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Endometrial cancer in Puerto Rico: incidence, mortality and survival (1992-2003)

BACKGROUND: Endometrial cancer is the most common gynecologic malignancy in Puerto Rico and the United States (US). METHODS: We compare the age-specific and age-adjusted incidence and mortality rates and the survival of endometrial cancer in Puerto Rico with that of non-Hispanic whites (NHW), non-Hi...

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Autores principales: Ortiz, Ana Patricia, Pérez, Javier, Otero-Domínguez, Yomayra, García-Rodríguez, Omar, Garced-Tirado, Sheyla, Escalera-Maldonado, Frances, Gaud-Quintana, Sadja, Santiago-Rodríguez, Elvis, Svensson, Katherine, Vergara-Arroyo, José L, Ortiz, Karen, Torres, Mariela, Tortolero-Luna, Guillermo, Figueroa-Vallés, Nayda
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2833143/
https://www.ncbi.nlm.nih.gov/pubmed/20128912
http://dx.doi.org/10.1186/1471-2407-10-31
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author Ortiz, Ana Patricia
Pérez, Javier
Otero-Domínguez, Yomayra
García-Rodríguez, Omar
Garced-Tirado, Sheyla
Escalera-Maldonado, Frances
Gaud-Quintana, Sadja
Santiago-Rodríguez, Elvis
Svensson, Katherine
Vergara-Arroyo, José L
Ortiz, Karen
Torres, Mariela
Tortolero-Luna, Guillermo
Figueroa-Vallés, Nayda
author_facet Ortiz, Ana Patricia
Pérez, Javier
Otero-Domínguez, Yomayra
García-Rodríguez, Omar
Garced-Tirado, Sheyla
Escalera-Maldonado, Frances
Gaud-Quintana, Sadja
Santiago-Rodríguez, Elvis
Svensson, Katherine
Vergara-Arroyo, José L
Ortiz, Karen
Torres, Mariela
Tortolero-Luna, Guillermo
Figueroa-Vallés, Nayda
author_sort Ortiz, Ana Patricia
collection PubMed
description BACKGROUND: Endometrial cancer is the most common gynecologic malignancy in Puerto Rico and the United States (US). METHODS: We compare the age-specific and age-adjusted incidence and mortality rates and the survival of endometrial cancer in Puerto Rico with that of non-Hispanic whites (NHW), non-Hispanic blacks (NHB) and Hispanics in the US. Data from the Puerto Rico Central Cancer Registry and the Surveillance, Epidemiology, and End Results program were analyzed from 1992-2003. RESULTS: Age-standardized incidence rates of endometrial cancer increased significantly (p < 0.05) in Puerto Rico (APC = 2.8%) and among NHB (APC = 1.9%) and remained constant (p > 0.05) for NHW (APC = -0.1%) and Hispanics in the US (APC = 0.4%). Mortality trends remained constant in all racial/ethnic groups (p > 0.05). For 1999-2003, women in Puerto Rico had similar incidence of endometrial cancer as Hispanics (Standardized rate ratio [SRR] = 0.94, 95% CI = 0.87-1.01), although their risk was lower than that of NHW (SRR = 0.56, 95% CI = 0.53-0.59) and NHB (SRR = 0.91, 95% CI = 0.84-0.98). Meanwhile, women in Puerto Rico had 15% higher risk of death than Hispanic women (SRR = 1.15, 95% CI = 1.03-1.30) similar risk than NHW (SRR = 0.93, 95% CI = 0.83-1.03), and lower risk than NHB (SRR = 0.51, 95% CI = 0.46-0.57). Puerto Rico (63.1%) and NHB (56.8%) had a lower 5-year survival than NHW (78.4%) and Hispanics (79.5%). An age-adjusted Cox proportional hazards model showed that compared with women in Puerto Rico, Hispanic women in the United States had 37% lower mortality risk (HR = 0.63, 95% CI = 0.56-0.71) and NHW had 53% lower mortality risk (HR = 0.47, 95% CI = 0.43-0.52) after 5 years of diagnosis; NHB women had 22% higher mortality risk than women in Puerto Rico (HR = 1.22, 95% CI = 1.09-1.36). CONCLUSIONS: The lower burden of endometrial cancer in Puerto Rico suggests the presence of protective factors or lower exposure to risk factors in this population, although increases in incidence suggest changes in the occurrence of lifestyles and environmental risk factors. Meanwhile, the lower five-year survival from endometrial cancer among Puerto Ricans suggests a health disparity for this group in areas such as quality of care and/or differences in terms of stage at diagnosis and associated comorbidities. Assessment of disease risk factors and characteristics, and access and response to treatment is required to further understand these results.
