Although the incidence of many cancers has decreased in recent years in the United State, a new study reports that endometrial cancer is on the rise. In addition, black women appear more likely to get the most aggressive types of tumors and die from the disease. The study was published online on August 19 in the in the journal Cancer, Epidemiology, Biomarkers and Prevention.
The goal of the study was to examine whether the increasing incidence and mortality from endometrial cancer are equally distributed by race/ethnicity and type of tumor. The researchers reviewed endometrial cancer incidence and mortality data from 2000 to 2011 contained in the Surveillance, Epidemiology, and End Results Program (SEER). Cancer incidence and mortality rates were assessed, and annual percent changes were calculated. Comparisons were made between different racial/ethnic groups. Five-year relative survival rates were reviewed to determine survival by stage at diagnosis.
The investigators found that incidence rates for endometrial cancers were rising among all racial/ethnic groups, with the greatest annual percentage increase seen among non-Hispanic black and Asian women (the annual percentage increase was 2.5 for both groups). In addition, compared to non-Hispanic white women, non-Hispanic black women were found to have significantly higher incidence rates of aggressive endometrial cancers (clear cell, serous, high-grade endometrioid, and malignant mixed Mullerian tumors) compared. Hispanic and Asian women had incidence rates equal to or lower than non-Hispanic white women for all types of endometrial cancer. For nearly every stage and type, the 5-year relative survival for non-Hispanic black women was significantly lower than non-Hispanic white women; in contrast, Hispanic and Asian women had the same or better survival.
The authors concluded that endometrial cancer incidence is increasing for all women, particularly the aggressive types. The disparity associated with excess incidence for these aggressive cancers and poorer survival is limited to NHB women. The researchers suggested that at least some of the increase in these tumors may be due to rising rates of obesity. Excess fat tissue produces more hormones such as insulin and estrogen, which may promote cancer cell growth. Endometrial cancer is the fourth most common malignancy among women, with nearly 50,000 cases diagnosed in the United States in 2013.
The researchers are affiliated with: Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan; Karmanos Cancer Institute Population Science and Disparities Research Program, Detroit, Michigan; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Research Center, New York, New York; Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas; and Department of Pathology, School of Medicine, Wayne State University, Detroit, Michigan.