African American Race and Low Income Neighborhoods Decrease Cause Specific Survival of Endometrial Cancer: A SEER Analysis

Background: This study analyzed Surveillance, Epidemiology and End Results (SEER) data to assess if socioeconomicfactors (SEFs) impact on endometrial cancer survival. Materials and
Methods: Endometrial cancerpatients treated from 2004-2007 were included in this study. SEER cause specific survival (CSS) data were usedas end points. The areas under the receiver operating characteristic (ROC) curve were computed for predictors.Time to event data were analyzed with Kaplan-Meier method. Univariate and multivariate analyses were usedto identify independent risk factors.
Results: This study included 64,710 patients. The mean follow up time(S.D.) was 28.2 (20.8) months. SEER staging (ROC area of 0.81) was the best pretreatment predictor of CSS.Histology, grade, race/ethnicity and county level family income were also significant pretreatment predictors.African American race and low income neighborhoods decreased the CSS by 20% and 3% respectively at 5years.
Conclusions: This study has found significant endometrial survival disparities due to SEFs. Future studiesshould focus on eliminating socio-economic barriers to good outcomes.