e17646 Background: Endometrial cancer (EC) is the most common gynecologic malignancy in high-income countries, with a rising mortality burden in the United States. However, long-term EC-specific mortality trends stratified by age, race/ethnicity, geography, and urbanization remain insufficiently characterized. Methods: We analyzed EC-related deaths among adults aged ≥45 years from 1999–2023 using the CDC WONDER database. Deaths were identified using ICD-10 code C54.1. Age-adjusted mortality rates (AAMRs) and crude mortality rates (CMRs) per 100,000 were calculated and stratified by age group, race/ethnicity, census region, state, and urbanization. Temporal trends were evaluated using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals (CIs). Results: A total of 125,502 EC-related deaths occurred from 1999–2023. Overall AAMR increased from 6.40 in 1999 to 10.42 in 2023, with an overall AAPC of 2.17% (95% CI, 1.35–2.98). Mortality declined from 1999–2014 (APC −0.54%; 95% CI, −0.86 to −0.21), followed by a sharp increase from 2014–2017 (APC 13.22%; 95% CI, 6.16–20.74) and continued rise from 2017–2023 (APC 3.78%; 95% CI, 2.83–4.73). Age-specific mortality increased markedly with advancing age. CMRs were lowest among individuals aged 45–54 years (1.37 during 1999–2020; 2.12 during 2021–2023) and highest among those aged ≥85 years (18.47 to 25.87), with an APC of 7.02% (95% CI, 5.52–8.54) after 2014. Racial disparities were pronounced. From 1999–2017, Black individuals had the highest AAMR (10.05; AAPC 1.56%; 95% CI, −0.06 to 3.20). From 2018–2023, the highest AAMR was observed among Native Hawaiian or Other Pacific Islanders (23.38). Both rural and urban areas demonstrated rising mortality after 2013, with APCs of 6.44% (95% CI, 4.29–8.64) and 8.46% (95% CI, 7.21–9.71), respectively. Regionally, AAMR was highest in the Northeast (AAPC 1.92%; 95% CI, 0.69–3.17), while the Midwest showed the greatest recent increase (AAPC 2.04%; 95% CI, 1.33–2.75). The District of Columbia had persistently highest state-level AAMRs. Conclusions: Endometrial cancer mortality has increased substantially in the United States over the past two decades, with widening disparities by age, race/ethnicity, region, and urbanization. Older adults, Black and Pacific Islander populations, and residents of high-burden regions experience the greatest mortality risk. These findings highlight an urgent need for equity-focused prevention, earlier diagnosis, and improved access to high-quality care.
Afaq et al. (Thu,) studied this question.