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Terri Madison, PhD, MPH, David Schottenfeld, MD, MSc, Sherman A. James, PhD, Ann G. Schwartz, PhD, MPH and Stephen B. Gruber, MD, PhD, MPH

At the time of the study, Terri Madison and Sherman A. James were with the School of Public Health, University of Michigan, Ann Arbor. David Schottenfeld is with the School of Public Health, University of Michigan. Ann G. Schwartz is with the Population Studies and Prevention Program of the Barbara Ann Karmanos Cancer Institute and the Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Mich. Stephen B. Gruber is with the Departments of Internal Medicine, Epidemiology, and Human Genetics, University of Michigan.

Correspondence: Requests for reprint should be sent to Terri Madison, PhD, MPH, i3Statprobe, 5430 Data Ct, Ste 200, Ann Arbor, MI 48103 (email: terri.madison{at}i3statprobe.com).

Objective. We evaluated the association between socioeconomic status and racial/ ethnic differences in endometrial cancer stage at diagnosis, treatment, and survival.

Methods. We conducted a population-based study among 3656 women.

Results. Multivariate analyses showed that either race/ethnicity or income, but not both, was associated with advanced-stage disease. Age, stage at diagnosis, and income were independent predictors of hysterectomy. African American ethnicity, increased age, aggressive histology, poor tumor grade, and advanced-stage disease were associated with increased risk for death; higher income and hysterectomy were associated with decreased risk for death.

Conclusions. Lower income was associated with advanced-stage disease, lower likelihood of receiving a hysterectomy, and lower rates of survival. Earlier diagnosis and removal of barriers to optimal treatment among lower-socioeconomic status women will diminish racial/ethnic differences in endometrial cancer survival.

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