Reduced healthcare access contributes to delay of care in endometrial cancer

• Published in: Gynecologic oncology 2024-03, Vol.182, p.115-120
• Main Authors: Fife, Alexander J., Najor, Anna J., Aspir, Tori B., Haines, Kaitlin E., Vilardo, Nicole A., Isani, Sara S., Cowan, Matthew, Gressel, Gregory M., Ye, Kenny Q., Nevadunsky, Nicole S., Kuo, Dennis Y., Lin, Ken Y.
• Format: Article
• Language: English
• Subjects: Black or African American; Carcinoma, Endometrioid; Delays to care in endometrial cancer; Endometrial Neoplasms - diagnosis; Endometrial Neoplasms - pathology; Endometrial Neoplasms - therapy; Female; Health Services Accessibility; Healthcare Disparities; Humans; Racial disparities in endometrial cancer; Reduced healthcare access; White People
• ISSN: 0090-8258; 1095-6859; 1095-6859
• DOI: 10.1016/j.ygyno.2024.01.010

We aimed to characterize delays to care in patients with endometrioid endometrial cancer and the role healthcare access plays in these delays. A chart review was performed of patients with endometrioid endometrial cancer who presented with postmenopausal bleeding at a diverse, urban medical center between 2006 and 2018. The time from symptom onset to treatment was abstracted from the medical record. This interval was subdivided to assess for delay to presentation, delay to diagnosis, and delay to treatment. We identified 484 patients who met the inclusion criteria. The median time from symptom onset to treatment was 4 months with an interquartile range of 2 to 8 months. Most patients had stage I disease at diagnosis (88.6%). There was no significant difference in race/ethnicity or disease stage at time of diagnosis between different groups. Patients who had not seen a primary care physician or general obstetrician-gynecologist in the year before symptom onset were more likely to have significantly delayed care (27.7% vs 14.3%, p = 0.02) and extrauterine disease (20.2% vs 4.9%, p