Racial and ethnic disparities across the diagnostic pathway for individuals with suspected or confirmed endometriosis: A scoping review.

Racial and ethnic disparities across the diagnostic pathway for individuals with suspected or confirmed endometriosis: A scoping review.

Endometriosis

09/10

Reema Ali and Rania Abdel Rahman

Racial and ethnic disparities across the diagnostic pathway for individuals with suspected or confirmed endometriosis: A scoping review Abstract Background: Endometriosis is associated with substantial diagnostic delay, and emerging evidence suggests that racial and ethnic disparities may influence progression through the diagnostic pathway. However, the extent and distribution of these disparities remain unclear. Objective: To chart the current evidence on racial and ethnic disparities across the diagnostic pathway for individuals with endometriosis and ascertain gaps in the current literature. Methods: A scoping review was conducted under the influence of the Joanna Briggs Institute methodological guidance. The Population, Concept and Context framework was used to develop the eligibility criteria. Studies examining racial or ethnic differences in endometriosis diagnosis, specialist referral or diagnostic investigation were included. Data were obtained on study characteristics, populations, racial and ethnic groups, healthcare settings and stages of the diagnostic pathway. Results: Three studies met the inclusion criteria, comprising one systematic review and meta-analysis and two retrospective cohort studies. All studies were conducted in the United States. Racial and ethnic differences were identified at multiple stages of the diagnostic pathway. Black women had lower odds of receiving a self-reported or surgically confirmed diagnosis compared with White women, while Black and Asian adolescents were less likely to undergo diagnostic laparoscopy. White women also had higher referral rates to pelvic pain specialists than Black, Asian and Hispanic women. However, substantial variation existed between studies in population characteristics, definitions of race and ethnicity, and stages of the diagnostic pathway examined. Conclusion: The existing evidence suggests that racial and ethnic disparities could occur at multiple stages of the endometriosis diagnostic pathway. Yet, the limited number of studies and their focus on US healthcare settings restrict the generalisability of these findings. Further research is needed, particularly within the UK and internationally, to determine whether similar disparities exist and to investigate the factors underlying these differences.

Endometriosis, Gynaecology, Pelvic pain.