Black women with postmenopausal bleeding have lower prevalence of endometrial cancer than other ethnic groups

Objectives: Modern medical practice strives for a personalized approach to patient care. The evidence regarding the prevalence of endometrial cancer in various ethnic groups is scarce and conflicting. This study was conducted to determine this prevalence in postmenopausal bleeding (PMB) women. Methods: Data for 1995 women attending PMB clinics over a 4-year period were prospectively collected. Women were grouped according to self-assigned ethnicity into 'White', 'Black', 'South Asian' and 'Others', and according to investigation results into group 1 (benign findings) and group 2 (hyperplasia or cancer). Results: The adjusted odds ratio (95% confidence interval) for Black ethnicity was 0.35 (0.17-72; p = 0.001). This means that Black women had 65% (28-83%) less odds for developing endometrial hyperplasia and cancer compared to White women, independent of other predictors. Compared to White ethnicity, women in all ethnic groups were significantly younger at presentation with PMB, had shorter duration since last menstrual period, and were less likely to be diabetic (p < 0.001). Conclusion: This study found significantly lower prevalence of endometrial cancer in the Black race in a population of PMB women, a finding that cannot be readily explained by other known risk factors. Further research is warranted to confirm the results and explore the underlying etiology.