Beyond Bleeding: An Analysis of Presenting Symptoms Among Black Patients with Endometrial Cancer
Objectives: Black patients have the highest mortality rate from endometrial cancer (EC), and yet remain underrepresented in EC research. Thus, currently published symptom patterns may not be comprehensive for this population. The purpose of this study is to analyze symptomatology among Black patient...
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| Format: | Article |
| Language: | English |
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Mary Ann Liebert
2025-02-01
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| Series: | Health Equity |
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| Online Access: | https://www.liebertpub.com/doi/10.1177/24731242251365480 |
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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 | Objectives: Black patients have the highest mortality rate from endometrial cancer (EC), and yet remain underrepresented in EC research. Thus, currently published symptom patterns may not be comprehensive for this population. The purpose of this study is to analyze symptomatology among Black patients with EC in the Guidelines for Ultrasound in the Detection of Early Endometrial Cancer study and to compare with those undergoing benign hysterectomy. Methods: This is a retrospective consecutive patient sample of Black individuals undergoing hysterectomy in an academic-affiliated 10-hospital health care system from 2014 to 2020. We collected clinical, sociodemographic, and diagnostic information for 24 months before hysterectomy, using merged structured and abstracted data from electronic health records. We used descriptive statistics to describe the sample and pertinent subgroups—patients with fibroids/enlarged uteri, without postmenopausal bleeding (PMB), and patients <50 years old. Symptom distribution between subgroups was analyzed using chi-square tests and Fisher exact tests. Results: The sample included 3,455 hysterectomy patients, 12% with EC (n = 404). Among EC patients, 77% had PMB and 7% had no bleeding history. EC patients were symptomatic beyond bleeding, with fibroids/enlarged uteri (70%), pelvic/abdominal pain (38%), anemia (30%), and more. Young patients (8% of all EC cases) had more pelvic/abdominal pain (61% vs. 36%, p = 0.017) and anemia requiring transfusion (33% vs. 6%, p < 0.001) compared with older patients. Subgroup symptom presentations overlapped between those with and without cancer, with few symptoms differing by >20%. Conclusions: PMB alone is rarely the only presenting symptom among Black patients with EC; symptoms overlap heavily with patients presenting with benign disease. Young patients, those with fibroids/enlarged uteri, and those without PMB represent subgroups with nuanced presentations, for whom EC should be considered. |
| format | Article |
| id | doaj-art-ec5a00337779424b8252ff55ffb30c86 |
| institution | Kabale University |
| issn | 2473-1242 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Mary Ann Liebert |
| record_format | Article |
| series | Health Equity |
| spelling | doaj-art-ec5a00337779424b8252ff55ffb30c862025-08-20T03:36:58ZengMary Ann LiebertHealth Equity2473-12422025-02-019137538510.1177/24731242251365480Beyond Bleeding: An Analysis of Presenting Symptoms Among Black Patients with Endometrial CancerMaya E. Gross0Mindy Pike1Julianna Alson2Patrice Williams3Mollie E. Wood4Erica Marsh5Erin Carey6Til Stürmer7Ronit Katz8Whitney R. Robinson9Kemi M. Doll10Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA.Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA.Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA.Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA.Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.Department of Obstetrics and Gynecology, School of Medicine, University of Michigan, Ann Arbor, Michigan, USA.Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA.Department of Obstetrics and Gynecology, School of Medicine, Duke University, Durham, North Carolina, USA.Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA.Objectives: Black patients have the highest mortality rate from endometrial cancer (EC), and yet remain underrepresented in EC research. Thus, currently published symptom patterns may not be comprehensive for this population. The purpose of this study is to analyze symptomatology among Black patients with EC in the Guidelines for Ultrasound in the Detection of Early Endometrial Cancer study and to compare with those undergoing benign hysterectomy. Methods: This is a retrospective consecutive patient sample of Black individuals undergoing hysterectomy in an academic-affiliated 10-hospital health care system from 2014 to 2020. We collected clinical, sociodemographic, and diagnostic information for 24 months before hysterectomy, using merged structured and abstracted data from electronic health records. We used descriptive statistics to describe the sample and pertinent subgroups—patients with fibroids/enlarged uteri, without postmenopausal bleeding (PMB), and patients <50 years old. Symptom distribution between subgroups was analyzed using chi-square tests and Fisher exact tests. Results: The sample included 3,455 hysterectomy patients, 12% with EC (n = 404). Among EC patients, 77% had PMB and 7% had no bleeding history. EC patients were symptomatic beyond bleeding, with fibroids/enlarged uteri (70%), pelvic/abdominal pain (38%), anemia (30%), and more. Young patients (8% of all EC cases) had more pelvic/abdominal pain (61% vs. 36%, p = 0.017) and anemia requiring transfusion (33% vs. 6%, p < 0.001) compared with older patients. Subgroup symptom presentations overlapped between those with and without cancer, with few symptoms differing by >20%. Conclusions: PMB alone is rarely the only presenting symptom among Black patients with EC; symptoms overlap heavily with patients presenting with benign disease. Young patients, those with fibroids/enlarged uteri, and those without PMB represent subgroups with nuanced presentations, for whom EC should be considered.https://www.liebertpub.com/doi/10.1177/24731242251365480endometrial cancerdisparitiesracefibroidspostmenopausal bleeding |
| 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 Beyond Bleeding: An Analysis of Presenting Symptoms Among Black Patients with Endometrial Cancer Health Equity endometrial cancer disparities race fibroids postmenopausal bleeding |
| title | Beyond Bleeding: An Analysis of Presenting Symptoms Among Black Patients with Endometrial Cancer |
| title_full | Beyond Bleeding: An Analysis of Presenting Symptoms Among Black Patients with Endometrial Cancer |
| title_fullStr | Beyond Bleeding: An Analysis of Presenting Symptoms Among Black Patients with Endometrial Cancer |
| title_full_unstemmed | Beyond Bleeding: An Analysis of Presenting Symptoms Among Black Patients with Endometrial Cancer |
| title_short | Beyond Bleeding: An Analysis of Presenting Symptoms Among Black Patients with Endometrial Cancer |
| title_sort | beyond bleeding an analysis of presenting symptoms among black patients with endometrial cancer |
| topic | endometrial cancer disparities race fibroids postmenopausal bleeding |
| url | https://www.liebertpub.com/doi/10.1177/24731242251365480 |
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