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
Research background

Endometrial cancer is the most common gynecologic cancer. Aggressive, type II histologies are known to disproportionately affect black women, but further risk stratification within this group has not been performed.

Research motivation

Miami-Dade County in South Florida is the home to the largest cohort of Haitian immigrants in the United States. A recent single-institution review was performed to evaluate if Caribbean-born black women had different outcomes. Haitian women were under-represented in that study, so the decision was made to utilize a larger state registry to evaluate the burden of disease in this group.

Research objectives

The primary objective was to describe a cohort of urban Haitian immigrant women with endometrial cancer and evaluate disease patterns as they compare to other populations of black women.

Research methods

Utilizing the Florida Cancer Data System, a retrospective cohort study was performed following STROBE guidelines.

Research results

Sixty-three point nine percent of the patients had a type II, high-grade, histology, and 52.6% presented with extrauterine metastatic disease. After stratification by histologic grade, both age [Hazard ratio (HR) = 0.88, 95% confidence interval (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.

Research conclusions

A greater proportion of Haitian women have type II endometrial cancer compared to other black populations in the United States. Prognostic variables for type II histologies were similar to previous reports.

Research perspectives

The roles of nativity, ancestry, and acculturation in defining endometrial cancer risk are poorly understood in black women. Our results demonstrate that Haitian women have a greater burden of aggressive endometrial cancer than previously reported among black women. Additional research on the hereditary, somatic, and environmental causes of these findings is required.