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spelling pubmed-28331432010-03-06 Endometrial cancer in Puerto Rico: incidence, mortality and survival (1992-2003) Ortiz, Ana Patricia Pérez, Javier Otero-Domínguez, Yomayra García-Rodríguez, Omar Garced-Tirado, Sheyla Escalera-Maldonado, Frances Gaud-Quintana, Sadja Santiago-Rodríguez, Elvis Svensson, Katherine Vergara-Arroyo, José L Ortiz, Karen Torres, Mariela Tortolero-Luna, Guillermo Figueroa-Vallés, Nayda BMC Cancer Research Article BACKGROUND: Endometrial cancer is the most common gynecologic malignancy in Puerto Rico and the United States (US). METHODS: We compare the age-specific and age-adjusted incidence and mortality rates and the survival of endometrial cancer in Puerto Rico with that of non-Hispanic whites (NHW), non-Hispanic blacks (NHB) and Hispanics in the US. Data from the Puerto Rico Central Cancer Registry and the Surveillance, Epidemiology, and End Results program were analyzed from 1992-2003. RESULTS: Age-standardized incidence rates of endometrial cancer increased significantly (p < 0.05) in Puerto Rico (APC = 2.8%) and among NHB (APC = 1.9%) and remained constant (p > 0.05) for NHW (APC = -0.1%) and Hispanics in the US (APC = 0.4%). Mortality trends remained constant in all racial/ethnic groups (p > 0.05). For 1999-2003, women in Puerto Rico had similar incidence of endometrial cancer as Hispanics (Standardized rate ratio [SRR] = 0.94, 95% CI = 0.87-1.01), although their risk was lower than that of NHW (SRR = 0.56, 95% CI = 0.53-0.59) and NHB (SRR = 0.91, 95% CI = 0.84-0.98). Meanwhile, women in Puerto Rico had 15% higher risk of death than Hispanic women (SRR = 1.15, 95% CI = 1.03-1.30) similar risk than NHW (SRR = 0.93, 95% CI = 0.83-1.03), and lower risk than NHB (SRR = 0.51, 95% CI = 0.46-0.57). Puerto Rico (63.1%) and NHB (56.8%) had a lower 5-year survival than NHW (78.4%) and Hispanics (79.5%). An age-adjusted Cox proportional hazards model showed that compared with women in Puerto Rico, Hispanic women in the United States had 37% lower mortality risk (HR = 0.63, 95% CI = 0.56-0.71) and NHW had 53% lower mortality risk (HR = 0.47, 95% CI = 0.43-0.52) after 5 years of diagnosis; NHB women had 22% higher mortality risk than women in Puerto Rico (HR = 1.22, 95% CI = 1.09-1.36). CONCLUSIONS: The lower burden of endometrial cancer in Puerto Rico suggests the presence of protective factors or lower exposure to risk factors in this population, although increases in incidence suggest changes in the occurrence of lifestyles and environmental risk factors. Meanwhile, the lower five-year survival from endometrial cancer among Puerto Ricans suggests a health disparity for this group in areas such as quality of care and/or differences in terms of stage at diagnosis and associated comorbidities. Assessment of disease risk factors and characteristics, and access and response to treatment is required to further understand these results. BioMed Central 2010-02-03 /pmc/articles/PMC2833143/ /pubmed/20128912 http://dx.doi.org/10.1186/1471-2407-10-31 Text en Copyright ©2010 Ortiz et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Ortiz, Ana Patricia
Pérez, Javier
Otero-Domínguez, Yomayra
García-Rodríguez, Omar
Garced-Tirado, Sheyla
Escalera-Maldonado, Frances
Gaud-Quintana, Sadja
Santiago-Rodríguez, Elvis
Svensson, Katherine
Vergara-Arroyo, José L
Ortiz, Karen
Torres, Mariela
Tortolero-Luna, Guillermo
Figueroa-Vallés, Nayda
Endometrial cancer in Puerto Rico: incidence, mortality and survival (1992-2003)
title Endometrial cancer in Puerto Rico: incidence, mortality and survival (1992-2003)
title_full Endometrial cancer in Puerto Rico: incidence, mortality and survival (1992-2003)
title_fullStr Endometrial cancer in Puerto Rico: incidence, mortality and survival (1992-2003)
title_full_unstemmed Endometrial cancer in Puerto Rico: incidence, mortality and survival (1992-2003)
title_short Endometrial cancer in Puerto Rico: incidence, mortality and survival (1992-2003)
title_sort endometrial cancer in puerto rico: incidence, mortality and survival (1992-2003)
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2833143/
https://www.ncbi.nlm.nih.gov/pubmed/20128912
http://dx.doi.org/10.1186/1471-2407-10-31
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