White women in SC. Cancer surveillance programs may use the MIR to monitor disparities across racial/ethnic groups and geographic regions going forward. MIRs have the potential to serve as an indicator of the long-term success of cancer surveillance programs.
Similar content being viewed by others
References
Siegel RL, Miller KD, Jemal A (2015) Cancer statistics, 2015. Ca Cancer J Clin 65(1):5–29
Farley J, Risinger JI, Rose GS, Maxwell GL (2007) Racial disparities in blacks with gynecologic cancers. Cancer 110(2):234–243
Long B, Liu FW, Bristow RE (2013) Disparities in uterine cancer epidemiology, treatment, and survival among African Americans in the United States. Gynecol Oncol 130(3):652–659
Sherman ME, Carreon JD, Lacey JV, Devesa SS (2005) Impact of hysterectomy on endometrial carcinoma rates in the United States. J. Natl Cancer Inst 97(22):1700–1702
Sherman ME, Devesa SS (2003) Analysis of racial differences in incidence, survival, and mortality for malignant tumors of the uterine corpus. Cancer 98(1):176–186
Freeman HP (2003) Commentary on the meaning of race in science and society. Cancer Epidemiol Biomark Prev 12(3):232S–236S
Kohler MF, Berchuck A, Davidoff AM, Humphrey PA, Dodge RK, Iglehart JD, Soper JT, Clarke-Pearson DL, Bast RC Jr, Marks JR (1992) Overexpression and mutation of p53 in endometrial carcinoma. Cancer Res 52(6):1622–1627
Madison T, Schottenfeld D, James SA, Schwartz AG, Gruber SB (2004) Endometrial cancer: socioeconomic status and racial/ethnic differences in stage at diagnosis, treatment, and survival. Am J Public Health 94(12):2104–2111
Maxwell GL, Risinger JI, Hayes KA, Alvarez AA, Dodge RK, Barrett JC, Berchuck A (2000) Racial disparity in the frequency of PTEN mutations, but not microsatellite instability, in advanced endometrial cancers. Clin Cancer Res 6(8):2999–3005
Plaxe SC, Saltzstein SL (1997) Impact of ethnicity on the incidence of high-risk endometrial carcinoma. Gynecol Oncol 65(1):8–12
Schouten LJ, Goldbohm RA, van den Brandt PA (2004) Anthropometry, physical activity, and endometrial cancer risk: results from the Netherlands cohort study. J Natl Cancer Inst 96(21):1635–1638
Hebert JR, Daguise VG, Hurley DM, Wilkerson RC, Mosley CM, Adams SA, Puett R, Burch JB, Steck SE, Bolick-Aldrich SW (2009) Mapping cancer mortality-to-incidence ratios to illustrate racial and sex disparities in a high-risk population. Cancer 115(11):2539–2552
Wagner SE, Hurley DM, Hebert JR, McNamara C, Bayakly AR, Vena JE (2012) Cancer mortality-to-incidence ratios in Georgia describing racial cancer disparities and potential geographic determinants. Cancer 118(16):4032–4045
Hsing AW, Tsao L, Devesa SS (2000) International trends and patterns of prostate cancer incidence and mortality. Int J Cancer 85(1):60–67
Kamangar F, Dores GM, Anderson WF (2006) Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 24(14):2137–2150
Sugerman PB, Savage NW (2002) Oral cancer in Australia: 1983–1996. Aust Dent J 47(1):45–56
Sunkara V, Hebert JR (2015) The colorectal cancer mortality-to-incidence ratio as an indicator of global cancer screening and care. Cancer 121:1563–1569
Armstrong K, Randall TC, Polsky D, Moye E, Silber JH (2011) Racial differences in surgeons and hospitals for endometrial cancer treatment. Med Care 49(2):207–214
Sabatino SA, Stewart SL, Wilson RJ (2009) Racial and ethnic variations in the incidence of cancers of the uterine corpus, United States, 2001–2003. J Womens Health 18(3):285–294
Oliver KE, Enewold LR, Zhu KM, Conrads TP, Rose GS, Maxwell GL, Farley JH (2011) Racial disparities in histopathologic characteristics of uterine cancer are present in older, not younger blacks in an equal-access environment. Gynecol Oncol 123(1):76–81
Alagkiozidis I, Wilson K, Ruffner N, Weedon J, Serur E, Economos K, Abulafia O, Lee YC, Salame G (2014) External validation of a nomogram for predicting survival of women with uterine cancer in a cohort of African American patients. Int J Gynecol Cancer 24(1):85–90
