Skip to main content
SpringerLink
Log in

Hysterectomy-corrected rates of endometrial cancer among women younger than age 50 in the United States

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Purpose

This analysis describes the impact of hysterectomy on incidence rates and trends in endometrioid endometrial cancer in the United States among women of reproductive age.

Methods

Hysterectomy prevalence for states containing Surveillance, Epidemiology, and End Results (SEER) registry was estimated using data from the Behavioral Risk Factor Surveillance System (BRFSS) between 1992 and 2010. The population was adjusted for age, race, and calendar year strata. Age-adjusted incidence rates and trends of endometrial cancer among women age 20–49 corrected for hysterectomy were estimated.

Results

Hysterectomy prevalence varied by age, race, and ethnicity. Increasing incidence trends were observed, and were attenuated after correcting for hysterectomy. Among all women, the incidence was increasing 1.6% annually (95% CI 0.9, 2.3) and this increase was no longer significant after correction for hysterectomy (+ 0.7; 95% CI − 0.1, 1.5). Stage at diagnosis was similar with and without correction for hysterectomy. The largest increase in incidence over time was among Hispanic women; even after correction for hysterectomy, incidence was increasing (1.8%; 95% CI 0.2, 3.4) annually.

Conclusion

Overall, endometrioid endometrial cancer incidence rates in the US remain stable among women of reproductive age. Routine reporting of endometrial cancer incidence does not accurately measure incidence among racial and ethnic minorities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Cohen SL, Vitonis AF, Einarsson JI (2014) Updated hysterectomy surveillance and factors associated with minimally invasive hysterectomy. J Soc Laparoendosc Surg 18:e2014.00096

    Article  Google Scholar 

  2. Whiteman MK, Hillis SD, Jamieson DJ, Morrow B, Podgornik MN, Brett KM et al (2008) Inpatient hysterectomy surveillance in the United States, 2000–2004. Am J Obstet Gynecol 198:34.e1–34.e7

    Article  Google Scholar 

  3. Merrill RM (2008) Hysterectomy Surveillance in the United States, 1997 through 2005. Med Sci Monit 14:24–31

    Google Scholar 

  4. Mikhail E, Salemi JL, Mogos MF, Hart S, Salihu HM, Imudia AN (2015) National trends of adnexal surgeries at the time of hysterectomy for benign indication, United States, 1998–2011. Am J Obstet Gynecol 213:713.e1–713.e13

    Article  Google Scholar 

  5. Doll KM, Dusetzina SB, Robinson W (2016) Trends in inpatient and outpatient hysterectomy and oophorectomy rates among commercially insured women in the United States, 2000–2014. JAMA Surg 151:876–877

    Article  PubMed  PubMed Central  Google Scholar 

  6. Sutton C (2010) Past, present, and future of hysterectomy. J Minim Invasive Gynecol 17:421–435

    Article  PubMed  Google Scholar 

  7. Temkin SM, Minasian L, Noone A-M (2016) The end of the hysterectomy epidemic and endometrial cancer incidence: what are the unintended consequences of declining hysterectomy rates? Front Oncol 6:89

    PubMed  PubMed Central  Google Scholar 

  8. Siegel RL, Miller KD, Jemal A (2016) Cancer statistics, 2016. CA Cancer J Clin 66:7–30

    Article  PubMed  Google Scholar 

  9. Wartko P, Sherman ME, Yang HP, Felix AS, Brinton LA, Trabert B (2013) Recent changes in endometrial cancer trends among menopausal-age US women. Cancer Epidemiol 37:374–377

    Article  PubMed  PubMed Central  Google Scholar 

  10. Sheikh MA, Althouse AD, Freese KE, Soisson S, Edwards RP, Welburn S et al (2014) USA endometrial cancer projections to 2030: should we be concerned? Future Oncol 10:2561–2568

    Article  CAS  PubMed  Google Scholar 

  11. Duncan ME, Seagroatt V, Goldacre MJ (2012) Cancer of the body of the uterus: trends in mortality and incidence in England, 1985–2008. BJOG Int J Obstet Gynaecol 119:333–339

    Article  CAS  Google Scholar 

  12. Siegel RL, Devesa SS, Cokkinides V, Ma J, Jemal A (2013) State-level uterine corpus cancer incidence rates corrected for hysterectomy prevalence, 2004 to 2008. Cancer Epidemiol Biomark Prev 22:25–31

    Article  Google Scholar 

  13. Stang A, Hawk H, Knowlton R, Gershman ST, Kuss O (2014) Hysterectomy-corrected incidence rates of cervical and uterine cancers in Massachusetts, 1995 to 2010. Ann Epidemiol 24:849–854

    Article  PubMed  Google Scholar 

  14. Sherman ME, Carreon JD, Lacey JV, Devesa SS (2005) Impact of hysterectomy on endometrial carcinoma rates in the United States. J Natl Cancer Inst 97:1700–1702

