Highlights of This Issue

Uterine corpus cancer is the most common invasive gynecologic cancer among United States women, and incidence of the epithelial type, endometrial cancer, is rapidly increasing. In this new article type, Felix and Brinton summarize the literature related to etiology, disparities, early detection, and survivorship of endometrial cancer, with a focus on progress that has been made and avenues for future research. The authors suggest that future research should be directed at reducing the prevalence of modifiable risk factors and identifying risk factors for aggressive endometrial cancer subtypes, particularly among black women.

Recent evidence suggests that the incidence of colorectal cancer among younger adults (under 50 years at diagnosis) is increasing, but data on incidence trends across racial/ethnic groups are limited. Using California Cancer Registry data, Ellis and colleagues examined trends in incidence of colorectal cancer among detailed racial/ethnic groups (non-Hispanic white, non-Hispanic black, Hispanic, and 7 Asian American groups) by age and stage over the 25-year period of 1990 to 2014. The authors found increases in the incidence of early onset colorectal cancer in most racial/ethnic groups in California. These finding may have implications for revisiting screening guidelines in the United States.

This study by Bergin and colleagues is the first to examine if delayed pathways to diagnosis and treatment contribute to rural–urban survival disparities seen in colorectal cancer, but not breast cancer. Survey data from patients in Victoria, Australia, their primary care physician and specialist, and cancer registry data were analyzed using quantile regression. Six intervals from first symptom or screening test to treatment were examined. Rural residence was associated with longer total intervals for colorectal cancer, but not breast cancer, with most disparities in the time from presentation to diagnosis. Pathways research such as this can identify where policy interventions should be targeted to reduce cancer disparities.

Cancer screening and survival rates in the Medicaid population are lower than in the privately insured population. Slater and colleagues conducted a population-based randomized controlled trial among all individuals enrolled in Minnesota's Medicaid program overdue for breast and/or colorectal cancer screening. The intervention – direct mail, a $20 incentive, and patient navigation – led to significantly higher screening in treatment versus control subjects (ORs of 1.30 and 1.12 for mammography and colonoscopy, respectively). Whereas this approach increased cancer screening in a Medicaid population, it may also have broader application for reaching individuals who remain outside the health care system despite having health insurance.