Racial disparities in high-risk uterine cancer histologic subtypes: A United States Cancer Statistics study

Mary Kathryn Abel, Cheng I. Liao, Chloe Chan, Danny Lee, Atharva Rohatgi, Kathleen M. Darcy, Chunqiao Tian, Amandeep K. Mann, George L. Maxwell, Daniel S. Kapp, John K. Chan*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Objective: Black women with uterine cancer on average have worse survival outcomes compared to White women, in part due to higher rates of aggressive, non-endometrioid subtypes. However, analyses of incidence trends by specific high-risk subtypes are lacking, including those with hysterectomy and active pregnancy correction. The objective of our study was to evaluate racial disparities in age-adjusted incidence of non-endometrioid uterine cancer in 720,984 patients. Methods: Data were obtained from United States Cancer Statistics using SEER*Stat. We used the Behavioral Risk Factor Surveillance System to correct for hysterectomy and active pregnancy. Age-adjusted, corrected incidence of uterine cancer from 2001 to 2016 and annual percent change (APC) were calculated using Joinpoint regression. Results: Of 720,984 patients, 560,131 (77.7%) were White, 72,328 (10.0%) were Black, 56,239 (7.8%) were Hispanic, and 22,963 (3.2%) were Asian/Pacific Islander. Age-adjusted incidence of uterine cancer increased from 40.8 (per 100,000) in 2001 to 42.9 in 2016 (APC = 0.5, p < 0.001). Black women had the highest overall incidence at 49.5 (APC = 2.3, p < 0.001). The incidence of non-endometrioid subtypes was higher in Black compared to White women, with the most pronounced differences seen in serous carcinoma (9.1 vs. 3.0), carcinosarcoma (6.1 vs. 1.8), and leiomyosarcoma (1.3 vs. 0.6). In particular, Black women aged 70–74 with serous carcinoma had the highest incidence (61.3) and the highest APC (7.3, p < 0.001). Conclusions: Black women have a two to four-fold higher incidence of high-risk uterine cancer subtypes, particularly serous carcinoma, carcinosarcoma, and leiomyosarcoma, compared to White women after correcting for hysterectomy and active pregnancy.

Original languageEnglish
Pages (from-to)470-476
Number of pages7
JournalGynecologic Oncology
Issue number2
StatePublished - May 2021
Externally publishedYes


  • Histology
  • Racial disparities
  • Uterine cancer


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