The Geographic Context of Racial Disparities in Aggressive Endometrial Cancer Subtypes: Integrating Social and Environmental Aspects to Discern Biological Outcomes

Anna Kimberly Miller, Jennifer Catherine Gordon, Jacqueline W. Curtis, Jayakrishnan Ajayakumar, Fredrick R. Schumacher and Stefanie Avril
Additional contact information
Anna Kimberly Miller: Department of Genetic and Genome Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
Jennifer Catherine Gordon: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University Hospitals Cleveland and Case Western Reserve University, Cleveland, OH 44106, USA
Jacqueline W. Curtis: Case Comprehensive Cancer Center, Cleveland, OH 44106, USA
Jayakrishnan Ajayakumar: Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
Fredrick R. Schumacher: Case Comprehensive Cancer Center, Cleveland, OH 44106, USA
Stefanie Avril: Case Comprehensive Cancer Center, Cleveland, OH 44106, USA

IJERPH, 2022, vol. 19, issue 14, 1-12

Abstract: The number of Endometrial Carcinoma (EC) diagnoses is projected to increase substantially in coming decades. Although most ECs have a favorable prognosis, the aggressive, non-endometrioid subtypes are disproportionately concentrated in Black women and spread rapidly, making treatment difficult and resulting in poor outcomes. Therefore, this study offers an exploratory spatial epidemiological investigation of EC patients within a U.S.-based health system’s institutional cancer registry ( n = 1748) to search for and study geographic patterns. Clinical, demographic, and geographic characteristics were compared by histotype using chi-square tests for categorical and t-tests for continuous variables. Multivariable logistic regression evaluated the impact of risks on these histotypes. Cox proportional hazard models measured risks in overall and cancer-specific death. Cluster detection indicated that patients with the EC non-endometrioid histotypes exhibit geographic clustering in their home address, such that congregate buildings can be identified for targeted outreach. Furthermore, living in a high social vulnerability area was independently associated with non-endometrioid histotypes, as continuous and categorical variables. This study provides a methodological framework for early, geographically targeted intervention; social vulnerability associations require further investigation. We have begun to fill the knowledge gap of geography in gynecologic cancers, and geographic clustering of aggressive tumors may enable targeted intervention to improve prognoses.

Keywords: endometrial cancer subtypes; racial disparities; geospatial; environmental mechanism; social vulnerability (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
https://www.mdpi.com/1660-4601/19/14/8613/pdf (application/pdf)
https://www.mdpi.com/1660-4601/19/14/8613/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:19:y:2022:i:14:p:8613-:d:863263

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().