Endometrial Cancer Risk and Trends Among Distinct African-Descent Populations
Sylvester researchers’ study compares data from the U.S. and the French Caribbean, and posits that social factors may influence cancer risk more than genetic-based, African ancestry factors only among Black women.
While documented disparities exist in endometrial cancer incidence for Black women in the U.S., studies tend to survey Black women as a homogenous group, and there is limited data available regarding subgroup populations.
To improve the data and learn more about causative factors, researchers from Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, examined endometrial disparities among women in African-descent subgroup populations outside of the U.S. They found that endometrial cancer rates are related to factors beyond ancestry.
“We need to disentangle the endometrial cancer disparities among Black women by focusing more on subpopulations, specifically on differences between countries and the socioeconomic context, while concentrating on the patterns for the deadlier non-endometrial subtype,” said the Miller School’s Heidy N. Medina, Ph.D., M.P.H., lead researcher of the study.
The study featured several Sylvester physician-scientists along with Dr. Medina, including Frank Penedo, Ph.D., Sylvester’s associate director for Cancer Survivorship and Translational Behavioral Sciences; Tulay Koru-Sengul, Ph.D., Sylvester researcher and professor of public health sciences for the Miller School; Matthew P. Schlumbrecht, M.D., M.P.H., professor of clinical obstetrics, gynecology and reproductive sciences, vice chair of global and community health and director of Gynecologic Oncology Fellowship at Sylvester; and Paulo S. Pinheiro, Ph.D., Sylvester researcher and Miller School research associate professor.
Genetic and Social Factors
Published in Cancer, the journal of the American Cancer Society, the international study looked at 34,789 recent cases of endometrial cancer in women of African descent from Florida and the French Caribbean islands.
Dr. Medina and her team wanted to gauge how much genetics and social factors influence cancer risks, but had little information on uterine cancer rates for Black women elsewhere. For a comparative study, they located reliable data on endometrial cancer in the French Caribbean’s Martinique and Guadeloupe, where most residents are Black or racially mixed and where the quality of health care is strong.
The analysis compared the incidence of endometrial cancer between the U.S. and the French Caribbean to examine the influence of African heritage on cancer rates. It found that Black women in the French Caribbean had lower rates than both Black and white women in the U.S., suggesting that endometrial cancer rates stem not only from genetics but also from social factors such as diet and access to care.
Dissection of Disparities
The study, entitled “Endometrial cancer risk and trends among distinct African-descent populations,” has its roots in U.S. cancer disparities. In 2022, endometrial cancer ranked as the fourth most common cancer for U.S. Black women, representing almost one in 10 new endometrial cancer cases — a higher incidence than in non-Hispanic whites, and a faster growth rate. Greater prevalence of obesity and diabetes in Black women in the U.S. may influence that disparity, the study says.
The team looked at the data available for 2005-2018 for two types of endometrial cancer and found that French Caribbean Black women had the lowest incidence. It also found rates for endometrioid cancer increased 1.8% yearly for U.S. Black women and 1.2% for U.S. white women, with no change observed for French Caribbean Black women over the same period. In addition, rates for non-endometroid cancer, a more aggressive form of the disease, rose faster for all three groups: up 5.6% yearly for U.S. Black women, 4.4% for French Caribbean Black women, and 3.9% for U.S. white women.
More Study Needed
Dr. Medina said the research shows that U.S. cancer trends for African-descent populations cannot be projected worldwide, and underscored the need to improve data collection to better assess cancer risks in specific locales for different population groups.
“The next steps are to examine differences between the majority African-descent populations of the French Caribbean to that of the predominantly white French mainland to determine existing disparities,” said Dr. Medina. “Additionally, particular attention should be made to investigate risk factors for non-endometrioid endometrial cancer, specifically.”