Psychosocial Well-being and Barriers to Care in Endometrial Cancer

Introduction

Endometrial cancer is the fourth most common cancer among women in the United States, with incidence and mortality rates continuing to rise despite increased research investments. Sociodemographic disparities and delays in care contribute to these adverse outcomes. This study examines psychosocial well-being and patient-reported barriers to endometrial cancer care using data from the Cancer Experience Registry (CER).

This study was sponsored by Bristol‐Myers Squibb and Genentech (a member of the Roche Group).

Authors

Erica E. Fortune, PhD, Samantha Ammons, PhD,

1. Cancer Support Community, Washington, DC, USA

Methods

We conducted a cross-sectional analysis of 98 U.S adults (≥18 years) with endometrial cancer who completed the CER online survey (Nov 2021-Aug 2025). Participants provided sociodemographic and clinical information and completed PROMIS29+2 measures (t-scores standardized to a U.S. population mean= 50, SD=10) assessing psychosocial and physical symptom burden and functioning. Respondents also reported barriers to their endometrial cancer care and treatment. Descriptive analyses summarized cohort characteristics, PROMIS t-scores, and barriers. Independent t-tests assessed differences in PROMIS t-scores by reported delays in care (Yes/No).

Results

The sample was 78% Non-Hispanic (NH) White, 11% NH Black/African American, and 11% multiple or other races; mean age 66 (SD=10). Median time since diagnosis was 4 years and 36% reported currently being in treatment. Moderate or severe impairment (≥1 SD from the mean) was most common for physical function (33%), fatigue (30%), and pain interference (29%). Slightly less participants reported moderate or severe anxiety (27%) or sleep disturbance (16%), while fewer reported depression (13%), social (17%), or cognitive (5%) difficulties. Approximately 28% reported treatment delays or barriers, citing lack of time (24%), couldn’t get time off work (16%), and lack of insurance coverage or payment (24%). Participants reporting delays or barriers had higher symptom burden and lower functioning in most domains, however, only sleep disturbance (mean = 56.8 vs. 52.1) and social functioning (mean = 44.4 vs. 49.7) were statistically significant (p < 0.05).

Conclusions

These findings suggest elevated emotional and physical burden and structural barriers to timely treatment for endometrial cancer patients, with sleep and social wellness at greater risk for those citing delays to care. Integrating psychosocial support and improving care navigation may reduce disparities and improve quality of life. Future work should identify modifiable factors to promote equitable access to endometrial cancer care.

Keywords

Access to Care/Healthcare Utilization Cancer Experience Registry Emotional and Mental Health Social Support and Well-Being Symptoms and Side Effects