1. Rosenberg, Karen


According to this study:


* Uterine cancer incidence rates, including for aggressive nonendometrioid subtypes and corrected for hysterectomy prevalence, have been rising significantly in the United States.


* Higher incidence of nonendometrioid cancers and poorer survival rates among non-Hispanic black women indicate profound racial differences and disparities.



Article Content

The incidence rate of uterine cancer in the United States has been rising during the past two decades and is projected to continue climbing. Recent studies suggest that incidence rates for nonendometrioid cancer-an aggressive form associated with worse outcomes and survival-have been disproportionately increasing among black women. However, these studies, like many others regarding uterine cancer incidence rates, didn't account for hysterectomy prevalence, which varies by race, ethnicity, and geographic region, among other factors, and affects a woman's risk of developing this type of cancer.


To evaluate racial and ethnic differences in uterine cancer incidence and patient survival from 2000 to 2015 while accounting for differences in hysterectomy prevalence, researchers used newly available data from 18 population-based registries in the Surveillance, Epidemiology, and End Results Program that represent 28% of the U.S. population. Hysterectomy-corrected rates for uterine cancer overall were similar among white and black women but significantly lower among Hispanic and Asian populations. Corrected rates of endometrioid carcinoma were significantly higher among white women compared with black, Hispanic, and Asian women. Corrected rates of nonendometrioid carcinoma, by contrast, were significantly higher among black women compared with white, Hispanic, and Asian women. Rates of sarcomas and other malignancies were also highest among black women.


Hysterectomy-corrected uterine cancer incidence rose significantly among white women from 2003 to 2015 and increased rapidly among black, Hispanic, and Asian women from 2000 to 2015. Corrected endometrioid carcinoma rates were stable among white women, but increased among black, Hispanic, and Asian women. Nonendometrioid carcinoma rates increased significantly in all racial and ethnic groups. Survival rates were lowest for black women, irrespective of stage at diagnosis and histology, a finding that supports previous observations and demonstrates strong racial differences and disparities related to both biological and care-related factors, according to the authors.


Among the limitations in this study noted by the authors is the potential for the misclassification of race and ethnicity data in the registries.




Clarke MA, et al. J Clin Oncol 2019 May 22 [Epub ahead of print].