Published online Oct 24, 2019. doi: 10.5306/wjco.v10.i10.340
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
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.
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.
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.
Utilizing the Florida Cancer Data System, a retrospective cohort study was performed following STROBE guidelines.
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.
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.
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.