It’s an unsettling fact that uterine and endometrial cancers are often detected at advanced stages within our community. The National Cancer Institute (NCI) has reported an alarming rise in uterine cancer fatalities across the United States, with the highest rates being prevalent in our community. In 2022, endometrial cancer was ranked as the fourth most common cancer for Black women in the country, and the incidence rates have continued to escalate by 1% to 2% annually. Although we don’t take a significant lead in the incidence of uterine cancer, we are nearly twice as likely to pass from endometrial cancer compared to our white counterparts, according to Memorial Sloan Kettering Cancer Center.
In our pursuit of more clarity, we turned to a trusted expert in the field, Dr. Eboni January, a board-certified obstetric gynecologist deeply committed to women’s health and education.
BHM: Why are Black women disproportionately affected by late diagnoses of uterine and endometrial cancer, and what can be done to address this issue?
Dr. January: Black women are disproportionately affected by late diagnoses of uterine and endometrial cancer due to disparities in healthcare access, socioeconomic status, and implicit biases in the medical system. Studies have shown that Black women are less likely to undergo regular gynecological exams and may experience delays in diagnostic testing and treatment initiation. To address this issue, we need to increase awareness and education about uterine cancer within Black communities, improve access to healthcare, and train healthcare providers in cultural competency to reduce these disparities.
Black women may face longer wait times for appointments, fewer referrals to specialists, and inadequate follow-up care.
Addressing these disparities requires systemic changes, such as expanding healthcare access, improving provider education on implicit biases, and fostering a more inclusive and culturally sensitive healthcare environment.
BHM: What are the most common symptoms of uterine and endometrial cancer that Black women should be aware of, and why might healthcare providers overlook these symptoms?
Dr. January: The most common symptoms of uterine and endometrial cancer include abnormal vaginal bleeding, pelvic pain, and unexplained weight loss. Healthcare providers can sometimes overlook these symptoms due to implicit biases and a tendency to attribute them to benign conditions, especially in Black women. Both patients and providers need to recognize the significance of these symptoms and advocate for thorough evaluations to help in early detection.
BHM: How can tools be improved to ensure better detection rates?
Dr. January: Currently, there is no specific screening tool for endometrial cancer, but tools like transvaginal ultrasound and endometrial biopsy are used for diagnosis when symptoms such as vaginal bleeding and pelvic pain are present. To improve detection rates, we need to develop more sensitive diagnostic methods, incorporate genetic and molecular markers, and ensure regular follow-ups and patient education occur. Research into tailored screening protocols that consider racial and genetic differences can also be beneficial.
BHM: How important is the patient-doctor communication in early detection of uterine/endometrial cancer, and what steps can be taken to improve this for Black women?
Dr. January: Effective patient-doctor communication is crucial for early uterine and endometrial cancer detection. As healthcare providers, we must ensure patients feel comfortable coming to us. We should understand that although patients are adults, we are the experts, and consideration of the social determinants of health is crucial. Improving this includes training healthcare providers in cultural competency, encouraging open and respectful dialogue, and ensuring patients feel heard and understood. Providing patient education materials that are culturally relevant and accessible can also enhance communication and early detection efforts.
BHM: Considering that obesity and diabetes are known risk factors for uterine cancer, how can awareness and management of this risk be better communicated and managed in our community?
Dr. January: Obesity and diabetes are significant risk factors for endometrial cancer, as they can lead to hormonal imbalances and chronic inflammation, which may promote cancer development. Black women have higher rates of obesity and diabetes, contributing to an increased incidence of endometrial cancer. Addressing these risk factors through lifestyle interventions, preventive care, and targeted education is essential for reducing cancer risk.
2015 I developed a text weight loss coaching program in response to my patients. Working with the underserved community, I found uterine cancer in women under the age of 45 who had excess weight. Due to the lack of a screening tool like we have for cervical cancer, I decided to help prevent it through weight loss and preventive health measures. Awareness and management of obesity as a risk factor for uterine cancer can be improved through targeted community outreach programs, culturally sensitive health education, and accessible weight management resources. Healthcare providers should engage with community leaders and organizations to disseminate information and support lifestyle interventions that promote healthy eating and physical activity.
BHM: What are the main factors contributing to the higher mortality rates of uterine and endometrial cancer among Black women compared to other demographics?
Dr. January: Higher mortality rates among Black women are attributed to factors such as later stage at diagnosis, less access to high-quality care, and potential biological differences in tumor behavior. Socioeconomic disparities and implicit biases in treatment recommendations also play significant roles. Improving access to timely and high-quality care, addressing socioeconomic barriers, and conducting research on tumor biology specific to Black women can help reduce these mortality rates.
BHM: Why is it important for Black women to participate in clinical trials and genetic research related to uterine cancer?
Dr. January: Participation in clinical trials and genetic research is vital to ensure that findings apply to diverse populations. It helps in understanding how uterine cancer affects Black women specifically and can lead to the development of tailored treatments and interventions. Encouraging participation requires researchers like myself to build trust, address historical mistrust, and ensure that trials are accessible and inclusive.
The battle against uterine and endometrial cancer in our community is complex; we face unique challenges when it comes to diagnoses and the specific types of cancer we encounter. Let’s continue to raise awareness about what we need to decrease our mortality rates. Every step we take towards more awareness, prevention, and early detection holds the potential to save lives. For all those reasons, we must keep this conversation going and push it beyond our recognition into active engagement to ensure change is documented.