Trends in Cardiovascular Mortality Among Women with Uterine Corpus Cancer in the United States: Racial Disparities and Pandemic-Era Increases, 1999–2023

Background: Cardiovascular disease (CVD) has emerged as an important competing cause of death among survivors of uterine corpus cancer (UCC). We aimed to characterize 25-year trends in CVD mortality burden among women with UCC and to assess whether racial disparities changed during the COVID-19 period. Methods : Using the CDC WONDER Multiple Cause of Death database (1999–2023), we identified 10,321 female decedents (9,261 White; 1,060 Black) aged ≥45 years with UCC recorded and CVD as the underlying cause. To address changes in U.S. race classification, analyses were conducted within two predefined eras (Era 1: 1999–2020; Era 2: 2018–2023). Primary measures included indexed mortality burden (stabilized to a 3-year mean baseline), Black-to-White ratios, premature CVD deaths (<65 years), and pandemic-era excess deaths. Results: In Era 1, the indexed mortality burden declined among White women to 0.75 by 2020, whereas the Black index increased to a peak of 1.47. In Era 2, the Black index reached 2.26 in 2022—more than doubling the era-specific baseline—while the White index increased to 1.36 by 2023. The Black-to-White disparity ratio peaked at 1.84 in 2022. By 2023, premature CVD deaths accounted for 29.8% of deaths among Black women compared with 10.9% among White women. Black women experienced 60 excess deaths in 2022 relative to the 2018–2019 mean. Conclusions : Racial disparities in CVD mortality among women with UCC persisted over time and widened during the COVID-19 period. A substantially higher proportion of premature cardiovascular deaths was observed among Black women. These findings highlight the importance of integrating cardiovascular risk assessment into cancer survivorship care, particularly for populations experiencing disproportionate mortality burden.