title: Trends in endometrial cancer incidence by race and histology with a correction for the prevalence of hysterectomy, SEER 1992 to 2008.
abstract: BACKGROUND
  Incidence rates of endometrial cancer are routinely calculated without removing women who have had a hysterectomy from the denominator, which leads to an underestimate. Furthermore, as the number of women who have had a hysterectomy (hysterectomy prevalence) varies by race, the estimate of racial difference in endometrial cancer incidence is incorrect.
  
  
  METHODS
  Data from 1992 to 2008 from the SEER Program were used to calculate incidence rates of endometrial cancer (corpus uterus and uterus, NOS) for 67,588 women 50 years and older. Data from the Behavioral Risk Factor Surveillance System were used to estimate hysterectomy prevalence. SEER area populations were reduced by hysterectomy prevalence, and corrected incidence rates were calculated.
  
  
  RESULTS
  For women 50 years and older, the corrected incidence rate of endometrial cancer was 136.0 per 100,000 among whites and 115.5 among blacks, a 73% and 90% increase respectively compared with the uncorrected rate. The increase was greater for black women because hysterectomy prevalence was higher among black women (47%) than white women (41%). The corrected incidence among black women significantly increased 3.1% per year compared with a 0.8% significant decrease among white women resulting in higher rates among black women toward the end of the study period.
  
  
  CONCLUSIONS
  Correcting the incidence rate for hysterectomy prevalence provides more accurate estimates of endometrial cancer risk over time.
  
  
  CONCLUSIONS
  Comparisons of rates of endometrial cancer among racial groups may be misleading in the absence of denominator correction for hysterectomy prevalence.
authors.affiliation: National Cancer Institute, Surveillance, Epidemiology, and End Results Program, Bethesda, MD, USA. missy.jamison@nih.gov
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Jamison
authors.forename: Anne-Michelle
authors.initials: AM
authors.lastname: Noone
authors.forename: Lynn A G
authors.initials: LA
authors.lastname: Ries
authors.forename: Nancy C
authors.initials: NC
authors.lastname: Lee
authors.forename: Brenda K
authors.initials: BK
authors.lastname: Edwards
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D003430:Cross-Sectional Studies; D016889:Endometrial Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D015994:Incidence; D008875:Middle Aged; D009367:Neoplasm Staging; D015995:Prevalence; D011379:Prognosis; D018426:SEER Program; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000150:complications / Q000601:surgery*; D044465:White People / Q000706:statistics & numerical data