BACKGROUND AND PURPOSE:

• Giaquinto et al. (Obstetrics & Gynecology, 2022) assessed mortality trends for uterine and ovarian cancer, including analysis by race and ethnicity

METHODS:

• Population-level study
• Setting
  • United States, between 1990 and 2019
  • Data on uterine and ovarian cancer death rates were obtained from SEER
• Study design
  • Cancer death rates were age-standardized to the 2000 U.S. standard population and expressed per 100,000 person-years
    • Rates were stratified by mutually exclusive racial and ethnic categories: Asian or Pacific Islander, Black, Hispanic, or White
  • The average annual percent change was calculated using regression analysis
  • Mortality rate ratio (RR) comparing uterine and ovarian cancer and racial and ethnic subpopulations with White people were calculated
• Primary outcome
  • Uterine cancer death rates
  • Ovarian cancer death rates

RESULTS:

• Deaths from uterine cancer: 232,957 | Deaths from ovarian cancer: 419,085
• Ovarian cancer mortality rates per 100,000 women decreased between 1990 and 2019
  • 1990: 9.3 per 100,000 women
  • 2019: 6.0 per 100,000 women
  • 2010 to 2019 average annual percent change: −2.7% (95% CI, −3.5 to −2.0)
• Uterine cancer mortality decreased from 1990 to 1997, but then increased by 2019
  • 1990: 4.3 per 100,000 women
  • 1997: 4.0 per 100,000 women
  • 2019: 5.1 per 100,000 women
  • 2010 to 2019 average annual percent change: 1.7% (95% CI 1.3 to 2.1%)
• Ovarian cancer mortality decreased during the early 1990s to 2019
  • Early 1990s: 5.0 per 100,000 women
  • 2019: 0.9 per 100,000 women
• Uterine cancer mortality rate ratio for Black compared with White women increased between 1990 and 2019 (P<0.001)
  • 1990 to 1994: RR 1.83 (95% CI, 1.77 to 1.89)
  • 2015 to 2019: R 1.98 (95% CI, 1.93 to 2.02)

CONCLUSION:

• While in the 1990s mortality risk was 2 times higher for ovarian cancer than for uterine cancer, over the past 20 years this increased risk has mostly been eliminated by opposite mortality trends
• Among Black women mortality disparities have widened
  • Black women face a twofold higher risk of uterine cancer mortality compared to White women, despite similar incidence
• The authors state

…the gynecologic cancer landscape is changing rapidly, and the risk of death from uterine cancer is now similar to that for ovarian cancer among women overall and approximately 60% higher among Black women based on national mortality statistics

Learn More – Primary Sources:

The Changing Landscape of Gynecologic Cancer Mortality in the United States

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