Health Services Research

PV QA 3 - Poster Viewing Q&A 3

TU_37_2963 - Racial differences in cervical cancer histology and staging at presentation: a National Cancer Database analysis

Tuesday, October 23
1:00 PM - 2:30 PM
Location: Innovation Hub, Exhibit Hall 3

Racial differences in cervical cancer histology and staging at presentation: a National Cancer Database analysis
K. A. Pearlstein1, C. Xu2, A. Deal2, O. Kaidar-Person1, R. C. Chen1, and E. L. Jones1; 1University of North Carolina Hospitals, Chapel Hill, NC, 2Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC

Purpose/Objective(s): Racial disparities in cervical cancer mortality have been well-documented, and contributing factors have been proposed including discrepancies in screening and socioeconomic factors.  Certain histologies, such as adenocarcinomas (AC), have a more aggressive course than squamous cell carcinomas (SqCC) and racial differences in histology may contribute to outcome differences.  We utilize the National Cancer Database (NCDB) to explore histology and staging of cervical cancer at the time of diagnosis among different races.

Materials/Methods: Patients diagnosed with SqCC or AC of the cervix from 2004-2014 were identified in the NCDB.  Race was classified as non-Hispanic white (NHW), non-Hispanic black (NHB), Hispanic, or other.  Demographics, clinical characteristics, and FIGO staging were examined, stratified by race and by histology.  Parametric statistics compared differences between groups.

Results: A total of 89183 individuals were identified- 65% were NHW, 16% NHB, and 13% Hispanic.  SqCC were more commonly diagnosed than AC (77% vs 23%, p<0.01), although the proportion of AC increased from 21% to 26% during the study period, a trend seen among all races.  NHW patients were more frequently diagnosed with AC compared to NHB or Hispanic patients  (27% vs 13% vs 20%, p<0.01).  This difference was most pronounced in younger patients: 32% of NHW <40 years old had AC compared to only 10% of NHB and 21% of Hispanic women.  For both AC and SqCC, presenting stage was significantly different among women of different races (Table, p<0.01 for both AC and SqCC).  Overall, approximately 50% of squamous cell carcinomas were diagnosed as stage I across all races (range 46% to 52%).  However, NHW and Hispanic women with AC were more frequently diagnosed as stage I compared to NHB, while NHB were more frequently diagnosed with stage IV disease.

Conclusion: Racial differences in histology and stage are evident at the time of diagnosis.  These findings warrant further investigation into the impact of race and histology on treatment decisions and outcomes.
Stage

Sqcc

AC

 

NHW

NHB

Hispanic

NHW

NHB

Hispanic

I

50%

46%

52%

73%

54%

71%

II

22%

23%

24%

13%

16%

16%

III

14%

18%

13%

5%

9%

5%

IV

14%

14%

10%

9%

21%

8%

 

Author Disclosure: K.A. Pearlstein: Employee; UNC Hospitals. C. Xu: None. A. Deal: None. O. Kaidar-Person: None. R.C. Chen: Research Grant; Accuray Inc. Consultant; Accuray Inc. E.L. Jones: Member; NCI GI Steering Committee.

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