Megan Clarke, Ph.D., M.H.S.

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Cancer Prevention Fellow
National Cancer Institute

Project Title: “Evaluating the Associations of Symptom Appraisal and Barriers to Care with Endometrial Cancer Presentation and Outcomes in a Diverse Population”

The rising incidence of endometrial cancer and related deaths among all women has hit African American women the hardest: They are nearly twice as likely as White women to die from this disease, a situation that comprises one of the largest racial disparities observed for any cancer. While the underlying reasons for these disparities are complex, it is possible that greater delays in symptom recognition (e.g., of postmenopausal bleeding) and diagnostic evaluation among African American women, compared with White women, may play an important role. When endometrial cancer is diagnosed early, before it spreads, it has a 5-year survival rate of about 95 percent, compared with less than 45 percent for later-stage diagnoses. To improve strategies for early detection of endometrial cancer and reduce racial disparities, researchers want to understand how the influences of symptom appraisal, healthcare access, and minority and underserved women’s preferences affect endometrial cancer outcomes and survival, while accounting for biological and tumor characteristics.

Researchers will evaluate vaginal tampon sampling as a strategy for early endometrial cancer detection in 900 African American and White women who undergo hysterectomy at the University of Alabama for endometrial cancer or benign uterine conditions. The study involves analysis of questionnaire and electronic health record data to evaluate the influence of factors related to symptom appraisal, healthcare access, tumor characteristics, outcomes, and survival. To determine whether self-sampling with tampons might overcome barriers to early detection of endometrial cancers in minority and underserved populations, researchers will also evaluate associations between tampon sampling acceptability and factors related to assessing symptoms and to healthcare access and preferences.