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Taparra K, Ing BI, Ewongwo A, Vo JB, Shing JZ, Gimmen MY, Keli'i KMK, Uilelea J, Pollom E, Kidd E. Racial Disparities in Brachytherapy Treatment among Women with Cervical and Endometrial Cancer in the United States. Cancers (Basel) 2023; 15:cancers15092571. [PMID: 37174037 PMCID: PMC10177217 DOI: 10.3390/cancers15092571] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/21/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
Brachytherapy improves clinical outcomes among women diagnosed with cervical and endometrial cancers. Recent evidence demonstrates that declining brachytherapy boosts for women with cervical cancer were associated with higher mortality. In this retrospective cohort study, women diagnosed with endometrial or cervical cancer in the United States between 2004 and 2017 were selected from the National Cancer Database for evaluation. Women ≥18 years of age were included for high intermediate risk (PORTEC-2 and GOG-99 definition) or FIGO Stage II-IVA endometrial cancers and FIGO Stage IA-IVA-non-surgically treated cervical cancers. The aims were to (1) evaluate brachytherapy treatment practice patterns for cervical and endometrial cancers in the United States; (2) calculate rates of brachytherapy treatment by race; and (3) determine factors associated with not receiving brachytherapy. Treatment practice patterns were evaluated over time and by race. Multivariable logistic regression assessed predictors of brachytherapy. The data show increasing rates of brachytherapy for endometrial cancers. Compared to non-Hispanic White women; Native Hawaiian and other Pacific Islander (NHPI) women with endometrial cancer and Black women with cervical cancer were significantly less likely to receive brachytherapy. For both NHPI and Black women, treatment at community cancer centers was associated with a decreased likelihood of brachytherapy. The data suggest racial disparities among Black women with cervical cancer and NHPI women with endometrial cancer and emphasize an unmet need for brachytherapy access within community hospitals.
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Affiliation(s)
- Kekoa Taparra
- Department of Radiation Oncology, Stanford Health Care, Stanford, CA 94305, USA
| | - Brandon I Ing
- Department of Obstetrics and Gynecology, Kaiser Permanente, Los Angeles, CA 90027, USA
| | - Agnes Ewongwo
- Department of Radiation Oncology, Stanford Health Care, Stanford, CA 94305, USA
| | - Jacqueline B Vo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA
| | - Jaimie Z Shing
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA
| | | | | | | | - Erqi Pollom
- Department of Radiation Oncology, Stanford Health Care, Stanford, CA 94305, USA
| | - Elizabeth Kidd
- Department of Radiation Oncology, Stanford Health Care, Stanford, CA 94305, USA
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