Assessing the essential parameters of race, ethnicity and geography in endometrial cancer and the impact on presentation, treatment and outcomes.

BACKGROUND

Race, ethnicity, and geography can impact cancer management, genomics and outcomes. We aimed to determine the ethnic and geographic diversity of endometrial carcinoma (EC) patients in our province and their impact on molecular subtype and outcomes.

METHODS

Clinicopathologic and molecular profiles, self-reported ethnicity, and postal code from EC patients in British Columbia were assessed for associations with management and outcomes.

RESULTS

EC molecular subtype distribution differed across 9 ethnicity cohorts (n = 1160;White-European, South Asian, Southeast Asian, East Asian, Indigenous, Latino, Middle Eastern, Black, Other;p = 0.017), including less MMRd in East Asian (16%), more p53abn in South Asian (36%), and less NSMP in Southeast Asian (34%) compared to White-European patients. There were also differences in age (p < 0.001), BMI (p < 0.001), stage (p = 0.005) and histotype (p = 0.042). Comparing White-European (n = 728,63%), aggregated Asian ethnicities (n = 330,28%), and other racially minoritized patients (n = 102,9%) revealed Asian and other racially minoritized patients were younger, and Asian patients thinner, higher stage, with more clear cell and dedifferentiated histology's. ER, PR, and L1CAM expression and mutation profiles did not differ by ethnicity, except for higher PTEN in Asian patients (p = 0.013). Progression-free, disease-specific, and overall survival did not differ across 9 ethnicities or between the 3 aggregated cohorts. Geographic comparisons (n = 2781) including rural (n = 812,29%) vs. urban (n = 1969,71%), distance from a cancer center, and population size were not associated with stage, treatment, molecular subtypes, or survival.

CONCLUSION

Molecular subtype distribution and clinicopathology differ by ethnicity in our EC population, however, no differences in survival were identified. Geographic distance/rurality were not associated with EC treatment or outcomes.