Disparities in Hysterectomy Access Linked to Higher Mortality in Early-Stage Endometrial Cancer Patients

Study Reveals Alarming Disparities in Endometrial Cancer Outcomes

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A groundbreaking study published in the journal O&G has unveiled significant disparities in treatment outcomes for patients with early-stage, low-grade endometrial cancer. Researchers, led by Dr. Vasanti Jhaveri, found that individuals who did not undergo hysterectomy—especially those from racial and ethnic minorities or older age groups—faced a markedly higher risk of death from endometrial cancer, cardiovascular disease, and other causes compared to those who received the standard surgical treatment.

Hysterectomy remains the gold standard for treating early-stage endometrioid adenocarcinoma, yet access to this life-saving procedure is not uniform across different demographic groups. The study utilized data from the Surveillance, Epidemiology, and End Results (SEER) program, representing 26.5% of the U.S. population, to analyze the outcomes of 27,331 patients diagnosed between 2010 and 2020.

Key Findings

The study revealed that a staggering 98.7% of patients underwent hysterectomy, while only 1.3% did not. Among those who forwent surgery, significant demographic differences emerged:

• Age: 7.2% of non-hysterectomy patients were 80 years or older, compared to just 2.6% of those who had the surgery.
• Ethnicity: 24.8% of non-hysterectomy patients identified as Hispanic, while 13.3% were non-Hispanic Black, compared to 15.6% and 5.7% respectively in the surgical group.

The mortality outcomes for patients who did not undergo hysterectomy were alarming:

• Endometrial Cancer-Specific Death: 4.2% vs. 1.2% for those who had surgery.
• Cardiovascular Death: 7.8% vs. 2.1%.
• All-Cause Mortality: 23% vs. 8.2%.

Implications for Healthcare Equity

This population-based analysis highlights the urgent need for equitable access to surgical treatment for all patients, particularly those from marginalized communities. The findings underscore that survival rates for early-stage endometrioid adenocarcinoma are significantly impacted by demographic factors, which can lead to poorer health outcomes.

Dr. Jhaveri and her colleagues emphasize that addressing these disparities is crucial for improving survival rates and ensuring that all patients receive the best possible care. “Survival from early-stage endometrioid adenocarcinoma requires equal access to surgical treatment,” they concluded.

As healthcare providers and policymakers look to improve cancer care, this study serves as a vital reminder of the disparities that persist in treatment access and outcomes, urging a collective effort to bridge the gap.

Reference

Jhaveri, Vasanti MD; Meyer, Larissa MD, MPH; Chen, Lu PhD, MPH; Matsuo, Koji MD, PhD; Romero, Roshni P. PharmD; Khor, Victor PhD; Lin, Yvonne G. MD, MS; Wright, Jason D. MD; Huepenbecker, Sarah P. MD, MPH. “Hysterectomy Status and Outcomes in Patients With Grade 1, Stage IA Endometrioid Adenocarcinoma.” O&G Open 2(6):e132, December 2025. DOI: 10.1097/og9.0000000000000132.