Comparing Characteristics of Endometrial Cancer in Women of South Asian and White Ethnicity in England

SIMPLE SUMMARY: Endometrial cancer (EC) incidence is increasing many countries. Potential reasons for this change include increasing prevalence of risk factors, including high body mass index and diabetes, and falling hysterectomy rates for benign gynaecological conditions. Recent studies report increasing prevalence and differences in demography of EC in people from ethnic minority groups, particularly age at diagnosis and tumour subtype. This study was conducted to describe the demographic and EC tumour characteristics of White and South Asian ethnicity patients living in the same geographical region of England (Leicestershire), which is served by a single NHS hospital. ABSTRACT: Differences in patient demographic and tumour characteristics between patients of South Asian and White ethnicity diagnosed with an endometrial cancer (EC) and currently living in England are not well described. We undertook a retrospective study of EC cases diagnosed at the University Hospitals of Leicester, UK. A total of 1884 cases were included, with 13% of the patients being of South Asian ethnicity. South Asian women were diagnosed at a significantly younger age (mean age of 60.3 years) compared to women of White ethnicity (mean age of 66.9 years) with a mean difference of 6.6 years (95% CI 5.1 to 8.1, p < 0.001). Rising body mass index (BMI) in the White patient group was significantly correlated with younger age at diagnosis (p < 0.001); however, this association was not seen in South Asian patients. A linear regression that adjusted for diabetes status, BMI, and the interaction terms of diabetes status with BMI and ethnicity with BMI, highlighted a younger age of diagnosis in South Asian patients with a BMI less than 45 kg/m(2). The difference was greatest at lower BMIs for both non-diabetics and diabetics. Further investigation is needed to explain these differences and to determine their impact on suspected cancer referral criteria.