Endometrial cancer mortality in the U.S.: Insights into inequities across demographics and regions.

Abstract

e22577 Background: Endometrial cancer, the most prevalent gynecological malignancy, presents a significant public health concern, with disparities in incidence, treatment, and survival outcomes reflecting broader inequities in healthcare access and delivery. Analyzing mortality trends offers valuable insights for improving clinical management and patient outcomes. Methods: Using data from the CDC WONDER database, we calculated the crude and age-adjusted mortality rates (AAMRs) per 1,000,000 individuals (≥25 years) and used Joinpoint regression to determine annual and average annual percent change (AAPC) in the mortality trends. Results: A total of 102,089 deaths were reported in patients with Endometrial cancer in the U.S. from 1999 to 2020 (AAPC: 1.9007; 95% CI: 1.42 to 2.37). Overall AAMR demonstrates a general upward trend, with annual fluctuations. Starting at 20.487 in 1999, the rate decreased slightly in the early 2000s before gradually rising from 2006 onwards. By 2020, the AAMR had reached 29.854, reflecting a notable rise in mortality. NH Black or African Americans had the highest overall AAMR (35.95), followed by NH White (21.5), Hispanics or Latinos (14.8), NH American Indians or Alaska Natives (14.27), and NH Asians or Pacific Islanders (13.34). AAMR also showed substantial variation by region (overall AAMR: Northeast: 24.2; Midwest: 23.9; South: 18.9; West: 18.6). Metropolitan areas consistently reported a higher AAMR (21.09) compared to Non-metropolitan areas (20.9). State-wise analysis revealed significant disparities, with the District of Columbia exhibiting the highest AAMR (39.6) and Nevada the lowest (12.06). Conclusions: Following a decline, endometrial cancer-related mortality has been steadily increasing since 2006. The highest AAMR was observed among NH Black individuals, along with patients residing in the Northeast region, District of Columbia, and metropolitan areas. These disparities highlight the need for targeted strategies to ensure equitable access to care. Deaths and Age-adjusted Mortality Rates (AAMRs) per 1,000,000 for endometrial cancer among adults in the United States between 1999 and 2020. Variable Death (N) AAMR (95% CI) Race/Ethnicity  NH American Indians 397 14.27 (12.8 to 15.7)  NH Asians 2,713 13.34 (12.8 to 13.8)  NH Blacks 16,226 35.95 (35.4 to 36.5)  NH White 96,003 21.5 (21.36 to 21.63)  Hispanics 5,854 14.8 (14.2 to 15.2) Geographic Region  Northeast 22,742 24.2 (23.9 to 24.5)  Midwest 25,926 23.9 (23.6 to 24.2)  South 33,897 18.9 (18.7 to 19.19)  West 19,534 18.6 (18.3 to 18.9)