Abstract IA013: Disparities in uterine cancer incidence and mortality

Abstract

Abstract Background: Hysterectomy-corrected uterine cancer incidence rates increased have increased by about 1% per year in the U.S. from 2003-2015, with the sharpest increases observed among Hispanic, non-Hispanic Asian, and non-Hispanic Black women, respectively. These increases have been primarily related to rates of aggressive non-endometrioid subtypes, which have been increasing among all women and are particularly high among Non-Hispanic Black women. Non-Hispanic Black women also have substantially lower survival, irrespective of stage at diagnosis or histologic subtype. To follow-up on these findings, we conducted an incidence-based mortality analysis to evaluate subtype- and stage-specific uterine cancer mortality rates by race and ethnicity. Methods: We used the U.S. Surveillance, Epidemiology, and End Results (SEER)-18 Incidence-Based Mortality database, with hysterectomy correction based on hysterectomy prevalence data from the Behavioral Risk Factor Surveillance System. We included uterine cancer deaths occurring between 2010-2017 among cases diagnosed between 2000-2017. Uncorrected and corrected mortality rates were age adjusted to the 2000 US standard population and expressed per 100,000 person-years according to tumor histology, stage at diagnosis, and race and ethnicity. Annual percent changes in rates were calculated using log-linear regression. Results: There were 16,797 uterine cancer deaths between 2010-2017, corresponding to a hysterectomy-corrected mortality rate of 15.7 per 100,000 person-years. Rates were highest among Blacks, overall, by histologic subtype, and stage at diagnosis. Among all women, uterine cancer mortality rates increased significantly by 1.8% per year from 2010-2017, as did rates of non-endometrioid carcinomas (2.7%), with the sharpest increases occurring among Hispanics (6.7%), followed by Blacks (3.5%), Asians (3.4%), and Whites (1.5%). In contrast, endometrioid carcinoma mortality rates remained stable over time. Conclusions: The underlying causes for the significant increase of non-endometrioid uterine carcinoma mortality rates, aligning with recent incidence trends, are not understood. Collectively, our findings underscore the importance of understanding the factors that contribute to the remarkable rise in non-endometrioid carcinoma incidence among all women, and the disproportionately higher incidence of these subtypes among Black women. We intend to follow-up these findings in our clinical study, DETECT, in collaboration with the University of Alabama Birmingham. Citation Format: Megan A. Clarke. Disparities in uterine cancer incidence and mortality [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr IA013.