Hysterectomy-Corrected Uterine Corpus Cancer Incidence in the United States
In a study reported in the Journal of Clinical Oncology, Clarke et al found that hysterectomy-corrected rates of uterine corpus cancer—particularly nonendometrioid subtypes—have been increasing in the United States, with racial disparities in incidence and survival being observed.
In the study, hysterectomy prevalence was estimated from the Behavioral Risk Factor Surveillance System. Hysterectomy-corrected age-standardized uterine corpus cancer incidence rates from 2000 to 2015 were calculated from the Surveillance, Epidemiology, and End Results (SEER) 18 registries.
Key Findings
Uterine corpus cancer incidence rates (per 100,000 women-years) were similar among whites and blacks (67.6) and lower among Hispanics (47.5) and Asians/Pacific Islanders (40.0). Endometrioid carcinoma rates were highest in whites (52.6); nonendometrioid carcinoma (25.9) and sarcoma (5.2) rates were highest in blacks.
Uterine corpus cancer incidence increased among whites from 2003 to 2015 (average annual percent change [APC] = 0.8%) and among blacks (APC = 2.1%), Hispanics (APC = 2.3%), and Asians/Pacific Islanders (APC = 2.2%) from 2000 to 2015. Overall incidence rates among blacks surpassed those of whites in 2007.
Endometrioid carcinoma rates rose among non-Hispanic blacks (APC= 1.3%), Hispanics (APC = 2.1%), and Asians/Pacific Islanders (1.8%), while remaining generally stable among whites (APC = -0.2%). Nonendometrioid carcinoma rates rose significantly among whites (APC = 2.3%), blacks (APC = 3.2%, Hispanics (APC = 3.8%), and Asians (APC = 4.4%).
Overall 5-year relative survival rates were 83.3% for uterine cancer, ranging from 95.4% in localized-stage disease to 69.9% in regional-stage disease and 18.1% in distant-stage disease. Rates were 91.8% in endometrioid carcinomas, 57.5% in nonendometrioid carcinomas, and 52.8% in sarcomas.
Blacks had the lowest 5-year survival rates overall (63.2% vs 81.4%–86.1%), including by stage at diagnosis (localized = 86.4% vs 93.9%–96.5%; regional = 48.7% vs 69.9%–73.1%; distant = 9.7% vs 18.1%–20.0%) and histologic subtype (endometrioid = 78.7% vs 89.5%–92.1%; nonendometrioid = 41.8% vs 57.5%–61.8%; sarcoma = 42.0% vs 52.8% vs 55.9%).
The investigators concluded, “Among all women, rates of nonendometrioid subtypes have been rising rapidly. Our analysis shows profound racial differences and disparities indicated by higher rates of nonendometrioid subtypes and poorer survival among non-Hispanic black women.”
Megan A. Clarke, PhD, of the Division of Cancer Epidemiology and Genetics, National Cancer Institute, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by a grant from the National Cancer Institute. For full disclosures of the study authors, visit jco.ascopubs.org.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
