ASPO Abstracts
NCCN Treatment Adherence and Endometrial Cancer Survival: Implications for Racial/Ethnic Disparities
Category: Cancer Health Disparities
Conference Year: 2020
Abstract Body:
PURPOSE: This study aimed to examine differences in overall survival of endometrial
cancer based on National Comprehensive Cancer Network (NCCN) treatment guidelines
and race/ethnicity. METHODS: Data was extracted from the Surveillance, Epidemiology,
and End Results (SEER) National Cancer Registry from January 1, 2007 to December
31, 2015. The study included a total of 80,852 adult women 18 years and older with
endometrial carcinomas after exclusion criteria were applied. Descriptive statistics,
Kaplan-Meier estimate of survival probability, log-rank tests, and Cox regression
proportional hazards models were performed to examine predictors of overall survival
after controlling for important sociodemographic, prognostic, and treatment factors.
RESULTS: Racial/ethnic distribution of women in the sample consisted of 69.8% non-
Latina white, 8.4% Black, 12.1% Latina, 7.2% Asian, 1.3% Pacific Islander, 0.6%
American Indian/Alaskan Native, and 0.6% unknown race/ethnicity. Overall, 34.4% of
women received NCCN treatment adherent care. Pacific Islander, Asian, and non-Latina
white women received the highest percentage of adherent care (40.5%, 38.4%, and
34.4% respectively) whereas Black, Latina, and American Indian/Alaskan Native women
received the lowest percentage of adherent care (29.6%, 32.0%, and 31.6%
respectively). NCCN treatment adherence was an independent and statistically
significant predictor of overall survival. Compared to their non-Latina white counterparts,
findings indicate that there was a higher risk of death among Black (HR=1.43, p < 0.001)
and Pacific Islander (HR=1.54, p < 0.001) women whereas improved survival was
observed among Asian women (HR=0.85, p < 0.001) after adjusting for treatment
adherence, age at diagnosis, socioeconomic status, stage at diagnosis, histology
subtype, grade, and year of diagnosis. CONCLUSIONS: Adherence to treatment
guidelines for endometrial cancer is independently associated with overall survival. Even
after adjusting for treatment adherence and other sociodemographic and prognostic
factors, disparities in survival persisted among racial/ethnic groups.
Keywords: Endometrial Cancer; Survival; Treatment Adherence; Disparities