Time to Diagnosis for Endometriosis by Race

Study Objective To determine if there is a difference in time to surgical diagnosis of endometriosis amongst patients of different racial backgrounds. Design Retrospective cohort study of all surgical treatment of endometriosis between 2015 – 2020. Setting Two Boston-area teaching hospitals. Patients or Participants All female patients, 18 years and older, who underwent surgical treatment for endometriosis via excision and/or ablation of the disease were identified using CPT code 58662. Patients are excluded if they had a prior surgical diagnosis of endometriosis or no treatment for endometriosis was described at time of surgery based on review of operative report. Interventions N/A. Measurements and Main Results Our primary outcome of interest is time to diagnosis of endometriosis, which is defined as date of onset of symptoms per patient report ascertained through chart review to date of surgery for endometriosis. Our primary exposure of interest is patient race. During our preliminary review, a total of 198 patients were included, 184 white patients (92.9%) and 14 black patients (7.1%). The average time to diagnosis for our patient cohort was 40.6 ± 56.9 months. Average time to diagnosis was 40.3 ± 56.8 for white patients and 43.7 ± 60.9 for black patients. Most patients presented with complains of pelvic pain (87.3%) and dysmenorrhea (72.5%). Within our cohort, 41.7% of black patients were given a diagnosis of fibroids prior to their surgical diagnosis of endometriosis, compared to 18.5% of white patients. Conclusion In our small cohort of preliminary results, we do not observe a statistically significant difference in time to surgical diagnosis of endometriosis from onset of patient reported symptom between black and white patients. A larger sample size and prospective studies are needed to more accurately assess for the true difference in time to diagnosis of endometriosis among patients of different races and ethnicities.