Twenty-Year Temporal Patterns of Endometrial Cancer Burden: Race/Ethnicity and Age-Specific Incidence-Mortality Trends Among U.S. Women (Aged ≥20 Years), 2000-2019

Background Endometrial cancer is one of the most prevalent gynecologic malignancies. Over the past three decades, its incidence has increased significantly, while mortality has decreased. These trends vary by age and race/ethnicity. Methods We obtained endometrial cancer incidence and mortality data from the Surveillance, Epidemiology, and End Results (SEER) program registry. Trends were quantified by average annual percent change and annual percentage changes through Joinpoint Regression modeling. Results In total, 217,228 endometrial cancer patients were included in the incidence analysis, and 45,812 deaths were included in the mortality analysis. The overall age-standardized incidence rate was 32.76 cases per 100,000 person-years, and the incidence-based mortality was 20.57 deaths per 100,000 person-years. From 2000 to 2019, the overall incidence rate increased by 0.95% annually, while the mortality rate increased by 0.29% per year from 2005 to 2019. Between 2000–2019, all racial/ethnic groups experienced accelerating incidence trends, with non-Hispanic White women showing a distinct pattern: a 1.2% annual increase confined to 2003–2016. The incidence among young and middle-aged women increased rapidly, while that among elderly women decreased significantly (AAPC = -1.28%). Similarly, the mortality rates of endometrial cancer in young and middle-aged women were rising significantly. Conclusions The incidence and mortality of endometrial cancer vary significantly by age group and race/ethnicity. Trends indicate that the incidence and mortality of young and middle-aged women increased rapidly from 2000 to 2019. Although non-Hispanic whites represented the vast majority of cases, their trend was relatively stable compared to other ethnic groups. These findings may offer evidence for future research on endometrial cancer risk factors and for uncovering health disparities among women.