Projected Surge in Uterine Cancer Mortality Rates in the U.S. by 2050

The incidence and mortality rates of uterine cancer in the United States are projected to rise significantly over the next three decades. A recent study published in the journal *Cancer Epidemiology, Biomarkers & Prevention* by Dr. Jason D. Wright, Chief of the Division of Gynecologic Oncology at Columbia University, highlights alarming trends that indicate a nearly threefold increase in incidence-based mortality among Black women compared to their white counterparts by the year 2050.

According to the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) Program, the average annual increase in uterine cancer cases from 2013 to 2022 was 0.7%, while age-adjusted death rates increased by 1.6% annually between 2014 and 2023. Dr. Wright noted that uterine cancer is one of the few cancers where both incidence and mortality rates are on the rise, with Black women facing a death rate approximately twice as high as other racial and ethnic groups. This disparity raises urgent concerns about healthcare access and treatment equity.

The study employed the Columbia University Uterine Cancer Model (UTMO), a sophisticated simulation that incorporates various factors such as age, race, and cancer stage. The projections indicate that the incidence of uterine cancer among white women will rise from 57.7 cases per 100,000 in 2018 to 74.2 cases per 100,000 by 2050. In contrast, Black women are expected to see an increase from 56.8 cases per 100,000 to 86.9 cases per 100,000 during the same period.

Mortality rates are similarly concerning, with incidence-based mortality for white women projected to jump from 6.1 per 100,000 to 11.2 per 100,000, while Black women could see rates escalate from 14.1 per 100,000 to 27.9 per 100,000. Notably, the increase in endometrioid tumors—more common and less aggressive—is expected to rise significantly in both demographics, but the uptick in non-endometrioid tumors, which generally have a worse prognosis, is anticipated to be much sharper in Black women.

The study also explored potential contributing factors to these rising rates. Dr. Wright attributed the increased burden of disease in Black women to a combination of genetic predisposition, delayed diagnosis, and treatment access issues. Furthermore, the model predicts that declining hysterectomy rates and rising obesity rates—both significant risk factors for uterine cancer—will exacerbate the situation. Hysterectomy rates are projected to decrease by 25.7% from 2020 to 2035, while obesity remains a known risk factor.

Dr. Wright emphasized the potential impact of early detection strategies. The study's findings suggest that introducing effective screening methods at age 55 could substantially reduce incidence rates over the ensuing years. Currently, there are no routine screening practices for uterine cancer, which underscores the need for further research and intervention strategies.

Despite these alarming projections, the study has limitations, including a reliance on population-level estimates and the exclusion of certain risk factors. Nonetheless, it provides critical insights that could inform public health strategies and resource allocation to combat this growing health crisis.

In conclusion, the projected rise in uterine cancer mortality highlights the urgent need for targeted interventions, increased access to healthcare, and more comprehensive screening programs, particularly for Black women who are disproportionately affected. As healthcare professionals and policymakers grapple with these challenges, the importance of addressing disparities in cancer care remains paramount, along with a commitment to research that seeks to improve outcomes for all women facing this disease.