Cote ML, Ruterbusch JJ, Ahmed Q, Bandyopadhyay S, Alosh B, Abdulfatah E, Seward S, Morris R, Ali-Fehmi R (2014) Endometrial cancer in morbidly obese women: do racial disparities affect surgical or survival outcomes? Gynecol Oncol 133(1):38–42
Sunkara V, Hebert JR (2015) The application of the mortality-to-incidence ratio for the evaluation of cancer care disparities globally. Cancer 122(3):487–488. doi:10.1002/cncr.29746
United States Cancer Statistics (1999–2012 cancer incidence and mortality data) https://nccd.cdc.gov/uscs/. Accessed 122315
Adams SA, Hebert JR, Bolick-Aldrich S, Daguise VG, Mosley CM, Modayil MV, Berger SH, Teas J, Mitas M, Cunningham JE et al (2006) Breast cancer disparities in South Carolina: early detection, special programs, and descriptive epidemiology. J S C Med Assoc 102(7):231–239
Alberg AJ, Horner MJ, Daguise VG, Carpenter MJ, Mosley CM, Vincent B, Silvestri G, Reed CE, Hebert JR (2006) Lung and bronchus cancer disparities in South Carolina: epidemiology and strategies for prevention. J S C Med Assoc 102(7):183–191
Brandt HM, Modayil MV, Hurley D, Pirisi-Creek LA, Johnson MG, Davis J, Mathur SP, Hebert JR (2006) Cervical cancer disparities in South Carolina: an update of early detection, special programs, descriptive epidemiology, and emerging directions. J S C Med Assoc 102(7):223–230
Daguise VG, Burch JB, Horner MJ, Mosley C, Hofseth LJ, Wargovich MJ, Lloyd SC, Hebert JR (2006) Colorectal cancer disparities in South Carolina: descriptive epidemiology, screening, special programs, and future direction. J S C Med Assoc 102(7):212–220
Drake BF, Keane TE, Mosley CM, Adams SA, Elder KT, Modayil MV, Ureda JR, Hebert JR (2006) Prostate cancer disparities in South Carolina: early detection, special programs, and descriptive epidemiology. J S C Med Assoc 102(7):241–249
Hebert JR, Adams SA, Daguise VG, Hurley D, Smith EW, Purdon C, Lawson A, Mitas M, Reed CE (2006) Esophageal cancer disparities in South Carolina: early detection, special programs, and descriptive epidemiology. J S C Med Assoc 102(7):201–209
Hebert JR, Elder K, Ureda JR (2006) Meeting the challenges of cancer prevention and control in South Carolina: focusing on seven cancer sites, engaging partners. J S C Med Assoc 102(7):177–182
Yen KL, Horner MJ, Reed SG, Daguise VG, Bolick-Aldrich SW, Young MR, Day TA, Wood PA, Hebert JR (2006) Head and neck cancer disparities in South Carolina: descriptive epidemiology, early detection, and special programs. J S C Med Assoc 102(7):192–200
Cote ML, Ruterbusch JJ, Olson SH, Lu K, Ali-Fehmi R (2015) The growing burden of endometrial cancer: a major racial disparity affecting black women. Cancer Epidemiol Biomark Prev 24(9):1407–1415
Siegel RL, Devesa SS, Cokkinides V, Ma JM, Jemal A (2013) State-level uterine corpus cancer incidence rates corrected for hysterectomy prevalence, 2004 to 2008. Cancer Epidemiol Biomark Prev 22(1):25–31
Sighoko D (2014) Ethnic and geographic variations in corpus uteri cancer burden: evidence based on data from 29 states and the District of Columbia. CI5 IX, X and SEER data (1998–2010). Cancer Causes Control 25(9):1197–1209
Cossrow N, Falkner B (2004) Race/ethnic issues in obesity and obesity-related comorbidities. J Clin Endocrinol Metab 89(6):2590–2594
Arem H, Irwin ML, Zhou Y, Lu LG, Risch H, Yu H (2011) Physical activity and endometrial cancer in a population-based case–control study. Cancer Causes Control 22(2):219–226
Colbert LH, Lacey JV, Schairer C, Albert P, Schatzkin A, Albanes D (2003) Physical activity and risk of endometrial cancer in a prospective cohort study (United States). Cancer Causes Control 14(6):559–567
Conroy MB, Sattelmair JR, Cook NR, Manson JE, Buring JE, Lee IM (2009) Physical activity, adiposity, and risk of endometrial cancer. Cancer Causes Control 20(7):1107–1115
