CANCER of the CORPUS UTERI

CANCER of the CORPUS UTERI Data Highlights The average annual (1994-98) age-adjusted incidence rate for cancer of the corpus uteri among whites was over 56 percent higher than the rate for blacks (25.6 compared to 16.4 per 100,000). In 1998, there were 2,209 cases of cancer of the corpus uteri diagnosed among female residents of Pennsylvania - the highest annual number of cases recorded between 1989 and 1998. Annual age-adjusted incidence rates for the years 1989 through 1998 showed that figures for whites and blacks increased. The average annual age-specific incidence rates for this site during 1994-98 rose dramatically and consistently starting at about age 40 and then began to decrease at about age 75. In 1998, seventy-nine percent of all cases were diagnosed at the in situ or localized stages of the disease. However, approximately 32 percent of the cases diagnosed among black females were regional or distant, compared to 21 percent for white females. Annual age-adjusted mortality rates for cancer of the corpus uteri were higher among black females than for whites, in spite of the lower incidence rates among blacks. The difference in stage distribution probably accounts for part of the difference in mortality rates between these two groups. The annual age-adjusted death rates for white females during the ten-year period of 1989 through 1998 have been lower in recent years. Because of the instability of the annual age-adjusted death rates for black females (due to the small annual numbers of events), it is difficult to interpret any mortality trend. FIGURE 13 Average Annual Age-Adjusted Incidence and Mortality Rates* by Race, Pennsylvania Residents, 1994-1998 Incidence Mortality Race All Females 1.9 25.0 1.8 25.6 2.6 16.4 0 5 10 15 20 25 30 Age-Adjusted Rate Risk Factors Anovulation. Infertility. Never pregnant. Irregular menses. Late onset of menopause. Obesity. *per 100,000 1970 U.S. standard million population. Estrogen replacement therapy. Personal history of ovarian cancer. Early Detection Mortality rates can be reduced with periodic pelvic examinations. The American Cancer Society recommends a pelvic exam every three years. Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1994-1998 - Page 116

Cancer of the Corpus Uteri: INCIDENCE TABLE 13-A Number of Cancer Cases, Age-Adjusted Incidence Rates and 95% Confidence Intervals by Race and Year, Pennsylvania Female Residents, 1989-1998 All Females* White Black Year No. Rate No. Rate No. Rate (CI) (CI) (CI) 1998 2,209 25.9 2,044 26.3 123 19.3 (24.8-27.0) (25.2-27.4) (15.9-22.7) 1997 2,205 25.7 2,068 26.5 100 15.1 (24.6-26.8) (25.4-27.6) (12.1-18.1) 1996 2,153 25.4 2,012 26.0 104 16.3 (24.3-26.5) (24.9-27.1) (13.2-19.4) 1995 2,068 24.4 1,947 25.1 108 16.8 (23.3-25.5) (24.0-26.2) (13.6-20.0) 1994 2,009 23.6 1,897 24.4 98 14.7 (22.6-24.6) (23.3-25.5) (11.8-17.6) 1993 2,109 25.1 1,991 26.0 103 16.1 (24.0-26.2) (24.9-27.1) (13.0-19.2) 1992 2,092 25.0 1,975 25.9 105 16.4 (23.9-26.1) (24.8-27.0) (13.3-19.5) 1991 2,019 24.5 1,918 25.5 84 12.7 (23.4-25.6) (24.4-26.6) (10.0-15.4) 1990 1,947 23.5 1,845 24.4 89 14.2 (22.5-24.5) (23.3-25.5) (11.2-17.2) 1989 1,794 21.9 1,704 22.8 83 12.8 (20.9-22.9) (21.7-23.9) (10.0-15.6) * Includes any unknowns. NOTES: Age-adjusted rates are per 100,000 and are computed by the direct method using the 1970 U.S. standard million population. Rates based on less than 20 events are considered statistically unreliable. CI = 95% confidence interval based on a formula for estimating the standard error or SE (see Technical Notes). FIGURE 13-A Age-Adjusted Incidence Rates by Race Pennsylvania Female Residents, 1989-1998 30 25 Rate per 100,000 20 15 10 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 Year Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1994-1998 - Page 117

