Record Details

Title State-level uterine corpus cancer incidence rates corrected for hysterectomy prevalence, 2004-2008
Author Siegel, RL
Secondary Authors Devesa SS, Cokkinides V, Ma J, Jemal A
Publication Type (Help) article
Journal Cancer Epidemiol Biomarkers Prev
Month Jan
Year 2013
Pages 25-31
Volume 22
Number 1
Note doi: 10.1158/1055-9965.EPI-12-0991
PubMed ID 23125334
EPub Date 2012 Nov 02
Citation Siegel RL, Devesa SS, Cokkinides V, Ma J, Jemal A. State-level uterine corpus cancer incidence rates corrected for hysterectomy prevalence, 2004-2008. Cancer Epidemiol Biomarkers Prev. 2013 Jan;22(1):25-31. EPub 2012 Nov 02. PMID 23125334. []


The interpretation of uterine cancer rates is hindered by the inclusion of women whose uterus has been surgically removed in the population at risk. Hysterectomy prevalence varies widely by state and race/ethnicity, exacerbating this issue. We estimated hysterectomy-corrected, age-adjusted uterine corpus cancer incidence rates by race/ethnicity for 49 states and the District of Columbia during 2004 to 2008 using case counts obtained from population-based cancer registries; population data from the U.S. Census Bureau; and hysterectomy prevalence data from the Behavioral Risk Factor Surveillance System. Corrected and uncorrected incidence rates were compared with regard to geographic and racial/ethnic disparity patterns and the association with obesity. Among non-Hispanic Whites, uterine cancer incidence rates (per 100,000 woman-years) uncorrected for hysterectomy prevalence ranged from 17.1 in Louisiana to 32.1 in New Jersey, mirrored regional hysterectomy patterns, and were not correlated with obesity prevalence (Pearson correlation coefficient, r = 0.06, two-sided P = 0.68). In comparison, hysterectomy-corrected rates were higher by a minimum of 30% (District of Columbia) to more than 100% (Mississippi, Louisiana, Alabama, and Oklahoma), displayed no discernible geographic pattern, and were moderately associated with obesity (r = 0.37, two-sided P = 0.009). For most states, hysterectomy correction diminished or reversed the Black/White deficit and accentuated the Hispanic/White deficit. Failure to adjust uterine cancer incidence rates for hysterectomy prevalence distorts true geographic and racial patterns and substantially underestimates the disease burden, particularly for Southern states. Correction for hysterectomy is necessary for the accurate evaluation of uterine cancer rates.