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Why mortality from endometrial cancer may be higher in black women

Endometrial cancer is the most common gynecologic cancer, diagnosed in one in 37 U.S. women. But there are known racial disparities in outcomes, as the five-year mortality rate among black women with endometrial cancer is 90% higher than it is among white women. Only 53% of black women with the condition receive an early diagnosis.

A new survey may explain why. A small cohort of black women with endometrial cancer reported knowledge gaps around menopause in their communities, misinterpretation of vaginal bleeding, and responses from healthcare providers that did not communicate risk for African-American patients, leading up to their diagnosis, according to Kemi Doll, MD, of the University of Washington in Seattle and colleagues.

All the study participants experienced abnormal or postmenopausal bleeding before diagnosis. But the majority of the women interpreted their bleeding not as cancer, but as a sign of resumed menstrual cycles or continued menopause. “Early stage endometrial cancer usually isn’t painful, it’s painless spotting,” Doll said. “For women to wait to the point that they experience pain or cramping, those are really signs of cancer progression.”

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