Cancer of the Corpus Uteri: INCIDENCE TABLE 13-B Average Annual Age-Specific Incidence Rates by Race Age Group All Females White Black Total 34.1 36.0 17.3 Under 5 0.1 0.1-5-9 - - - 10-14 - - - 15-19 0.1 0.1 0.4 20-24 0.4 0.5-25-29 1.4 1.3 1.3 30-34 4.3 4.6 2.6 35-39 7.7 7.8 5.6 40-44 17.5 18.2 11.1 45-49 32.0 33.6 10.8 50-54 58.3 61.9 22.7 55-59 82.5 85.6 49.9 60-64 94.3 95.4 80.2 65-69 105.9 107.3 75.1 70-74 110.2 110.2 87.7 75-79 104.1 105.5 74.1 80-84 92.2 93.7 64.3 85+ 57.0 56.7 50.6 NOTE: Rates are per 100,000 female population (1994-1998) for each specified group. FIGURE 13-B Average Annual Age-Specific Incidence Rates by Race 120 100 80 Rate per 100,000 60 40 20 0 Under 5 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Age Group 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1994-1998 - Page 118

Cancer of the Corpus Uteri: INCIDENCE TABLE 13-C Total Number of Cancer Cases by Age and Race Age Group All Females* White Black Total 10,644 9,968 533 Under 5 1 1 0 5-9 0 0 0 10-14 0 0 0 15-19 3 2 1 20-24 9 9 0 25-29 27 22 3 30-34 96 89 6 35-39 180 162 13 40-44 398 369 24 45-49 659 619 20 50-54 1,021 974 35 55-59 1,259 1,178 66 60-64 1,365 1,254 96 65-69 1,567 1,468 79 70-74 1,555 1,450 79 75-79 1,248 1,185 53 80-84 787 749 33 85+ 469 437 25 * Includes any unknowns. FIGURE 13-C Stage of Disease at Diagnosis, Percent by Race Pennsylvania Female Residents, 1998 90 80 77.4 In Situ Local Regional 70 67.0 Distant 60 Percent 50 40 30 20 13.4 17.0 15.2 10 7.2 0 2.0 0.9 Number and Percent of Cases Microscopically Confirmed: 2,200-99.6% Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1994-1998 - Page 119

Cancer of the Corpus Uteri: MORTALITY TABLE 13-D Number of Cancer Deaths, Age-Adjusted Death Rates and 95% Confidence Intervals by Race and Year, Pennsylvania Female Residents, 1989-1998 All Females* White Black Year No. Rate No. Rate No. Rate (CI) (CI) (CI) 1998 179 1.7 160 1.6 19 2.4 (1.5-1.9) (1.4-1.8) (1.3-3.5) 1997 199 1.9 175 1.8 23 3.1 (1.6-2.2) (1.5-2.1) (1.8-4.4) 1996 203 2.0 182 1.9 21 3.2 (1.7-2.3) (1.6-2.2) (1.8-4.6) 1995 179 1.7 168 1.7 10 1.6 (1.5-1.9) (1.4-2.0) (0.6-2.6) 1994 218 2.2 199 2.1 18 2.6 (1.9-2.5) (1.8-2.4) (1.4-3.8) 1993 211 2.1 189 2.0 21 3.1 (1.8-2.4) (1.7-2.3) (1.8-4.4) 1992 209 2.0 186 1.9 23 3.2 (1.7-2.3) (1.6-2.2) (1.9-4.5) 1991 203 1.9 187 1.9 16 2.3 (1.6-2.2) (1.6-2.2) (1.2-3.4) 1990 213 2.1 195 2.1 17 2.5 (1.8-2.4) (1.8-2.4) (1.3-3.7) 1989 193 2.0 174 2.0 19 2.9 (1.7-2.3) (1.7-2.3) (1.6-4.2) * Includes any unknowns. NOTES: Age-adjusted rates are per 100,000 and are computed by the direct method using the 1970 U.S. standard million population. Rates based on less than 20 events are considered statistically unreliable. CI = 95% confidence interval based on a formula for estimating the standard error or SE (see Technical Notes). FIGURE 13-D Age-Adjusted Death Rates by Race Pennsylvania Female Residents, 1989-1998 4 3 Rate per 100,000 2 1 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 Year Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1994-1998 - Page 120