    Article  PubMed  Google Scholar 

  15. Merrill RM (2006) Impact of hysterectomy and bilateral oophorectomy on race-specific rates of corpus, cervical, and ovarian cancers in the United States. Ann Epidemiol 16:880–887

    Article  PubMed  Google Scholar 

  16. Redburn JC, Murphy MFG (2001) Hysterectomy prevalence and adjusted cervical and uterine cancer rates in England and Wales. BJOG Int J Obstet Gynaecol 108:388–395

    Article  CAS  Google Scholar 

  17. Luoto R, Raitanen J, Pukkala E, Anttila A (2004) Effect of hysterectomy on incidence trends of endometrial and cervical cancer in Finland 1953–2010. Br J Cancer 90:1756–1759

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Wong C, Jim M, King J, Tom-Orme L, Henderson J, Saraiya M et al (2011) Impact of hysterectomy and bilateral oophorectomy prevalence on rates of cervical, uterine, and ovarian cancer among American Indian and Alaska Native women, 1999–2004. Cancer Causes Control 22:1681–1689

    Article  PubMed  Google Scholar 

  19. Stang A (2012) Impact of hysterectomy on the age-specific incidence of cervical and uterine cancer in Germany and other countries. Eur J Pub Health 23:879–883

    Article  Google Scholar 

  20. Stang A, Merrill R, Kuss O (2012) Prevalence-corrected hysterectomy rates by age and indication in Germany 2005–2006. Arch Gynecol Obstet 286:1193–1200

    Article  PubMed  Google Scholar 

  21. Hammer A, Rositch AF, Kahlert J, Gravitt PE, Blaakaer J, Søgaard M (2015) Global epidemiology of hysterectomy: possible impact on gynecological cancer rates. Am J Obstet Gynecol 213:23–29

    Article  PubMed  Google Scholar 

  22. Jamison PM, Noone A-M, Ries LAG, Lee NC, Edwards BK (2013) Trends in endometrial cancer incidence by race and histology with a correction for the prevalence of hysterectomy, SEER 1992 to 2008. Cancer Epidemiol Biomark Prev 22:233–241

    Article  Google Scholar 

  23. DeSantis CE, Lin CC, Mariotto AB, Siegel RL, Stein KD, Kramer JL et al (2014) Cancer treatment and survivorship statistics, 2014. CA Cancer J Clin 64:252–271

    Article  PubMed  Google Scholar 

  24. Soliman PT, Oh JC, Schmeler KM, Sun CC, Slomovitz BM, Gershenson DM et al (2005) Risk factors for young premenopausal women with endometrial cancer. Obstet Gynecol 105:575–580

    Article  PubMed  Google Scholar 

  25. Topuz S, Sozen H, Vatansever D, Iyibozkurt AC, Ozgor BY, Bastu E et al (2016) Do obesity and age effect the clinicopathological features and survival outcomes in premenopausal women with endometrial cancer? Eur J Gynaecol Oncol 37:320–326

    CAS  PubMed  Google Scholar 

  26. Duska LR, Garrett A, Rueda BR, Haas J, Chang Y, Fuller AF (2001) Endometrial cancer in women 40 years old or younger. Gynecol Oncol 83:388–393

    Article  CAS  PubMed  Google Scholar 

  27. Garg K, Soslow RA (2014) Endometrial carcinoma in women aged 40 years and younger. Arch Pathol Lab Med 138:335–342

    Article  PubMed  Google Scholar 

  28. Goodwin PJ, Stambolic V (2015) Impact of the obesity epidemic on cancer. Annu Rev Med 66:281–296

    Article  CAS  PubMed  Google Scholar 

  29. Lambe M, Wuu J, Weiderpass E, Hsieh C-C (1999) Childbearing at older age and endometrial cancer risk (Sweden). Cancer Causes Control 10:43–49

    Article  CAS  PubMed  Google Scholar 

  30. Fritz A, Ries LAG (1988) Surveillance Research Program, National Cancer Institute. SEER Extent of Disease—1988: Codes and Coding Instructions, 3rd edn.

  31. Costa-Paiva L, Godoy CE Jr, Antunes A Jr, Caseiro JD, Arthuso M, Pinto-Neto AM (2011) Risk of malignancy in endometrial polyps in premenopausal and postmenopausal women according to clinicopathologic characteristics. Menopause 18:1278–1282

    Article  PubMed  Google Scholar 

  32. Byun JY, Kim SE, Choi BG, Ko GY, Jung SE, Choi KH (1999) Diffuse and focal adenomyosis: MR imaging findings. Radiographics, 19 Spec No:S161-70

  33. Kim H-J, Fay MP, Feuer EJ, Midthune DN (2000) Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 19:335–351

    Article  CAS  PubMed  Google Scholar 

  34. Lee NK, Cheung MK, Shin JY, Husain A, Teng NN, Berek JS et al (2007) Prognostic factors for uterine cancer in reproductive-aged women. Obstet Gynecol 109:655–662

