Obesity May Be Driving Rise in Uterine Cancers
Cases of uterine cancer are charting a slow but steady rise among American women, and so are deaths from the disease, new statistics show.
Looking at federal health data, researchers from the U.S. Centers for Disease Control and Prevention found that "during 1999-2015, uterine cancer incidence rates increased 12 percent, about 0.7 percent per year, on average."
More than two-thirds (68 percent) of cases involved cancers of the endometrium, the lining of the uterus.
Uterine cancers are often curable if detected early, but late detection often means the tumor has spread and can become fatal. According to the new CDC study, deaths due to uterine cancer have also risen steadily, at an average increase of 1.1 percent per year.
That means that between 1999 and 2016, "uterine cancer death rates increased 21 percent," wrote researchers led by S. Jane Henley, of the CDC's Division of Cancer Prevention and Control.
Why the increases? One expert had a theory.
"In general, uterine cancers are the result of excess circulating estrogens that occur when a woman is overweight and has completed the menopause," said Dr. Benjamin Schwartz. He directs obstetrics and gynecology at Northwell Health's Southside Hospital in Bay Shore, N.Y.
"Since the obesity epidemic worsened over the years studied, it is not a surprise then that the incidence of uterine cancers also continued to rise," Schwartz said.
Henley and the CDC team agreed. Overweight or obese women "are approximately two to four times as likely to develop endometrial cancer as are women with healthy weight," they pointed out.
The new report shows that some groups have been hit harder by uterine cancers than others. Most notably, black women had a much higher increase in cases than the general population -- a 2.4 percent annual rise, adding up to a total 46 percent increase in cases between 1999 and 2016.
Rates for Hispanic women were also significantly higher than the average, the report found.
Again, obesity may be a factor, Henley's group said. While 2013-2016 statistics showed that 40 percent of all U.S. women were obese, that number rose to 56 percent among black women and 49 percent among Hispanics, the researchers noted.
All of this means that "public health efforts to help women achieve and maintain a healthy weight and obtain sufficient physical activity," would help bring uterine cancer numbers down, the CDC team said.
Earlier detection of these cancers would help save lives, especially for minority women.
The study found that while 8 percent of uterine tumors among women generally were detected only after they had spread to other tissues, that number doubled to 16 percent among black women.
That may have led to a near-doubling of fatal uterine cancers among black women. On average, 5 out of every 100,000 U.S. women now die from uterine cancer, the study found, but the rate for black women is 9 out of every 100,000.
"The data shows clearly that the earlier the cancer is caught, the easier it is to cure," according to Schwartz.
Certain symptoms can alert women to a potential problem.
According to the CDC researchers, "an important early symptom of uterine cancer is abnormal vaginal bleeding, including bleeding between periods or after sex or any unexpected bleeding after menopause." This symptom occurs in 9 out of 10 uterine cancer cases, they said.
Dr. Jennifer Wu is an obstetrician-gynecologist at Lenox Hill Hospital in New York City. She agreed that "patients need to know that they should always discuss abnormal uterine bleeding with their doctors."
And despite the new numbers, Wu stressed that advances in treatment are making uterine cancer much less lethal than before.
"Treatments for uterine cancer have improved," Wu said. "Uterine cancers can be treated with minimally invasive surgery such as laparoscopy and robotics, and patients can now have quicker recoveries from these types of surgery."
The new research was published Dec. 7 in the CDC journal Morbidity and Mortality Weekly Report.
The U.S. National Cancer Institute has more on uterine cancers.
SOURCES: Benjamin Schwartz, M.D.,
chairman, department of obstetrics and gynecology, Northwell Health's Southside Hospital, Bay Shore, N.Y.; Jennifer Wu, M.D., obstetrician-gynecologist, Lenox Hill Hospital, New York City; Dec. 7, 2018, Morbidity and Mortality Weekly Report