Understanding why these disparities exist involves looking at a mix of factors. One key reason is that Black women often don’t receive appropriate care, says Dr. Onyewuenyi. They often face delays in getting diagnosed and treated for endometrial cancer. Part of the problem is systemic racism, which refers to racial bias and discrimination in healthcare systems, she adds.
And because Black women are at a greater risk of rare and more aggressive endometrial cancer subtypes, their symptoms might look different from what healthcare providers expect to see with the more common form of the disease, says Onyewuenyi. This can lead to missed or delayed diagnosis.
When Black women are diagnosed with endometrial cancer, they’re less likely to receive guideline-recommended treatments. Research shows that Black women often don’t receive timely surgery, minimally invasive surgery, lymph node checks for high-risk tumors, or the right chemotherapy for advanced stages — all of which can affect survival.
Another challenge is how endometrial cancer is diagnosed, which may be less reliable for Black women, says Dr. Salani. Healthcare providers typically use transvaginal ultrasound to measure the thickness of the uterine lining. If the lining is thickened but under 4 millimeters, it’s usually considered low risk for endometrial cancer, and no further testing is needed, she says.
There’s also the issue of stigma around discussing reproductive health symptoms. Many Black women may feel uncomfortable talking about vaginal bleeding or other gynecological symptoms, and may delay seeking medical attention. Cultural factors and past negative experiences with healthcare can also make Black women hesitant to bring up these concerns with their healthcare providers.
Plus, another study found that many Black women lacked clear information about menopause and didn’t recognize abnormal bleeding as a warning sign. Some felt uncomfortable talking about these symptoms, and when they did seek help, their concerns were often dismissed or downplayed by healthcare professionals.
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