Two studies presented at the Society of Gynecologic Oncology (SGO) 2021 Annual Meeting on Women’s Cancer highlighted the importance of addressing racial inequities in gynecologic cancers, including improving minorities’ low participation rates in clinical trials of women’s cancers.
Clinical Trial Enrollment in the Deep South
Racial and ethnic minorities are underrepresented in clinical studies, which is a concern because people of different races and ethnicities may react differently to medical treatments. This underrepresentation is worse in the Deep South for many reasons, said the study’s presenting author, Nathaniel Jones, MD, of the University of Alabama Mitchell Cancer Institute, Mobile (Abstract ID: 10966).
“This is particularly worrisome for Black women with endometrial cancer, one of the few gynecologic cancers with increasing incidence and one that disproportionately affects Black women with worse survival rates,” Dr. Jones said.
To encourage Black women with endometrial cancer to participate in clinical trials, the researchers relied on the cancer institute’s patient navigation program. In place since 2012, the diverse navigation workforce mirrors the demographics of their patient population, noted Dr. Jones. The program trains laypersons to guide all patients with cancer through their care plan and educate them about benefits of clinical trial participation.
Over 7 years, a similar proportion of Black and White women with endometrial cancer enrolled in clinical trials: 8.3 % of Black patients (23 of 277) and 8.5% of White patients (61 of 718). The researchers found their institution had a higher enrollment among Black patients with endometrial cancer than expected in the Deep South.
Importantly, clinical trial participants had comparable progression-free survival by race. Black women were alive without cancer recurrence at 13 months on average vs 14 months among White patients, according to Dr. Jones.
Treatment Delays
In another study presented at the SGO meeting (Abstract ID: 11566), Tanvi Joshi, MD, reported that Black and Hispanic women had longer delays in starting appropriate treatment after diagnosis of gynecologic cancer than White women. For all gynecologic cancers, more Black and Hispanic women than White women experienced treatment delays longer than 6 weeks, according to data from the National Cancer Database on 652,565 women. By cancer type, treatment delays were as high as nearly 12 days among Hispanic women with vaginal and vulvar cancers.
Overall, Black patients had a 25% higher risk of death compared with White patients with the same cancer type and stage, said Dr. Joshi, of Abington-Jefferson Hospital.
“Whether treatment delays affect survival remains unknown, but even short delays can increase patient care costs and illness,” said Dr. Joshi. “Treatment delays remain an important modifiable factor for achieving health-care equity.”
