Online Appendix

Appendix Figure 1. Study Population of endometrial cancer cases from SEER- Medicare linked database.

10930 uterine cancer cases:  in study area (Los Angeles, CA; San Francisco-Oakland, CA; San Jose-Monterey, CA; and the state of New Mexico);  diagnosed between 01/01/1992 and 31/12/2004;  aged 66 years and older at diagnosis.

7644 Individuals excluded who had at least one of the following: 1875 Not first primary invasive cancer 192 Not invasive cancer (behavior code <3) 718 Not endometrial cancer histology 1412 Other race/ethnicity (not Hispanic white or non-Hispanic white) 222 Diagnosis was not microscopically confirmed 98 Diagnosis available from death certificate or autopsy only 4938 In HMO at diagnosis in the 12 months prior to diagnosis or otherwise not enrolled in Medicare AB (fee-for-service) in the 12 months prior to diagnosis 5711 Not enrolled continuously in Medicare AB (fee-for-service) from diagnosis to the end of follow-up 201 Individuals with insufficient medical encounters/records to determine comorbidities in the 12 months prior to diagnosis.

3286 Women with endometrial cancer included in analysis cohort (Hispanic white, n= 322; non-Hispanic white, n= 2964) Online Appendix

Appendix Table 1. Classification of tumors by histology (for ICD site codes 54.0-54.3, 54.8, 54.9, and 5.59).

Histologic category Description ICDO codesa Type I Adenocarcinoma; endometrioid, 8140, 8210, 8255, 8260, 8262, 8263, cystic, mucinous, and complex 8323, 8380-8382, 8480, 8481, 8560b, epithelial carcinoma 8570 Type II Clear cell and serous carcinomas, 8310, 8441, 8460, 8461, 8950, 8951, carcinosarcomas 8980, 8981 a: Classification modeled after that presented in [5]. Codes listed are the codes found in our SEER- Medicare cohort. b: Only included if ICD site code = 54.1 (endometrium) Online Appendix Appendix Table 2. Endometrial cancera specific comorbidity weights, 12 SEER Registriesb, diagnosis years 1992-200 4. Calculated 2-year mortalityc Endometrial Standard Cancer-Specific Charlson Comorbidity Coefficient Hazard Weightsd Weightse Ratio

Myocardial Infarction 0.195 1.22 1 1

Old Myocardial Infarction -0.243 0.79 0 1

Congestive Heart Failure 0.495 1.64 2 1

Peripheral Vascular Disease 0.219 1.25 1 1

Peripheral Vascular Disease Surgery 0.439 1.55 2 1

Cerebrovascular Disease 0.329 1.39 1 1

Chronic Obstructive Pulmonary Disease 0.375 1.46 1 1

Dementia 0.597 1.82 2 1

Paralysis 0.499 1.65 2 2

Diabetes 0.415 1.51 2 1

Diabetes with sequelae 0.202 1.22 1 2

Chronic Renal Failure 0.552 1.74 2 2

Various Cirrhodites 1.168 3.22 3 1

Moderate-severe Liver Disease 1.372 3.94 4 3

Ulcers (acute) -0.027 0.97 0 1

Ulcers (chronic) 0.055 1.06 0 1

Rheumatologic Disease 0.370 1.45 1 1 a: Based in ICD site code 54.1 (endometrium) and all races/ethnicities. b: The 12 SEER Registries cover six metropolitan areas (Atlanta, GA; Detroit, MI; Los Angeles, CA; San Francisco-Oakland, CA; San Jose-Monterey, CA; and Seattle-Puget Sound, WA) and seven states/regions (Connecticut, Hawaii, Iowa, New Mexico, Utah, rural Georgia) c: Calculated as per the method of Klabunde et al. [30] d: Hazard Ratios coded to an integer by the following scheme: <1.20=0; >1.2-1.49=1; 1.50-2.49=2; 2.50-3.49=3; 3.50-4.49=4 as per [24]. e: [24]. Online Appendix Appendix Table 3. Codes used to identify treatment in the inpatient and outpatient Medicare claims (only codes found in the dataset are listed).

Procedure ICD-9 HCPC HCPC level 2 68.3, 68.4, 68.5, 58150, 58152, 58180, 58200, 58210, 58240, 58260, Surgery 68.6, 68.7, 68.8, 58262, 58263, 58267, 58270, 58275, 58280, 58285, 68.9 58290, 58291, 58292, 58293, 58294 77300, 77301, 77305, 77310, 77315, 77321, 77326, 77327, 77328, 77331, 77332, 77333, 77334, 77336, 92.20- 92.27, 77370, 77399, 77401, 77402, 77403, 77404, 77406, 92.29 508.0, 77407, 77408, 77409, 77411, 77412, 77413, 77414, 508.1, 558.1, 77416, 77417, 77418, 77419, 77420, 77425, 77427, 595.82, 909.2, 77430, 77431, 77432, 77470, 77435, 77421, 77422, Radiation 990, E8732, 77423, 77427, 77431, 77789, 77778, 77790, 77777, 692.82, V58.0, 77776, 77761, 77762, 77763, S8049, S2270, C9728, V66.1, V67.1 A4650, 0197T, 0190T, 6045F, 6040F, 4182F, 4181F, 4165F, 3318F, 0520F, 88249, 77370, 77373, 77399, 77338, 77336, 77300, 77014, 76950, 61770, 57156, 51555, 01922, 32553, 49327, 49411, 49412 J9000, J9001, J9010, J9015, J9017, J9020, J9025, J9027, J9031, J9033, J9035, J9040, J9041, J9045, J9050, J9055, J9060, J9065, 96401, 96402, 96405, 96406, 96409, 96411, 96413, J9070, J9098, J9100, J9120, J9130, J9150, 99.25 , V58.1, 96415, 96416, 96417, 96420, 96422, 96423, 96425, J9151, J9155, J9160, J9165, J9171, J9175, V66.2, V67.2, 96440, 96446, 96450, 96521, 96522, 96523, 96542, J9178, J9181, J9185, J9190, J9200, J9201, 99.25 96549, Q0083, Q0084, Q0085 J9202, J9206, J9207, J9208, J9209, J9211, Chemotherapy J9212, J9213, J9214, J9215, J9216, J9217, J9218, J9219, J9225, J9226, J9230, J9245, J9250, J9260, J9261, J9263, J9264, J9265, J9266, J9268, J9270, J9280, J9293, J9300, J9302, J9303, J9305, J9307, J9310, J9315, J9320, J9328, J9330, J9340, J9351, J9355, J9357, J9360, J9370, J9390, J9395, J9600, J9999 Abbreviations: ICD-9, International Classification of Disease 9th Edition; HCPC, Healthcare Common Procedure Coding System