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Uterine Cancer in Ohio, 2011-2015 Page 1 September 2018 Uterine Cancer in Ohio, 2011-2015 Page 1 Uterine Cancer in Ohio, 2011-2015 Incidence and Mortality Key Findings and Populations at High Risk Cancer that starts in the uterus is called uterine cancer. • An average of 2,225 cases of uterine cancer were Uterine cancer made up 3.5 percent of newly diagnosed diagnosed each year in Ohio in 2011-2015. (incidence) cancer cases in Ohio reported to the Ohio Cancer Incidence Surveillance System (OCISS) from 2011 to • The uterine cancer incidence rate in Ohio was 29.2 2015. An average of 2,225 cases of uterine cancer were per 100,000 females, compared to the national rate diagnosed annually in Ohio during this time period (Table of 26.0 per 100,000 females in 2011-2015. 1). The average annual age-adjusted uterine cancer • In both Ohio and the United States, whites had the incidence rate in Ohio was 29.2 cases per 100,000 females, highest incidence rates of uterine cancer, while compared to the national (SEER) incidence rate of 26.0 per blacks had the highest mortality rates. 100,000 females. In Ohio in 2011-2015, the uterine cancer incidence rate was highest among whites (29.9 per • Uterine cancer was most frequently diagnosed 100,000 females) and lowest among Asians/Pacific among Ohio women aged 60 to 64. Islanders (12.9 per 100,000 females). In Ohio and the • From 1996 to 2015, incidence rates of uterine cancer United States, uterine cancer incidence rates were about in Ohio increased for whites and blacks, while five times higher for females 65 and older than those less mortality rates were relatively stable. than 65. • There was no clear geographic pattern of incidence An average of 397 deaths from uterine cancer occurred rates of uterine cancer by county in Ohio. each year in Ohio in 2011-2015 (Table 1). Ohio’s average • White women in Ohio were more likely to be annual age-adjusted uterine cancer mortality rate was 5.0 diagnosed with uterine cancer at a local stage, while per 100,000 females, compared to the U.S. mortality rate blacks had a higher proportion of cases diagnosed at of 4.6 per 100,000 females. In contrast to incidence, the a distant stage. mortality rate was higher for blacks (7.0 deaths per • 100,000 females) than whites (4.8 per 100,000 females) The proportion of regional and distant stage uterine and Asians/Pacific Islanders (2.8 per 100,000 females) in cancer diagnoses increased in Ohio from 1996 to Ohio during this time period. Uterine cancer mortality 2015, while the proportion of unstaged/missing stage rates were about 15 times higher for females 65 and older diagnoses decreased. than those less than 65 in both Ohio and the United States. Table 1. Uterine Cancer: Average Annual Number of Invasive Cancer Cases and Deaths and Age-adjusted Incidence and Mortality Rates per 100,000 Females by Race and Age Group, Ohio and the United States, 2011-2015 Incidence Mortality Ohio Cases Ohio Rate U.S. Rate Ohio Deaths Ohio Rate U.S. Rate Total 2,225 29.2 26.0 397 5.0 4.6 White 1,992 29.9 26.6 338 4.8 4.3 Race Black 195 24.0 25.4 55 7.0 8.3 Asian/Pacific Islander 15 12.9 20.8 3 2.8 2.9 Age <65 1,274 19.4 16.9 128 1.8 1.7 Group 65+ 950 96.8 88.6 269 26.7 24.8 Sources: Ohio Cancer Incidence Surveillance System, Ohio Department of Health, 2018; Bureau of Vital Statistics, Ohio Department of Health, 2018; Surveillance, Epidemiology and End Results (SEER) Program, National Cancer Institute, 2018. Page 2 Uterine Cancer in Ohio, 2011-2015 Incidence and Mortality by Race Figure 1. Uterine Cancer: Average Annual Age-adjusted Incidence and Mortality Rates per 100,000 Females by Race, Ohio and the United States, 2011-2015 30 29.9 25 26.6 25.4 20 24.0 20.8 15 10 12.9 5 8.3 2.8 2.9 4.8 4.3 7.0 Rate perRate 100,000 Females 0 White Black Asian/Pacific White Black Asian/Pacific Islander Islander Ohio U.S. Incidence Mortality Source: Ohio Cancer Incidence Surveillance System, Ohio Department of Health, 2018; Bureau of Vital Statistics, Ohio Department of Health, 2018; Surveillance, Epidemiology and End Results (SEER) Program, National Cancer Institute, 2018. In both Ohio and the United States, whites had the highest incidence rates of uterine cancer, while blacks had the highest mortality rates (Figure 1). The uterine cancer incidence rate among whites was 12 percent higher in Ohio compared to the United States, while the incidence rates among blacks and Asians/Pacific Islanders were 6 percent and 38 percent lower in Ohio compared to the United States, respectively. Incidence