Du MM, Kraft P, Eliassen AH, Giovannucci E, Hankinson SE, De Vivo I (2014) Physical activity and risk of endometrial adenocarcinoma in the nurses’ health study. Int J Cancer 134(11):2707–2716
Friberg E, Mantzoros CS, Wolk A (2006) Physical activity and risk of endometrial cancer: a population-based prospective cohort study. Cancer Epidemiol Biomark Prev 15(11):2136–2140
Friedenreich C, Cust A, Lahmann PH, Steindorf K, Boutron-Ruault MC, Clavel-Chapelon F, Mesrine S, Linseisen J, Rohrmann S, Pischon T et al (2007) Physical activity and risk of endometrial cancer: the European prospective investigation into cancer and nutrition. Int J Cancer 121(2):347–355
Gierach GL, Chang SC, Brinton LA, Lacey JV, Hollenbeck AR, Schatzkin A, Leitzmann MF (2009) Physical activity, sedentary behavior, and endometrial cancer risk in the NIH-AARP diet and health study. Int J Cancer 124(9):2139–2147
Tavani A, Bravi F, Dal Maso L, Zucchetto A, Bosetti C, Pelucchi C, Montella M, Franceschi S, La Vecchia C (2009) Physical activity and risk of endometrial cancer: an Italian case–control study. Eur J Cancer Prev 18(4):303–306
Voskuil DW, Monninkhof EM, Elias SG, Vlems FA, van Leeuwen FE (2007) Task force phys activity C: physical activity and endometrial cancer risk, a systematic review of current evidence. Cancer Epidemiol Biomark Prev 16(4):639–648
Trimble EL, Harlan LC, Clegg LMX, Stevens JL (2005) Pre-operative imaging, surgery and adjuvant therapy for women diagnosed with cancer of the corpus uteri in community practice in the United States. Gynecol Oncol 96(3):741–748
County Health Rankings and Roadmaps; Adult obesity and physical inactivity in South Carolina. http://www.countyrankings.org/app/south-carolina/2015/measure/factors/11/map available on 122315
Cook LS, Kmet LM, Magliocco AM, Weiss NS (2006) Endometrial cancer survival among US black and white women by birth cohort. Epidemiology 17(4):469–472
Elshaikh MA, Munkarah AR, Robbins JR, Laser BS, Bhatt N, Cogan C, Siddiqui F (2013) The impact of race on outcomes of patients with early stage uterine endometrioid carcinoma. Gynecol Oncol 128(2):171–174
Kost ER, Hall KL, Hines JF, Farley JH, Nycum LR, Rose GS, Carlson JW, Fischer JR, Kendall BS (2003) Asian-Pacific Islander race independently predicts poor outcome in patients with endometrial cancer. Gynecol Oncol 89(2):218–226
Maxwell GL, Tian C, Risinger J, Brown CL, Rose GS, Thigpen JT, Fleming GF, Gallion HH, Brewster WR (2006) Racial disparity in survival among patients with advanced/recurrent endometrial adenocarcinoma: a gynecologic oncology group study. Cancer 107(9):2197–2205
Olson SH, Atoria CL, Cote ML, Cook LS, Rastogi R, Soslow RA, Brown CL, Elkin EB (2012) The impact of race and comorbidity on survival in endometrial cancer. Cancer Epidemiol Biomark Prev 21(5):753–760
Ruterbusch JJ, Ali-Fehmi R, Olson SH, Sealy-Jefferson S, Rybicki BA, Hensley-Alford S, Elshaikh MA, Gaba AR, Schultz D, Munkarah AR et al (2014) The influence of comorbid conditions on racial disparities in endometrial cancer survival. Am J Obstet Gynecol 211(6):627-e1
Yap OW, Matthews RP (2006) Racial and ethnic disparities in cancers of the uterine corpus. J Natl Med Assoc 98(12):1930–1933
Cook LS, Kmet LM, Magliocco AM, Weiss NS (2006) Endometrial cancer survival among U.S. black and white women by birth cohort. Epidemiology 17(4):469–472
Acknowledgments
We acknowledge the Department of Health and Environmental Services (DHEC) for making their data available for use and particularly, and we appreciate the SCCCR Director Susan Bolick for giving us additional information.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Babatunde, O.A., Adams, S.A., Eberth, J.M. et al. Racial disparities in endometrial cancer mortality-to-incidence ratios among Blacks and Whites in South Carolina. Cancer Causes Control 27, 503–511 (2016). https://doi.org/10.1007/s10552-016-0724-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10552-016-0724-7