Retrospective Cohort Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Oct 24, 2019; 10(10): 340-349
Published online Oct 24, 2019. doi: 10.5306/wjco.v10.i10.340
Endometrial cancer among a cohort of urban Haitian immigrants
Matthew Schlumbrecht, Parker Bussies, Marilyn Huang, Erin Kobetz, Sophia George
Matthew Schlumbrecht, Marilyn Huang, Sophia George, Division of Gynecologic Oncology, Sylvester Comprehensive Cancer center, University of Miami Miller School of Medicine, Miami, FL 33139, United States
Matthew Schlumbrecht, Parker Bussies, Marilyn Huang, Sophia George, Department of Obstetrics, Gynecology, and Reproductive Science, University of Miami Miller School of Medicine, Miami, FL 33139, United States
Erin Kobetz, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33139, United States
Author contributions: Schlumbrecht M and George SHL contributed to research design, data analysis, and manuscript drafting; Bussies P contributed to data analysis and manuscript drafting; Huang M and Kobetz E contributed to manuscript drafting; All authors manuscript revision and final approval.
Institutional review board statement: Review and analysis of the database was approved by the State of Florida Department of Health Institutional Review Board.
Informed consent statement: Informed consent is waived by the Florida Department of Health as all patient information is de-identified and non-discoverable.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: No additional data are available.
STROBE statement: The manuscript meets the STROBE checklist requirements for cohort studies.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Matthew Schlumbrecht, MD, Associate Professor, Division of Gynecologic Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1121 Northwest 14th Street, Suite 345C, Miami, FL 33136, United States.
Telephone: +1-305-2435463 Fax: +1-305-2434938
Received: May 13, 2019
Peer-review started: May 14, 2019
First decision: August 16, 2019
Revised: August 22, 2019
Accepted: September 20, 2019
Article in press: September 20, 2019
Published online: October 24, 2019

Black women are known to have a higher risk of aggressive endometrial cancers. Little data exist about the role of nativity as a determinant of survival outcomes in women with this disease.


Our objective was to evaluate a population of Haitian immigrants with endometrial cancer in an urban setting using the Florida Cancer Data System (FCDS).


A search of FCDS identified 107 women born in Haiti and who received treatment for invasive endometrial cancer in Miami-Dade County between 1989 and 2013. Clinicopathologic data were extracted to describe the cohort and assess associations with overall survival. Statistical analyses were performed using Cox proportional hazards models, the log-rank test, and the Kaplan-Meier method, with significance set at P ≤ 0.05.


Median age at diagnosis was 65 years. 63.9% of the patients had a type II, high-grade, histology, and 52.6% presented with extrauterine metastatic disease. Nearly three quarters had health insurance. Within the entire cohort, only presence of extrauterine disease was associated with worse overall survival [Hazard ratio (HR) = 2.70, 95% confidence interval (CI): 1.31-5.57, P = 0.007]. However, after stratification by histologic grade, both age (HR = 0.88, 95%CI: 0.81-0.96, P = 0.002) and extrauterine disease (HR = 2.49, 95%CI: 1.01-6.21, P = 0.049) were independently associated with worse survival, but only in women with type II malignancies.


Urban Haitian women with endometrial cancer have a high burden of aggressive histologies. Additional investigation to explain the etiology of these findings is needed.

Keywords: Endometrial cancer, Nativity, Haitian, Black, Survival

Core tip: Black women of Haitian nativity have a higher prevalence of type II endometrial cancers than previously reported in other large, population-based studies performed in the United States. Further investigation into the genetic, epigenetic, and behavioral determinations of this observed health outcome is necessary.