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Report: Endometrial Cancer on Rise in U.S.

Black and Asian women are at greatest risk

Endometrial cancer is becoming more common in the U.S., and black women appear more likely to get the most aggressive types of tumors and die from the disease, a new study suggests.

According to a Reuters report, researchers analyzed cancer registry data from 2000 to 2011 and found that incidence rates for endometrial tumors increased among all racial and ethnic groups. But for white women, the increase was less than 1% overall, compared with 1.8% for Hispanic women and 2.5% for black and Asian women.

Survival odds were also bleaker for black women. The authors compared black women with white women who were similar in age, tumor type, and stage of cancer at diagnosis. After 5 years, the black women were 6% less likely to survive low-grade tumors and 59% less likely to survive more-aggressive malignancies.

The findings were published in Cancer, Epidemiology, Biomarkers, and Prevention.

The reasons why black women have an increased risk for endometrial tumors are unclear, said lead author Dr. Michele Cote, a researcher at Wayne State University’s Karmanos Cancer Institute in Detroit.

“We have worked over the last decade to try to disentangle the various factors associated with survival,” Cote told Reuters in an email. “It is highly complex, with socioeconomic factors and access to care certain to play a role. In addition, we believe that there are differences in tumor biology that we have yet to identify that make the disease more aggressive in black women.”

Endometrial cancer is the fourth most common malignancy among women, with nearly 50,000 cases diagnosed in the U.S. in 2013.

At least some of the increase in these tumors may be due to rising rates of obesity, the authors note in their article. Excess fat tissue produces more hormones, such as insulin and estrogen, which may help cancer cells grow.

Black women were also more prone to aggressive tumors, the study found. When researchers looked at some of the more fast-growing and serious types of endometrial cancers, black women were 1.9 times to 2.5 times more likely to develop these malignancies than white women.

Hispanic and Asian women, in contrast, were less likely than white women to have aggressive subtypes of endometrial cancer.

One limitation of the study, the researchers acknowledged, is that they couldn’t review lab tests of tumors to verify the precise type of tumor and stage of cancer the women had. This might have led to misclassification of tumor subtypes, but it would probably not be associated with race or ethnicity, they noted.

It’s also possible that issues not addressed in the study –– such as access to specialists or the affordability of care –– may have influenced the outcomes for black women, said Dr. Robert DeBernardo, a researcher in gynecologic oncology at the Cleveland Clinic.

“Aggressive endometrial cancers are difficult to treat and cure in the best of hands, and without access to specialists it is likely women are not receiving the best therapies and unlikely they have access to clinical trials,” DeBernardo, who wasn’t involved in the study, told Reuters via email.

Sources: Reuters; August 19, 2015; and CEBP; August 19, 2015.

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