by Age Group Figure 2. Uterine Cancer: Average Annual Number of Invasive Cancer Cases and Age-specific Incidence Rates per 100,000 Females by Age Group, Ohio, 2011-2015 450 140 400 120 350 100 300 250 80 200 60 150 40 100 Rate perRate 100,000 Females Average Average Number Cases of 50 20 0 // 0 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Cases Rate Age Group Source: Ohio Cancer Incidence Surveillance System, Ohio Department of Health, 2018. Figure 2 shows that uterine cancer was most frequently diagnosed among women in the 60-64 age group in Ohio during 2011-2015. Uterine cancer age-specific incidence rates increased with advancing age group from ages 20-24 years to 65- 69 years, followed by a decline for those age 70 and older. Uterine Cancer in Ohio, 2011-2015 Page 3 Trends in Incidence and Mortality Figure 3. Uterine Cancer: Trends in Age-adjusted Incidence and Mortality Rates per 100,000 Females by Race, Ohio, 1996-2015 Sources: Ohio Cancer Incidence Surveillance System, Ohio Department of Health, 2018; Bureau of Vital Statistics, Ohio Department of Health, 2018. Figure 3 shows trends in incidence and mortality rates of uterine cancer in Ohio according to year of diagnosis or death (1996 to 2015) by race. For each year of comparison, the incidence rate for whites was greater than the rate for blacks, while the mortality rate among blacks was greater than the rate for whites. Comparing 1996 to 2015, the uterine cancer incidence rate increased 14 and 81 percent among whites and blacks, respectively, while mortality rates were relatively stable. Did You Know? • Uterine cancer is the most common cancer of the female reproductive system, accounting for more new cancer cases than ovarian, cervical, vaginal and vulvar cancers combined. • Approximately 2.9 percent of women will be diagnosed with uterine cancer at some point during their lifetime. Page 4 Uterine Cancer in Ohio, 2011-2015 Incidence by County Figure 4 shows 2011-2015 average annual age-adjusted uterine cancer incidence rates by county of residence. County- specific uterine cancer incidence rates in Ohio ranged from 21.6 to 45.1 per 100,000 female residents, compared with Ohio’s rate of 29.2 per 100,000 females. There was no clear geographic pattern of incidence rates by county. The following five counties, in decreasing order, had the highest incidence rates for this time period: Crawford, Pike, Coshocton, Muskingum and Highland. Figure 4. Uterine Cancer: Average Annual Age-adjusted Incidence Rates per 100,000 Females by County of Residence, Ohio, 2011-2015 Source: Ohio Cancer Incidence Surveillance System, Ohio Department of Health, 2018. Each category represents approximately 25 percent of the 88 Ohio counties. Uterine Cancer in Ohio, 2011-2015 Page 5 Stage at Diagnosis Cancer stage at diagnosis, which refers to the extent or spread of a cancer in the body, is used to select appropriate treatment and is an important determinant of survival. The stages of cancer, in order of increasing spread, are in situ, local, regional and distant. The 2011-2015 Ohio data presented in Figure 5 show that most uterine cancers were diagnosed at a local stage. White women in Ohio were more likely than black women to be diagnosed at this early stage (68.9 percent versus 56.9 percent). Blacks had a higher proportion of cases diagnosed at a distant stage (14.9 percent), where survival for black women is only 9.2 percent. Figure 5. Uterine Cancer: Proportion of Cases(%) by Stage at Diagnosis and Race, Ohio, 2011-2015 80% 60% 68.9% 56.9% 40% 20.0% Percent 20% 14.9% 22.5% 7.0% 0.5% 0.8% 3.6% 4.9% 0% In situ Local Regional Distant Unstaged/Missing White Black Stage at Diagnosis Source: Ohio Cancer Incidence Surveillance System, Ohio Department of Health, 2018. Trends in Stage at Diagnosis Figure 6 shows the distribution of stage at diagnosis of uterine cancer according to year of diagnosis from 1996 to 2015. The proportion of regional stage diagnoses increased 63 percent in Ohio, from 12.5 percent in 1996 to 20.4 percent in 2015, while the proportionof unstaged/missing stage diagnoses decreased 61 percent in Ohio during this 20-year period. The proportion of local stage tumors was relatively stable while distant stage diagnoses increased 37 percent (from 5.9 percent in 1996 to 8.1 percent in 2015) during this time period. Figure 6. Uterine Cancer: Trends in the Proportion of Cases (%) by Stage at Diagnosis and Year, Ohio, 1996-2015 Source: Ohio Cancer Incidence Surveillance System, Ohio Department of Health, 2018.
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