Age-stratified outcomes and racial disparities in hospitalized patients with endometrial cancer: A national analysis.

Abstract

e17648 Background: The incidence of endometrial cancer is increasing in both younger and older populations, yet national age-specific data on outcomes, comorbidities and racial disparities remain limited. Methods: We performed a retrospective analysis of adult endometrial cancer hospitalizations using the National Inpatient Sample. Weighted estimates were used to generate national trends. Patients were stratified by age <50 vs >50 years. Data were queried in Google BigQuery and analyzed in R. Multivariable regression adjusted for demographic, hospital, and clinical factors; race–age interactions were assessed. Results: The cohort represented approximately 1.29 million hospitalizations, predominantly among patients aged >50 years. In-hospital mortality was higher in patients >50 than £50 years (4.98% vs 3.56%), with increased adjusted odds of death (AOR 1.44, 95% CI 1.22–1.69). Length of stay was modestly longer among older patients, while adjusted hospital charges were similar. Racial disparities varied by age (interaction p=0.020). Black patients had higher mortality than White patients in both age groups (£50: AOR 1.73; >50: AOR 1.62). Among younger patients, Asian/Pacific Islander race was associated with increased mortality (AOR 1.44), while among older patients, Hispanic ethnicity was associated with modestly higher mortality (AOR 1.09). Older patients had substantially higher cardiovascular and renal comorbidity burden (all p<0.001). Obesity was more prevalent in younger patients and inversely associated with older age (AOR 0.66). Older patients were less likely to receive inpatient chemotherapy (AOR 0.77) or blood transfusion (AOR 0.79). Conclusions: Age is a major determinant of in-hospital mortality, comorbidity burden, and treatment patterns among patients hospitalized with endometrial cancer. Persistent age-specific racial disparities underscore inequities not explained by age alone and highlight the need for age-adapted, equity-focused strategies to improve outcomes.