State-Specific Incidence of Endometrial Cancer in the United States by Histologic Subtype Corrected for Hysterectomy Prevalence from 2010 to 2019.

IF 3.4
Megan A Clarke, Jared A Fisher, Nicolas Wentzensen, Akemi T Wijayabahu, Rebecca C Arend, Rena R Jones, Britt K Erickson
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Abstract

Background: Accurate reporting of state-specific endometrial cancer incidence is important for informing cancer control efforts and may lead to new hypotheses about environmental and/or geographic risk factors. Previous studies have demonstrated the importance of accounting for hysterectomy prevalence when estimating state-level endometrial cancer incidence rates as hysterectomy prevalence varies by geographic region.

Methods: We used the Cancer in North America Public Use Dataset produced by the North American Association of Central Cancer Registries to identify incident endometrial cancer cases among women ≥20 years of age diagnosed from 2010 to 2019. We estimated state-specific hysterectomy-corrected, age-adjusted incidence rates overall and by histology. State-specific hysterectomy prevalence data were obtained from the Behavioral Risk Factor Surveillance System.

Results: Hysterectomy prevalence was highest in Southern and Midwestern states and lowest in the Northeast. Although uncorrected endometrial cancer incidence rates were highest in the Northeast, hysterectomy-corrected rates were highest in states within the Midwest and Appalachia. Geographic patterns of the hysterectomy-corrected incidence of endometrioid cancer resembled those of endometrial cancer overall. In contrast, corrected rates of non-endometrioid cancer were highest in the South and in certain states within the Northeast and Midwest. There was no overlap in the top 10 states with the highest rates of endometrioid and non-endometrioid cancers, respectively.

Conclusions: State-specific, hysterectomy-corrected incidence rates of endometrial cancer vary by histology, suggesting potential differences in behavioral, sociodemographic, and/or environmental exposures at the state level.

Impact: This study presents an accurate assessment of US endometrial cancer rates and emphasizes the importance of hysterectomy correction for geographic comparisons.

2010年至2019年美国子宫内膜癌的州特异性发病率(按子宫切除术患病率校正的组织学亚型)
背景:准确报告特定国家的子宫内膜癌发病率对于告知癌症控制工作非常重要,并可能导致有关环境和/或地理危险因素的新假设。先前的研究表明,在估计州子宫内膜癌发病率时,考虑子宫切除术患病率的重要性,因为子宫切除术患病率因地理区域而异。方法:我们使用北美中央癌症登记处协会制作的北美癌症公共使用数据集来确定2010年至2019年诊断的年龄≥20岁的女性子宫内膜癌病例。我们估计了州特异性子宫切除术校正后,年龄调整后的总体发病率和组织学。从行为危险因素监测系统获得各州子宫切除术患病率数据。结果:子宫切除术的患病率在南部和中西部各州最高,在东北部最低。虽然未矫正的子宫内膜癌发病率在东北部最高,但子宫切除矫正率在中西部和阿巴拉契亚州最高。子宫切除术后子宫内膜样癌发病率的地理分布与子宫内膜癌的总体分布相似。相比之下,非子宫内膜样癌的矫正率在南部以及东北部和中西部的某些州最高。子宫内膜样癌和非子宫内膜样癌发病率最高的前10个州分别没有重叠。结论:各州子宫切除术后的子宫内膜癌发病率因组织学而异,表明各州在行为、社会人口统计学和/或环境暴露方面存在潜在差异。影响:本研究提出了美国子宫内膜癌发病率的准确评估,并强调了子宫切除术矫正的重要性。
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