By Ann Miller Baker - December 11, 2018
While other types of cancer are mostly on the decline, women need to be aware of one type that’s becoming more frequent and deadly. Uterine cancer, also called endometrial cancer, is one of the few cancers with increasing incidence and mortality, according to a new report from the Centers for Disease Control and Prevention (CDC). The numbers of cases – and deaths – are both rising about one percent per year according to the latest CDC figures. But a Moffitt researcher notes there may be a hidden explanation behind those numbers.
Overall cancer rates have been declining by about two percent per year for the past decade, but uterine cancer has bucked the downward trend. It’s now the fourth most commonly diagnosed cancer and seventh most common cause of cancer death among U.S. women. The numbers are even worse for minorities, especially black women who are twice as likely to die from uterine cancer as women in other racial/ethnic groups. Early detection is key; women are urged to see their healthcare provider if they experience abnormal bleeding between periods, after sex or after menopause.
So, what’s behind this upward trend?
The CDC cites increasing obesity, long known to be a contributing factor to uterine cancer. Moffitt cancer epidemiologist Dr. Shelley Tworoger, associate center director of Population Science, agreed with that assessment but said another factor may be the declining number of hysterectomies performed in the U.S. “Surgery to remove the uterus has become less common over the past decade,” said Tworoger. That’s likely a result of improved treatments for some of the conditions that once led to hysterectomy. The CDC’s incidence and mortality numbers don’t take this into account. “We don’t necessarily know many of women in that population have had their uterus removed,” said Tworoger. “But if you no longer have a uterus, you can’t get uterine cancer.”
As for the disparity in uterine cancer incidence and deaths among black women, Tworoger attributes part of the higher mortality to the fact that black women experience a more aggressive form of uterine tumors. “This has been seen for a number of different cancers, including breast and prostate cancers,” said Tworoger. “Very aggressive cancer grows so much faster that it often progresses to late-stage disease before it’s diagnosed.” She added that access to care and social determinants of health can lead to racial disparities in cancer.
The one piece of advice Tworoger offered for all women is not to ignore any abnormal bleeding. “Especially as women enter perimenopause, when cycles become less normal, this is an important symptom to take seriously,” said Tworoger. “Any time a woman feels something is not normal with respect to bleeding, she should see her gynecologist.”