Effect of Social Determinants of Health on Advanced Stage Type 2 Endometrial Cancer at Time of Diagnosis [ID: 1376689]

Abstract

INTRODUCTION: Type 2 endometrial cancer (T2EC) accounts for 38.7% of all endometrial cancers but is responsible for 74.6% of endometrial cancer deaths. This is potentially due to advanced stage at time of diagnosis. We examine whether social determinants of health are predictors associated with T2EC diagnosed at an advanced stage. METHODS: Retrospective analysis of T2EC cases was performed from May 1, 2015, to March 31, 2022, at one academic site. The primary outcome was advanced stage at time of surgical diagnosis, defined as FIGO stages 3 or 4. Patient age, ethnicity, race (White versus non-White), obesity, and diabetes were evaluated. Multivariate logistic regression model was used to investigate predictors associated with increased risk of advanced-stage disease (ASD), with two-sided P value of <.05 considered significant. RESULTS: A total of 72 patients with T2EC were identified. Thirty-eight (52.7%) cases had early-stage disease and 34 (47.3%) cases had ASD at diagnosis. Ethnicity was the only predictor significantly associated with the primary outcome. Hispanic or Latina ethnicity was associated with 5 times higher odds (odds ratio 5.1, 95% CI 1.2–21.6, P=.028) of ASD at diagnosis, compared to non-Hispanic or Latina. CONCLUSION: Our results show that Hispanic or Latina ethnicity was significantly associated with advanced stage at diagnosis. Non-White race, obesity, diabetes, and age at surgery were not found to be predictors significantly associated with the primary outcome. This could be due to sample size limitations. To facilitate health equity, there is continued need for investigation into the effect of social determinants of health on ASD for T2EC.