Risk factors for delayed diagnosis of endometrial cancer among black individuals: Results from the GUIDE-EC study
Objective: Black patients with endometrial cancer (EC) experience disproportionately advanced stage at diagnosis. We aimed to identify variables, beyond race and histologic subtype, which increase risk for delayed diagnosis of EC. Methods: This is a retrospective study of Black individuals with EC i...
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Elsevier
2025-08-01
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| Series: | Gynecologic Oncology Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S235257892500147X |
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| author | Maya E. Gross Mindy Pike Julianna Alson Patrice Williams Mollie E. Wood Erica Marsh Erin Carey Til Stürmer Ronit Katz Whitney R. Robinson Kemi M. Doll |
| author_facet | Maya E. Gross Mindy Pike Julianna Alson Patrice Williams Mollie E. Wood Erica Marsh Erin Carey Til Stürmer Ronit Katz Whitney R. Robinson Kemi M. Doll |
| author_sort | Maya E. Gross |
| collection | DOAJ |
| description | Objective: Black patients with endometrial cancer (EC) experience disproportionately advanced stage at diagnosis. We aimed to identify variables, beyond race and histologic subtype, which increase risk for delayed diagnosis of EC. Methods: This is a retrospective study of Black individuals with EC in a large academic-affiliated healthcare system from 2014 to 2020. Primary outcome was delayed diagnosis of EC, defined as prolonged time to diagnosis (>28 days to reach diagnosis). We used descriptive statistics, univariate regression, and factor analysis to identify variables associated with delayed diagnosis, achieve data reduction, and calculate odds ratios for delayed diagnosis. Results: Of 388 patients with EC included for analysis, one fifth (n = 79, 20 %) experienced delayed diagnosis. Ultrasound had the strongest association with delayed diagnosis in univariate regression (OR 4.4, 95 % CI 2.4, 7.8) and factor analysis (OR 2.2, 95 % CI 1.6, 3.0). BMI ≥ 40 (OR 1.9, 95 % CI 1.1, 3.3) was also associated with delayed diagnosis. Age ≥ 50 was associated with decreased odds of delayed diagnosis (OR 0.3, 95 % CI 0.2, 0.7). Presence of an endometrial biopsy was associated with decreased odds of delayed diagnosis on univariate regression (OR 0.4, 95 % CI 0.2, 1.4). Conclusions: A fifth of Black patients with EC experienced delayed diagnosis, and preoperative ultrasound was most strongly associated with delayed diagnosis. Providers should consider a tissue-sampling-first approach in Black patients at risk for EC. |
| format | Article |
| id | doaj-art-a739f808d9ed45bcb50ed69933a4c2d3 |
| institution | Kabale University |
| issn | 2352-5789 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj-art-a739f808d9ed45bcb50ed69933a4c2d32025-08-21T04:17:18ZengElsevierGynecologic Oncology Reports2352-57892025-08-016010192210.1016/j.gore.2025.101922Risk factors for delayed diagnosis of endometrial cancer among black individuals: Results from the GUIDE-EC studyMaya E. Gross0Mindy Pike1Julianna Alson2Patrice Williams3Mollie E. Wood4Erica Marsh5Erin Carey6Til Stürmer7Ronit Katz8Whitney R. Robinson9Kemi M. Doll10Department of Obstetrics and Gynecology, Fred Hutchinson Cancer Center, University of Washington, USA; Corresponding author.Department of Obstetrics and Gynecology, Fred Hutchinson Cancer Center, University of Washington, USADepartment of Obstetrics and Gynecology, Fred Hutchinson Cancer Center, University of Washington, USADepartment of Obstetrics and Gynecology, Fred Hutchinson Cancer Center, University of Washington, USADepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina, USADepartment of Obstetrics and Gynecology, School of Medicine, University of Michigan, USADepartment of Obstetrics and Gynecology, School of Medicine, University of North Carolina, USADepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina, USADepartment of Obstetrics and Gynecology, Fred Hutchinson Cancer Center, University of Washington, USADepartment of Obstetrics and Gynecology, School of Medicine, Duke University, USADepartment of Obstetrics and Gynecology, Fred Hutchinson Cancer Center, University of Washington, USAObjective: Black patients with endometrial cancer (EC) experience disproportionately advanced stage at diagnosis. We aimed to identify variables, beyond race and histologic subtype, which increase risk for delayed diagnosis of EC. Methods: This is a retrospective study of Black individuals with EC in a large academic-affiliated healthcare system from 2014 to 2020. Primary outcome was delayed diagnosis of EC, defined as prolonged time to diagnosis (>28 days to reach diagnosis). We used descriptive statistics, univariate regression, and factor analysis to identify variables associated with delayed diagnosis, achieve data reduction, and calculate odds ratios for delayed diagnosis. Results: Of 388 patients with EC included for analysis, one fifth (n = 79, 20 %) experienced delayed diagnosis. Ultrasound had the strongest association with delayed diagnosis in univariate regression (OR 4.4, 95 % CI 2.4, 7.8) and factor analysis (OR 2.2, 95 % CI 1.6, 3.0). BMI ≥ 40 (OR 1.9, 95 % CI 1.1, 3.3) was also associated with delayed diagnosis. Age ≥ 50 was associated with decreased odds of delayed diagnosis (OR 0.3, 95 % CI 0.2, 0.7). Presence of an endometrial biopsy was associated with decreased odds of delayed diagnosis on univariate regression (OR 0.4, 95 % CI 0.2, 1.4). Conclusions: A fifth of Black patients with EC experienced delayed diagnosis, and preoperative ultrasound was most strongly associated with delayed diagnosis. Providers should consider a tissue-sampling-first approach in Black patients at risk for EC.http://www.sciencedirect.com/science/article/pii/S235257892500147XEndometrial cancerRacial disparitiesDiagnosisTransvaginal ultrasoundHealthcare quality |
| spellingShingle | Maya E. Gross Mindy Pike Julianna Alson Patrice Williams Mollie E. Wood Erica Marsh Erin Carey Til Stürmer Ronit Katz Whitney R. Robinson Kemi M. Doll Risk factors for delayed diagnosis of endometrial cancer among black individuals: Results from the GUIDE-EC study Gynecologic Oncology Reports Endometrial cancer Racial disparities Diagnosis Transvaginal ultrasound Healthcare quality |
| title | Risk factors for delayed diagnosis of endometrial cancer among black individuals: Results from the GUIDE-EC study |
| title_full | Risk factors for delayed diagnosis of endometrial cancer among black individuals: Results from the GUIDE-EC study |
| title_fullStr | Risk factors for delayed diagnosis of endometrial cancer among black individuals: Results from the GUIDE-EC study |
| title_full_unstemmed | Risk factors for delayed diagnosis of endometrial cancer among black individuals: Results from the GUIDE-EC study |
| title_short | Risk factors for delayed diagnosis of endometrial cancer among black individuals: Results from the GUIDE-EC study |
| title_sort | risk factors for delayed diagnosis of endometrial cancer among black individuals results from the guide ec study |
| topic | Endometrial cancer Racial disparities Diagnosis Transvaginal ultrasound Healthcare quality |
| url | http://www.sciencedirect.com/science/article/pii/S235257892500147X |
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