New study shows increasing U.S. cases of uterine cancer overall and higher mortality in Black women
Cases of uterine cancer are increasing so rapidly that it’s expected to displace colorectal cancer by 2040 as the third most common cancer among women. A recent study also found sharp spikes in mortality rates among Asian, Hispanic, and the highest among Black women. KERA’s Sam Baker talked about this with Dr. Jayanthi Lea. She’s an OB-Gyn and Director of the Gynecologic Oncology Fellowship Program at UT Southwestern Medical Center.
Why were Black women long thought to get uterine cancer less than white women?
One can only speculate on that. Maybe not as many black women were getting diagnosed. You know, public awareness of the disease has something to do with it. When to seek care is another thing. What are the signs and symptoms one should look for? So, I think there are a lot of sort of social factors, modifiable factors that would account for that discrepancy.
Now we know it to be the opposite.
10% of uterine cancers are diagnosed in black women. And even though 10% are diagnosed, that disproportionately about 18% of the deaths due to uterine cancers are in black women. So, there's a disparity there.
Do we know why?
What I think everyone is going to say is we know there are underlying biologic reasons that could explain that. Some studies have shown that there is a higher risk of recurrence of uterine cancers in black women.
So the question you ask there is, why is that happening? Are there underlying biologic reasons that cause the higher risk of recurrence? Or is it that standard of care treatment doesn't work as well on black women as it does on white women?
I think at the end of the day, studies have to be done to be able to truly understand it. And other than the biological reasons that I think everyone is going to think about, it's important that we look at non-biologic things, modifiable factors that we can study change. Looking at what we now know as the standard of care for, you know, uterine cancers and how each standard of care algorithm works in terms of, you know, applicability to every socioeconomic group or racial group, so on and so forth.
Lack of access to quality care or lack of awareness about the disease?
That could certainly be a factor as well. It's important to note, though, that irrespective of the stage, the mortality in black women is much higher. So these are women who already have been diagnosed and staged.
So that, to me, means the diagnosis is all done, that we are talking about a group that already had that awareness to go and get tested and have the diagnosis. Even after diagnosis, the outcome seems to be worse.
So why is that? Is that because the care delivery is not the same? Receipt of care is not the same? These are speculations, of course, but I think that these are things that we can work on for sure.
Does uterine cancer get the same amount of media attention as, say, breast, lung, or liver cancer?
I have to say I don't think so. I would love for it to have more press. Breast cancer is a lot more common in the United States and even worldwide than uterine cancers are. I mean, GYN cancers on a whole represent about 16% of cancers that women get. But I think in light of the latest evidence that the mortality from uterine cancers is increasing 2% every year, this should garner the interest of the public, and we need to absolutely put it front and center.
I do like your point, though, about awareness, as a whole, because awareness of uterine cancers will allow us to detect cancers early. It's something that all women need to keep in mind. Symptoms such as post-menopausal bleeding and irregular bleeding should prompt a further investigation to rule out uterine cancer.
Did you just give me the primary symptoms or are there others that people should be aware of?
Those are not the most common symptoms. I mean, if a woman is post-menopausal, then, you know, if they have bleeding or any type of, you know, discharge, which would or could be bleeding. I mean, that's something that they need to approach their doctor about to get further workup done to make sure this is not a small cancer in the uterus that's causing these symptoms.
Then how about women who are not post-menopausal? Because we see uterine cancers arising in that group of women as well. So irregular bleeding is one of the symptoms there. So, the woman would not have irregular cycles. Instead, they would have haphazard bleeding anyway between the cycles. So, when situations like that arise, then they should get further workup done.
Interview highlights were lightly edited for clarity.
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