# Racial Disparity in Diagnostic Evaluation of Uterine Cancer

> **NIH NIH R01** · YALE UNIVERSITY · 2021 · $654,967

## Abstract

Uterine cancer is the most common gynecologic malignancy in the U.S., with a two-fold higher risk of mortality
for black women than white women. Early diagnosis is vital for patients’ prognosis as it greatly improves the
effectiveness of subsequent treatment. Evidence has shown a significant black-white difference in uterine
cancer stage at diagnosis (53% of black women versus 69% of white women are diagnosed at early stage),
which explains more of the racial gap in mortality risk than any other factor. However, there has been little
research elucidating barriers in the diagnostic pathway that lead to this disparity in early diagnosis, and
reasons for the more advanced-stage uterine cancer in black women remain largely unclear, hindering our
ability to address this important health inequity. Since many factors in the diagnostic pathway may be
modifiable and amenable to interventions, this reflects a lost opportunity of secondary prevention (i.e., early
detection and control of the cancerous process). The overarching objective of this project is to reduce racial
disparity in the early diagnosis of uterine cancer by systematically examining patients’ diagnostic pathway and
identifying barriers to early diagnosis in black women. We will achieve this objective via the following specific
aims: 1) to examine racial disparity between black and white women with uterine cancer in the quality of
diagnostic evaluation they receive; 2) to compare symptoms and diagnostic evaluation of women who have
early versus advanced stage uterine cancer and examine their role in influencing racial disparity in stage at
diagnosis; and 3) to conduct a population-based patient experience survey and link to cancer registry data to
examine how sociocultural, behavioral and access barriers affect disparity in uterine cancer diagnosis. Aims 1-
2 will draw on three unique large healthcare databases that have patient-level indicators of race/ethnicity and
socioeconomic status, contain a complete record of patients’ diagnostic pathway starting from the time when
symptoms are reported to a provider, and cover a diverse patient population encompassing the commercially
insured, Medicaid enrollees, and Medicare beneficiaries. These databases include the Optum Clinformatics
Data Mart, the MarketScan Multi-State Medicaid Database, and the Surveillance, Epidemiology and End
Results (SEER)-Medicare database. Aim 3 will exploit the infrastructure of statewide cancer registries and the
latest technology of rapid case ascertainment to survey a population-based sample of women newly diagnosed
with uterine cancer about their experience. By further linking patient reported survey data to pathology/clinical
data in cancer registry, we can uniquely examine how sociocultural, behavior, and patient-perceived barriers
affect uterine cancer stage at diagnosis and the potential interplay between tumor characteristics (e.g.,
histologic type) and patient experience. Findings from this study will provide...

## Key facts

- **NIH application ID:** 10276384
- **Project number:** 1R01MD016386-01
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Jason Wright
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $654,967
- **Award type:** 1
- **Project period:** 2021-08-27 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10276384

## Citation

> US National Institutes of Health, RePORTER application 10276384, Racial Disparity in Diagnostic Evaluation of Uterine Cancer (1R01MD016386-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10276384. Licensed CC0.

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