Presentation Authors: Elishia McKay*, Jonathan Davila, Nitya Abraham, Bronx, NY
Introduction: Pelvic Floor Disorders (PFD) includes urinary incontinence (UI), fecal incontinence (FI) and pelvic organ prolapse (POP). These disorders affect up to one in four women and deleteriously impact physical and psychosocial health. Multi-center randomized clinical trials on PFDs allow us to provide evidence-based care. Alarmingly, the demographics of several clinical trials in oncology disproportionately reflect the racial/ethnic distribution of the population affected. The objective of this study was to investigate the racial/ethnic distribution in key PFD clinical trials compared to the national population, while considering racial/ethnic differences in PFD in the literature.
Methods: Demographic data was collected from major PFD trials. The national racial composition was obtained from the US Census Bureau. Prevalence of PFD by race/ethnicity was obtained from the National Health and Nutritional Examination Survey (NHANES). Percentage representation in PFD trials that was less than the US census percentage of that demographic group was considered underrepresentation.
Results: Compared to national census data underrepresentation was demonstrated in Asians across all PFD sub groups, except for one trial in fecal incontinence. In contrast, White women were overrepresented in every PFD subgroup. Hispanics were underrepresented or not even included as a unique group in at least half of the trials in urgency UI, POP, and FI. Black women were underrepresented compared to US census data in SUI and POP studies, which is consistent with lower prevalence of these PFDs in this racial/ethnic group. NHANES also demonstrates the weighted prevalence rate for POP is highest in Hispanics 5.3 (41, 6.8), and for FI and UI is highest in Whites 10.2 (9.1, 11.3) and 18.2 (16.7, 20.0) respectively. See Table.
Conclusions: The invaluable body of literature that has advanced the management of PFDs also demonstrates underrepresentation of certain minority groups, most evidently Asian Americans. Our study suggests that PFD research would benefit from targeted sampling of minority groups. Understanding nuances across demographic groups may be helpful in improving quality of life for all women.