Black women with postmenopausal bleeding have lower prevalence of endometrial cancer than other ethnic groups

Abstract

Objectives: Modern medical practice strives for a personalized approach to patient care. The evidence regarding the prevalence of endometrial cancer in various ethnic groups is scarce and conflicting. This study was conducted to determine this prevalence in postmenopausal bleeding (PMB) women.

Methods: Data for 1995 women attending PMB clinics over a 4-year period were prospectively collected. Women were grouped according to self-assigned ethnicity into ‘White’, ’Black’, ‘South Asian’ and ‘Others’, and according to investigation results into group 1 (benign findings) and group 2 (hyperplasia or cancer).

Results: The adjusted odds ratio (95% confidence interval) for Black ethnicity was 0.35 (0.17–72; p = 0.001). This means that Black women had 65% (28–83%) less odds for developing endometrial hyperplasia and cancer compared to White women, independent of other predictors. Compared to White ethnicity, women in all ethnic groups were significantly younger at presentation with PMB, had shorter duration since last menstrual period, and were less likely to be diabetic (p < 0.001).

Conclusion: This study found significantly lower prevalence of endometrial cancer in the Black race in a population of PMB women, a finding that cannot be readily explained by other known risk factors. Further research is warranted to confirm the results and explore the underlying etiology.

摘要

目的：现代医疗实践努力为患者提供个性化的护理。关于子宫内膜癌在不同种族人群中的流行病学情况的证据很少, 而且相互矛盾。这项研究是为了确定绝经后出血(PMB)妇女的子宫内膜癌的患病率。

方法：前瞻性地收集了4年内在PMB诊所就诊的1995名女性。根据自我认定的种族将其分为“白人”、“黑人”、“南亚人”和“其他人”, 并根据调查结果分为第1组(良性结果)和第2组(增生或癌症)。

结果：调整后的黑人种族优势比(95%可信区间)为0.35(0.17-72；p = 0.001)。这意味着与白人女性相比, 黑人女性患子宫内膜增生和子宫内膜癌的几率要低65%(28-83%), 这与其他预测因素无关。与白人相比, 所有种族的女性在出现PMB时明显较年轻, 月经周期较短, 且患糖尿病的可能性较低(p < 0.001)。

结论：这项研究发现, 在PMB女性人群中, 黑人种族中子宫内膜癌的患病率显著降低, 这一发现不容易用其他已知的危险因素来解释。进一步的研究是有必要的, 以确认结果和探索潜在的病因。

Keywords:

• Endometrial cancer
• endometrial hyperplasia
• ethnicity
• postmenopausal bleeding
• race

Potential conflict of interest

None of the authors has any conflicts of interest for this manuscript

Additional information

Funding

No fund was obtained for this study but the research fellowship for AG was funded by Aswan University, Egypt and the Egyptian Cultural Bureau, London, UK.