Racial disparities in blacks with gynecologic cancers

Authors

  • John Farley MD,

    1. Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda Maryland
    2. Gynecologic Disease Center and the U.S. Military Cancer Institute, Walter Reed Army Medical Center, Washington, DC
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    • The views expressed herein are those of the authors and do not reflect the official policy or opinion of the Department of Defense or the United States Army or Navy

  • John I. Risinger PhD,

    1. Department of Laboratory Oncology Research, Curtis and Elizabeth Anderson Cancer Institute, Memorial Health University Medical Center, Savannah Georgia
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    • The views expressed herein are those of the authors and do not reflect the official policy or opinion of the Department of Defense or the United States Army or Navy

  • G. Scott Rose MD,

    1. Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda Maryland
    2. Gynecologic Disease Center and the U.S. Military Cancer Institute, Walter Reed Army Medical Center, Washington, DC
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    • The views expressed herein are those of the authors and do not reflect the official policy or opinion of the Department of Defense or the United States Army or Navy

  • G. Larry Maxwell MD

    Corresponding author
    1. Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda Maryland
    2. Gynecologic Disease Center and the U.S. Military Cancer Institute, Walter Reed Army Medical Center, Washington, DC
    • Gynecologic Disease Center, Walter Reed Army Medical Center, Building 2, Room 2J06, 6900 Georgia Ave. N.W., Washington, DC 20307
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    • The views expressed herein are those of the authors and do not reflect the official policy or opinion of the Department of Defense or the United States Army or Navy

    • Fax: (202) 782-9278


Abstract

Black women have a lower incidence of gynecologic cancers but they have a higher mortality associated with their disease. The etiology of the racial disparity in outcome among gynecologic cancer patients is multifactoral and site-specific. Black women with endometrial cancer often present with more advanced stage tumors that are associated with a worse prognosis compared with White women. Evidence suggests that observed disparities in outcome are due to inequalities in treatment or differing biologic etiologies. For cervix cancer, studies have suggested that survival among Black women may be lower than survival among White women that develop this disease. This occurs despite evidence that indicates that Pap smears are utilized similarly by Black and White women for cervix cancer screening. These differences in outcome may become less pronounced when comorbidities are accounted for and inequalities in treatment are eliminated. For ovarian cancer patients, survival has improved with the use of contemporary therapies over the past 30 years in Whites but less so for Blacks. This may be due to differences in the likelihood of primary surgical cytoreductions, which are performed less frequently in some Black women because of extensive metastatic spread or comorbidities. The observed decreases in survival for all 3 gynecologic cancers potentially may be affected by socioeconomic status of the patient in some healthcare settings. An improved understanding of the causative factors associated with racial disparities in gynecologic cancer outcome is necessary to facilitate efforts aimed at correcting this important healthcare problem. Cancer 2007. © 2007 American Cancer Society.

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