Major differences exist between black and white women in stages of endometrial cancer at detection and at subsequent survival. Although the incidence of endometrial cancer is lower among black women, mortality is higher. The National Cancer Institute initiated a Black/White Cancer Survival Study  and concluded that higher-grade and more aggressive histologies appear to be related to excess risk of advanced-stage disease in black women. It is difficult to disentangle the effects that biology and socioeconomic status may have on the lower survival rates of African American women with endometrial cancer. Evidence suggests that lower income is associated with advanced-stage disease, lower probability of undergoing a hysterectomy, and lower survival rates. Others, however, assert that there is no black/white difference in the interval from patient-reported symptoms to initial medical consultation, making it unlikely that patient delay after onset of symptoms could explain much of the excess of advanced-stage disease found in black women. Further research is necessary to understand why black women tend to be diagnosed with more aggressive disease and have a higher probability of dying than white women, despite their lower incidence of endometrial cancer.
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