    Article  PubMed  Google Scholar 

  35. Cote ML, Ruterbusch JJ, Olson SH, Lu K, Ali-Fehmi R (2015) The growing burden of endometrial cancer: a major racial disparity affecting black women. Cancer Epidemiol Biomark Prev 24:1407–1415

    Article  Google Scholar 

  36. Siegel RL, Fedewa SA, Miller KD, Goding-Sauer A, Pinheiro PS, Martinez-Tyson D et al (2015) Cancer statistics for Hispanics/Latinos, 2015. CA Cancer J Clin 65:457–480

    Article  PubMed  Google Scholar 

  37. Geiss LS, Wang J, Cheng YJ et al (2014) Prevalence and incidence trends for diagnosed diabetes among adults aged 20 to 79 years, United States, 1980–2012. JAMA 312:1218–1226

    Article  CAS  PubMed  Google Scholar 

  38. Aguilar M, Bhuket T, Torres S, Liu B, Wong RJ (2015) Prevalence of the metabolic syndrome in the United States, 2003–2012. Jama 313:1973–1974

    Article  CAS  PubMed  Google Scholar 

  39. Prevalence of Obesity Among Adults and Youth: United States, 2011–2014. In: Prevention CfDCa, editor. National Center for Health Statistics 2015

  40. 1992 BRFSS SUMMARY QUALITY CONTROL REPORT. 1992

  41. Behavioral Risk Factor Surveillance System 2010 Summary Data Quality Report Centers for Disease Control 2010

  42. Schneider KL, Clark MA, Rakowski W, Lapane KL (2012) Evaluating the impact of non-response bias in the Behavioral Risk Factor Surveillance System (BRFSS). J Epidemiol Community Health 66:290–295

    Article  PubMed  Google Scholar 

  43. Brett KM, Madans JH (1994) Hysterectomy use: the correspondence between self-reports and hospital records. Am J Public Health 84:1653–1655

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Hardeman RR, Medina EM, Kozhimannil KB (2016) Structural racism and supporting black lives—the role of health professionals. N Engl J Med 375:2113–2115

    Article  PubMed  PubMed Central  Google Scholar 

  45. Ansell DA, McDonald EK (2015) Bias, black lives, and academic medicine. N Engl J Med 372:1087–1089

    Article  CAS  PubMed  Google Scholar 

  46. Doll KM, Winn AN, Goff BA (2017) Untangling the Black-White mortality gap in endometrial cancer: a cohort simulation. Am J Obstet Gynecol 216:324–325

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was presented in part at the Meeting of the International Gynecologic Cancer Society in Lisbon, Portugal, in October 2016. The authors thank T Gibson and S Scoppa from Information Management Systems, Inc, for their assistance with data management.

Author information

Authors and Affiliations

  1. Division of Gynecologic Oncology, Virginia Commonwealth University, Richmond, VA, USA

    Sarah M. Temkin & Lisa Rubinsak

  2. Cancer Therapy Evaluation Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    Elise C. Kohn

  3. Division of Cancer Control & Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    Lynne Penberthy, Kathleen A. Cronin, Lois A. Dickie & Anne-Michelle Noone

  4. Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    Lori Minasian

  5. Department of Obstetrics and Gynecology, Virginia Commonwealth University, 1250 E Marshall Street, Main Hospital, Rm 8-206, Richmond, VA, 23298, USA

    Sarah M. Temkin

Authors
  1. Sarah M. Temkin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elise C. Kohn
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lynne Penberthy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kathleen A. Cronin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lisa Rubinsak
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lois A. Dickie
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Lori Minasian
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Anne-Michelle Noone
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sarah M. Temkin.

Appendix

Appendix

FIGO stage

Extent of disease (1992–1997)

Extent of disease (1998–2003)

Collaborative stage (2004–2009)

Collaborative stage (2010)

Stage 0

0

0

0

 

Stage 1

10–15, 20–25, 30–35

10–14

100, 110, 115, 120, 123, 125, 130, 133, 135, 140, 160, 180, 400

100, 110, 114, 120, 123, 125–126, 130, 135, 140, 145, 160, 180, 400

Stage 2

40, 50

40, 50–52

500, 510, 520, 523, 525, 540, 545, 550

500, 520, 523, 525, 540

Stage 3

60

60–61, 64–66

600, 610, 635, 640, 645, 650, 660, 663, 670, 680, 688, 692

545, 550, 605, 630, 635, 640, 655, 660, 662, 665, 680

Stage 4

70, 80, 85

70, 80, 85

700, 705, 715, 800, 810, 820

682, 688, 693–694, 696, 708, 710, 715, 800, 810, 820

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Temkin, S.M., Kohn, E.C., Penberthy, L. et al. Hysterectomy-corrected rates of endometrial cancer among women younger than age 50 in the United States. Cancer Causes Control 29, 427–433 (2018). https://doi.org/10.1007/s10552-018-1018-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-018-1018-z

Keywords

Search

Navigation