Cancer of the Corpus Uteri: MORTALITY TABLE 13-E Number of Deaths and Average Annual Age-Specific Death Rates by Race All Females* White Black Age Group No. Rate No. Rate No. Rate Total* 978 3.1 884 3.2 91 3.0 Under 5 0-0 - 0-5-9 0-0 - 0-10-14 0-0 - 0-15-19 0-0 - 0-20-24 0-0 - 0-25-29 0-0 - 0-30-34 1 0.0 1 0.1 0-35-39 6 0.3 4 0.2 1 0.4 40-44 4 0.2 4 0.2 0-45-49 9 0.4 9 0.5 0-50-54 33 1.9 32 2.0 1 0.6 55-59 55 3.6 46 3.3 8 6.1 60-64 95 6.6 79 6.0 16 13.4 65-69 149 10.1 134 9.8 14 13.3 70-74 178 12.6 167 12.7 11 12.2 75-79 172 14.4 156 13.9 16 22.4 80-84 149 17.5 134 16.8 15 29.2 85+ 126 15.3 118 15.3 8 16.2 * Includes any unknowns. NOTE: Rates are per 100,000 female population (1994-1998) for each specified group. FIGURE 13-E Average Annual Age-Specific Death Rates by Race 30 20 Rate per 100,000 10 0 Under 5 5-9 10-14 15-19 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+ Age Group Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1994-1998 - Page 121

Cancer of the Corpus Uteri: INCIDENCE TABLE 13-F Number of Cases, Average Annual Age-Adjusted Incidence Rates and 95% Confidence Intervals by County, F e m a l e s F e m a l e s County No. Rate (CI) County No. Rate (CI) All Counties 10,644 25.0 (24.5-25.5) Adams 90 31.4 (24.9-37.9) Juniata 24 35.0 (21.0-49.0) Allegheny 1,210 23.7 (22.4-25.0) Lackawanna 237 27.3 (23.8-30.8) Armstrong 77 29.5 (22.9-36.1) Lancaster 367 26.2 (23.5-28.9) Beaver 174 24.1 (20.5-27.7) Lawrence 74 19.9 (15.4-24.4) Bedford 53 29.0 (21.2-36.8) Lebanon 121 30.5 (25.1-35.9) Berks 299 24.4 (21.6-27.2) Lehigh 260 23.9 (21.0-26.8) Blair 137 27.1 (22.6-31.6) Luzerne 413 31.4 (28.4-34.4) Bradford 54 24.8 (18.2-31.4) Lycoming 102 24.9 (20.1-29.7) Bucks 385 21.5 (19.4-23.6) McKean 43 27.7 (19.4-36.0) Butler 178 32.7 (27.9-37.5) Mercer 103 22.1 (17.8-26.4) Cambria 165 27.3 (23.1-31.5) Mifflin 60 35.2 (26.3-44.1) Cameron 9 37.6 (13.0-62.2) Monroe 102 29.4 (23.7-35.1) Carbon 73 33.0 (25.4-40.6) Montgomery 611 23.9 (22.0-25.8) Centre 78 24.1 (18.8-29.4) Montour 21 36.0 (20.6-51.4) Chester 290 23.6 (20.9-26.3) Northampton 253 28.2 (24.7-31.7) Clarion 45 34.0 (24.1-43.9) Northumberland 115 31.8 (26.0-37.6) Clearfield 78 28.6 (22.3-34.9) Perry 35 26.7 (17.9-35.5) Clinton 34 26.5 (17.6-35.4) Philadelphia 1,112 21.6 (20.3-22.9) Columbia 78 35.5 (27.6-43.4) Pike 14 10.8 (5.1-16.5) Crawford 71 23.3 (17.9-28.7) Potter 9 16.3 (5.7-26.9) Cumberland 153 21.7 (18.3-25.1) Schuylkill 217 36.5 (31.6-41.4) Dauphin 199 24.5 (21.1-27.9) Snyder 45 37.6 (26.6-48.6) Delaware 424 21.7 (19.6-23.8) Somerset 76 24.3 (18.8-29.8) Elk 33 28.2 (18.6-37.8) Sullivan 8 40.3 (12.4-68.2) Erie 210 23.3 (20.1-26.5) Susquehanna 32 22.2 (14.5-29.9) Fayette 152 27.1 (22.8-31.4) Tioga 29 20.7 (13.2-28.2) Forest 1 3.6 (0.0-10.7) Union 32 30.8 (20.1-41.5) Franklin 101 22.3 (18.0-26.6) Venango 50 23.2 (16.8-29.6) Fulton 12 26.2 (11.4-41.0) Warren 34 21.3 (14.1-28.5) Greene 30 22.6 (14.5-30.7) Washington 206 24.8 (21.4-28.2) Huntingdon 30 19.8 (12.7-26.9) Wayne 58 36.2 (26.9-45.5) Indiana 85 31.4 (24.7-38.1) Westmoreland 341 23.6 (21.1-26.1) Jefferson 48 28.3 (20.3-36.3) Wyoming 36 41.2 (27.7-54.7) York 348 29.1 (26.0-32.2) NOTES: Age-adjusted rates are per 100,000 and are computed by the direct method using the 1970 U.S. standard million population. Rates based on less than 20 events are considered statistically unreliable. CI = 95% confidence interval based on a formula for estimating the standard error or SE (see Technical Notes). Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1994-1998 - Page 122

