From the Journals

Uterine cancer incidence and mortality on the rise in the U.S.



Uterine cancer incidence and mortality in the United States increased significantly from 1999 to 2015, with the greatest increases among nonwhite women, according to data published in the Morbidity and Mortality Weekly Report.

Uterine cancer is the fourth most common cancer diagnosed and the seventh most common cause of cancer death among women in the United States, wrote S. Jane Henley and her colleagues from the division of cancer prevention and control at the National Center for Chronic Disease Prevention and Health Promotion. Its incidence is thought to be on the rise because of the increasing prevalence of overweight and obesity.

In this report, researchers analyzed data from population-based cancer registries to find new cases of invasive uterine cancer from 1999 to 2015.

Over that period, incidence rates of uterine cancer increased around 0.7% per year on average, with an overall 12% increase. However, among American Indian and Alaskan Native women, the incidence rate during that time increased by 53%, among black women it increased by 46%, among Asian/Pacific Island women the incidence rate increased by 38%, and among Hispanic women it increased by 32%.

Uterine cancer death rates also increased by 21% from 1999 to 2015, representing approximately a 1.1% average increase per year. Again, the greatest increases were seen in American Indian and Alaskan Native women (52%), Hispanic women (33%), and black women (29%). Death rates increased by 18% among white women but were stable among Asian/Pacific Island women.

The most common type of uterine cancer was the endometrioid carcinomas, which accounted for 68% of uterine cancers overall. However black women had a higher percentage of other carcinomas, carcinosarcomas, and sarcomas, compared with women from other ethnic groups.

Two-thirds of cancer overall were diagnosed at a localized stage, but this was less common in black women than women of other ethnicities, while the proportion of cancers diagnosed at distant stage was higher among black women.

“This report found that black women were more likely to receive a diagnosis at distant stage and with more aggressive histologic types than were other women, which might in part account for the higher death rate among black women,” the authors wrote.

Despite the increasing incidence and mortality, the authors wrote that population-based screening tests are not recommended for uterine cancer, partly because around 90% of women with uterine cancer report abnormal vaginal bleeding.

“Uterine cancer outcomes could be improved by increasing awareness among women that abnormal vagi­nal bleeding should be evaluated promptly by a health care provider,” they wrote.

No conflicts of interest were reported.

SOURCE: Henley SJ et al. MMWR Morb Mortal Wkly Rep. 2018 Dec 7;67:1333-8.

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