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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2022

22-09-2022 | Hysterectomy | Gynecologic Oncology

Racial Disparities in Surgical Outcomes Among Women with Endometrial Cancer

Authors: Ashley S. Felix, PhD, MPH, Toluwaniose Nafiu, BA, Casey M. Cosgrove, MD, Aldenise P. Ewing, PhD, MPH, CPH, Christian Mpody, MD, PhD, MPH, MBA

Published in: Annals of Surgical Oncology | Issue 13/2022

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Abstract

Purpose

Endometrial cancer (EC) is the most common gynecological cancer among women in the United States. Despite well-documented racial/ethnic disparities in EC incidence and mortality rates, limited data exist regarding disparities in hysterectomy surgical outcomes. We evaluated associations of race/ethnicity with postoperative complications, serious adverse events (SAEs), and length of hospital stay among women undergoing EC-related hysterectomy.

Methods

Using National Surgical Quality Improvement Program (NSQIP) data, we identified women (≥18 years) undergoing hysterectomy to treat EC between 2014 and 2020. We used multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations of race/ethnicity (white, black, and Latina) with postoperative complications and SAEs. We used Poisson regression with robust standard errors to calculate incidence rate ratios (IRRs) and 95% CIs for the association of race/ethnicity with length of hospital stay.

Results

Of 22,778 women undergoing EC-related hysterectomy, 3.1% developed postoperative complications. Black (adjusted OR: 1.62; 95% CI 1.05–2.48) and Latina women (adjusted OR: 1.79; 95% CI 1.04–3.09) had higher postoperative complication risks than white women. The overall SAE incidence was 5.0%. Black women (adjusted OR: 1.55, 95% CI 1.13–2.15) had higher SAE risks than white women. Length of hospital stay was significantly longer for black women than white women (IRR: 1.18; 95% CI 1.07–1.30).

Conclusions

We observed racial/ethnic disparities in EC-related hysterectomy surgical outcomes in a large, diverse sample of U.S. women between 2014 and 2020. Studies to elucidate the underlying mechanisms of these racial disparities, with a focus on social context remain necessary.
Appendix
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Metadata
Title
Racial Disparities in Surgical Outcomes Among Women with Endometrial Cancer
Authors
Ashley S. Felix, PhD, MPH
Toluwaniose Nafiu, BA
Casey M. Cosgrove, MD
Aldenise P. Ewing, PhD, MPH, CPH
Christian Mpody, MD, PhD, MPH, MBA
Publication date
22-09-2022
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 13/2022
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-022-12527-8

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