Women in Black ethnic minority groups are at greater risk of dying from uterine cancer, latest data, published by the United Kingdom’s Office for National Statistics (ONS).  The data highlight those women with Black, Black British, Black Welsh, Caribbean, or African ethnic groups having a substantially higher mortality rate compared to other ethnic groups in England and Wales.[1]

The data also shows that between 2017 and 2019, the rates of uterine cancer deaths in females from Black African or Black Caribbean ethnic groups were more than twice that of women who were white, when accounting for differences in age of the populations. [2]

Symptom awareness
Although uterine cancer is the most common gynecological cancer in the United Kingdom*. And while the incidence of uterine cancer in the United Kingdom and other countries has been steadily increasing over the last decade, the disease has attracted much less interest than other gynecological cancers with regard to symptom awareness.  One possible reason for this lack of symptom awareness is that a high number of cases are diagnosed at an early stage, and, as a result can be treated with good long-term prognosis. However, this may not always be the case.

In an article published in June 2023 edition of The Lancet Oncology, Natalie E. Darko, MD, Associate Professor of Social Sciences and Director of Inclusion at the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, Esther Moss, MD, Associate Professor in Gynecological Oncology in the University of Leicester’s Cancer Research Centre, and Lucy Teece, MD, Lecturer in Medical Statistics from the Department of Population Health Sciences, have highlighted the alarming substantial disparities in uterine cancer mortality. [3]

Need to rase the profile
Their commentary highlights the need to raise the profile of uterine cancer, its common symptoms and barriers that patients may experience, which can lead to a delay in diagnosis.

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“Vaginal bleeding following the menopause is the major red flag symptom, but any abnormal bleeding should not be ignored,” noted Moss, who is also a consultant gynecologist at University Hospitals of Leicester National Health Service (NHS) Trust.

Also, we need to dispel the misconception that a cervical smear test result excludes all gynecological cancers, since a negative result can create false reassurance and potentially delay a trip to the GP,” Moss added.

Inequities in provision and lack of trust in the healthcare system was another contributing factor with 78% of Black women in the United Kingdom not believing that their health was as equally protected by the NHS compared to white women.

“Our hope is that publication of the ONS data will raise the alarm of the issue of Black women and uterine cancer so that increased awareness of these inequities can start to reverse the association of late diagnoses and worse outcomes,” Darko explained.

“These findings underscore the critical importance of identifying women at highest risk, and ensuring that every woman, regardless of her race or ethnicity, has access to the care and resources she needs to prevent and treat uterine cancer,” she concluded.

Note:* Uterine cancer is the fourth most common cancer for women in the United States. and it is estimated that in 2023, 66,200 women in the United States will be diagnosed with uterine, or endometrial, cancer. Worldwide, an estimated 417,367 people were diagnosed with uterine cancer in 2020.[4][5][6]

[1] Age-standardised mortality rates for uterine and cervical cancer by ethnic group, females aged 10 and above, deaths registered in England and Wales: 2012 and 2019. Office for National Statistics. Online. Last accesses on June 1, 2023
[2] Uterine cancer statistics. Cancer Research UK. Online. Last accesses on June 1, 2023.
[3] Moss EL, Teece L, Darko N. Uterine cancer mortality and Black women: time to act. The Lancer Oncology. DOI: https://doi.org/10.1016/S1470-2045(23)00113-4 [Article]
[4] American Cancer Society. Facts & Figures 2023. American Cancer Society. Atlanta, Ga. 2023.
[5] American Cancer Society. Cancer Facts & Figures for African American/Black People 2022-2024.
[6] Giaquinto AN, Miller KD, Tossas KY, Winn RA, Jemal A, Siegel RL. Cancer statistics for African American/Black People 2022 [published online ahead of print, 2022 Feb 10]. CA Cancer J Clin. 2022;10.3322/caac.21718.

Featured image by Guillaume Bolduc on Unsplash. Used with permission.

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