Yale Study Finds Racial Disparity in Uterine Cancer Testing and Diagnosis

Early diagnosis of uterine cancer is known to improve a patient’s chances for survival. When diagnosed while the cancer is still confined to the uterus, nearly 95 percent of patients will survive for at least five years. But that rate drops to less than 70 percent once the cancer has spread to areas or lymph nodes nearby and plummets to around 18 percent once the cancer has spread to other parts of the body.

Previous research has found that Black patients are less likely to receive early diagnoses than people of other racial and ethnic groups. A new analysis by Yale researchers provides insights into why that is: They found that Black patients were more likely than their White counterparts to experience testing delays or to not receive recommended tests at all.

For their analysis, researchers included adult patients who had reported abnormal uterine bleeding to their healthcare providers and later received a diagnosis of uterine cancer. Abnormal uterine bleeding is the most common symptom of uterine cancer. The American College of Obstetricians and Gynecologists recommends several procedures to evaluate the cause of abnormal uterine bleeding, such as endometrial biopsy, transvaginal/pelvic ultrasound, and hysteroscopy, in which a physician examines the inside of the cervix and uterus with a small, telescope-like device. In the new study, researchers found that more than twice as many Black patients than White patients did not receive any of these procedures.

Further, of the patients who did receive procedures, Black patients were more likely than White patients to experience a delay of more than two months in receiving their first diagnostic procedure following their report of abnormal uterine bleeding. Ultimately, Black patients were more likely than White patients to experience a delay in receiving their cancer diagnosis. The researchers found that 11.3 percent of Black patients who had reported abnormal uterine bleeding waited more than a year to receive a uterine cancer diagnosis, compared with 8.3 percent of White patients.

The full study, “Racial Disparities in Diagnostic Evaluation of Uterine Cancer among Medicaid Beneficiaries,” was published in the Journal of the National Cancer Institute. It may be accessed here.

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