Addressing Health Disparities in Endometrial Cancer: Insights from Experts

Основні поняття

Endometrial cancer incidence and mortality rates are disproportionately higher among certain racial and ethnic groups, particularly Black and Hispanic women, due to a complex interplay of factors including obesity, tumor biology, and social determinants of health.

Анотація

This discussion between Dr. Ursula Matulonis and Dr. Bhavana Pothuri explores the significant health disparities observed in endometrial cancer.
Key insights:

Endometrial cancer incidence is rising faster among Hispanic, Asian, Pacific Islander, and non-Hispanic Black women compared to non-Hispanic White women, especially in younger age groups. This is largely driven by the higher prevalence of obesity and metabolic conditions in these populations.
Survival rates for endometrial cancer are also worsening, with Black women experiencing nearly twice the mortality rate of White women. This is attributed to more aggressive tumor biology, including higher rates of serous carcinomas and TP53 mutations, as well as social determinants of health.
Barriers to clinical trial participation for underrepresented minorities include language exclusion, lack of demographic data reporting, and institutional biases. Strategies to improve access include community engagement, culturally-sensitive outreach, and decentralizing trial procedures.
Developing preclinical models that better reflect the diversity of endometrial cancer patients is crucial to advancing targeted therapies and addressing disparities.
Increased research funding for endometrial cancer is needed to drive progress in understanding and addressing these disparities.

Статистика

For every 5-unit increase in BMI, the risk of endometrial cancer increases by more than 50%.
Black patients comprised over a third of carcinosarcomas and almost 50% of serous endometrial cancers in a study.
38% of serous endometrial cancers in Black patients had CCNE1 amplification, compared to 0% in White patients.
42% of Black patients had TP53 mutations, compared to 26% in White patients.
HER2 overexpression was more common in Black patients, while mismatch repair-deficient tumors were more prevalent in White patients.
10% of endometrial cancer clinical trials specified language in their inclusion/exclusion criteria, with 23 out of 27 studies excluding all non-English speakers.
Demographic information, including race and ethnicity, was omitted in more than 40% of published endometrial cancer studies.

Цитати

"We shouldn't be ignoring abnormal bleeding in young women, in women who are obese and women of color. I think that's a really important take-home message."
"Black women now have nearly twice the mortality of a White woman with endometrial cancer."
"If we can somehow set up a national repository, that would be incredible."
"Without the research funding, we're not going to be able to improve outcomes. This is a critical problem that we have."

Ключові висновки, отримані з

Episode 4: Health Disparities and Endometrial Cancer

by Ursula A. Ma... о www.medscape.com 08-27-2024

https://www.medscape.com/viewarticle/999851

Глибші Запити

How can healthcare systems and research institutions foster more meaningful community partnerships to better understand the unique needs and barriers faced by underrepresented populations with endometrial cancer?

To foster more meaningful community partnerships, healthcare systems and research institutions can take several proactive steps. Firstly, they should engage with community leaders and establish community advisory boards to build trust and educate the community about clinical trials and research initiatives. It is essential to communicate in a culturally sensitive manner, using language and references that resonate with the community. Including underrepresented individuals in the early stages of clinical trial development can ensure that their voices are heard and their needs are addressed. Additionally, providing resources such as social work support, patient navigators, and assistance with transportation can help mitigate barriers to participation. By opening clinical trial sites in communities with high populations of underrepresented minorities, healthcare systems can make trials more accessible and increase participation rates.

What are the potential ethical and practical considerations in developing a national biobank and repository for rare endometrial cancer subtypes to advance translational research?

When developing a national biobank and repository for rare endometrial cancer subtypes, several ethical and practical considerations need to be taken into account. Ethically, ensuring patient privacy, confidentiality, and informed consent are paramount. Patients must understand how their samples will be used and stored, and their rights to withdraw consent should be respected. Additionally, issues of data security and protection against breaches must be addressed to maintain patient trust. Practically, establishing standardized protocols for sample collection, storage, and sharing is crucial to ensure the quality and integrity of the specimens. Collaborating with multiple institutions and researchers to contribute samples to the biobank requires clear guidelines for data sharing, authorship, and intellectual property rights. Moreover, funding and sustainability of the biobank are essential considerations to ensure its long-term viability and impact on translational research.

Given the complex interplay of biological, social, and systemic factors contributing to endometrial cancer disparities, what innovative, multidisciplinary approaches could be explored to drive more equitable outcomes?

To address the multifaceted nature of endometrial cancer disparities, innovative and multidisciplinary approaches are needed. One approach could involve implementing community-based participatory research, where researchers collaborate with community members to co-design studies and interventions that address the specific needs of underrepresented populations. Utilizing artificial intelligence and machine learning algorithms to analyze large datasets can help identify patterns and factors contributing to disparities, leading to targeted interventions. Engaging with policymakers to advocate for increased funding for endometrial cancer research and initiatives aimed at reducing disparities is crucial. Implementing culturally tailored interventions, such as patient navigation programs and telehealth services, can improve access to care for underrepresented populations. Furthermore, fostering diversity and inclusion in research teams and clinical trial recruitment efforts can help ensure that studies are representative of the populations they aim to serve. By combining biological, social, and systemic perspectives in a collaborative and innovative manner, more equitable outcomes in endometrial cancer care can be achieved.