Cancer of the Corpus Uteri: MORTALITY TABLE 13-G Number of Deaths, Average Annual Age-Adjusted Death Rates and 95% Confidence Intervals by County, F e m a l e s F e m a l e s County No. Rate (CI) County No. Rate (CI) All Counties 978 1.9 (1.8-2.0) Adams 6 1.4 (0.3-2.5) Juniata 2 1.4 (0.0-3.3) Allegheny 107 1.7 (1.4-2.0) Lackawanna 17 1.5 (0.8-2.2) Armstrong 8 1.7 (0.5-2.9) Lancaster 26 1.5 (0.9-2.1) Beaver 18 1.7 (0.9-2.5) Lawrence 3 1.0 (0.0-2.1) Bedford 7 3.1 (0.8-5.4) Lebanon 8 1.6 (0.5-2.7) Berks 25 1.6 (1.0-2.2) Lehigh 22 1.6 (0.9-2.3) Blair 6 0.9 (0.2-1.6) Luzerne 36 1.9 (1.3-2.5) Bradford 4 1.1 (0.0-2.2) Lycoming 14 2.9 (1.4-4.4) Bucks 44 2.2 (1.5-2.9) McKean 6 2.9 (0.6-5.2) Butler 16 2.1 (1.1-3.1) Mercer 8 1.4 (0.4-2.4) Cambria 13 1.7 (0.8-2.6) Mifflin 3 1.5 (0.0-3.2) Cameron 1 2.2 (0.0-6.5) Monroe 6 1.5 (0.3-2.7) Carbon 7 3.1 (0.8-5.4) Montgomery 48 1.5 (1.1-1.9) Centre 6 1.6 (0.3-2.9) Montour 3 3.6 (0.0-7.7) Chester 28 1.9 (1.2-2.6) Northampton 17 1.7 (0.9-2.5) Clarion 3 2.0 (0.0-4.3) Northumberland 8 1.2 (0.4-2.0) Clearfield 10 3.2 (1.2-5.2) Perry 2 1.5 (0.0-3.6) Clinton 2 1.5 (0.0-3.6) Philadelphia 154 2.6 (2.2-3.0) Columbia 12 4.7 (2.0-7.4) Pike 2 1.5 (0.0-3.6) Crawford 4 1.1 (0.0-2.2) Potter 2 1.7 (0.0-4.1) Cumberland 5 0.5 (0.1-0.9) Schuylkill 18 2.5 (1.3-3.7) Dauphin 11 1.2 (0.5-1.9) Snyder 3 2.0 (0.0-4.3) Delaware 38 1.6 (1.1-2.1) Somerset 7 2.1 (0.5-3.7) Elk 3 1.9 (0.0-4.1) Sullivan 1 4.0 (0.0-11.8) Erie 16 1.8 (0.9-2.7) Susquehanna 4 2.9 (0.1-5.7) Fayette 15 2.2 (1.1-3.3) Tioga 3 1.5 (0.0-3.2) Forest 1 6.1 (0.0-18.1) Union 4 3.3 (0.1-6.5) Franklin 10 1.7 (0.6-2.8) Venango 7 2.8 (0.7-4.9) Fulton 0 - Warren 10 4.2 (1.6-6.8) Greene 3 1.8 (0.0-3.8) Washington 19 2.1 (1.2-3.0) Huntingdon 4 2.3 (0.0-4.6) Wayne 6 3.4 (0.7-6.1) Indiana 8 2.0 (0.6-3.4) Westmoreland 36 2.0 (1.3-2.7) Jefferson 2 0.8 (0.0-1.9) Wyoming 3 2.4 (0.0-5.1) York 27 1.8 (1.1-2.5) NOTES: Age-adjusted rates are per 100,000 and are computed by the direct method using the 1970 U.S. standard million population. Rates based on less than 20 events are considered statistically unreliable. CI = 95% confidence interval based on a formula for estimating the standard error or SE (see Technical Notes). Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality 1994-1998 - Page 123