Study: Uterine Cancer Incidence and Mortality Rates Expected to Significantly Increase by 2050

Uterine cancer, also known as endometrial cancer, is a malignant tumor that develops in the lining of the uterus or endometrium. It is the most common cancer of the female reproductive system. And while the term uterine cancer can also refer to other cancers within the uterus, endometrial cancer is the most prevalent. [1]

For decades, the incidence of most cancer types, including lung cancer, colorectal cancer, and some leukemias, has been decreasing.  This is, in part, due to factors including improved screening, early detection, and advancements in treatment. However, in contrast, the incidence of uterine cancer is, particularly in the United States and other high-income countries, increasing. [1]

With the increased incidence, the mortality rates of uterine cancer are also increasing. And, over the next three decades, incidence and mortality are projected to increase significantly, with incidence-based mortality expected to be nearly three times higher in Black women compared with white women by 2050.[1][2]

This is the conclusion based on a study, supported by funds from the National Cancer Institute (NCI) and published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research (AACR).[3]

Increasing incidence and mortality
Cases of uterine cancer increased an average of 0.7% each year between 2013 and 2022 and age-adjusted death rates increased 1.6% annually between 2014 and 2023, according to the Surveillance, Epidemiology, and End Results (SEER) Program at the National Cancer Institute (NCI).[4]

Black women are disproportionally affected with a death rate from uterine cancer that is about twice as high compared with women of other races or ethnicities. Results from a study published in 2021 shows that the higher incidence, of high-risk uterine cancer subtypes, after correcting for hysterectomy and active pregnancy, includes in particularly serous carcinoma, carcinosarcoma, and leiomyosarcoma. [5][6]

“Overall, uterine cancer is one of the few cancers where both incidence and mortality have been increasing, and prior studies have consistently shown significant racial disparities among Black and white women,” noted Jason D. Wright, MD, chief of the Division of Gynecologic Oncology at Columbia University, who is the lead author of the study.

“Understanding future trends will help inform the development of robust strategies to reduce the burden and improve outcomes” Wright added.

Study design
As part of the NCI’s Cancer Intervention and Surveillance Modeling Network (CISNET), Wright and his colleagues built the Columbia University Uterine Cancer Model (UTMO). This natural history model of uterine cancer simulates the trajectories for incidence and mortality based on characteristics from a sample population, taking into account factors such as age (between 18 and 84), race (Black and white), birth cohort (grouped in 10-year intervals starting in 1910-1920), stage (as determined by the American Joint Committee on Cancer), and histologic subtype (the more common endometrioid uterine cancer vs. non-endometrioid cancers, which tend to have a worse prognosis). Survival estimates are based on current available treatments with the model unable to account for potential advances in therapeutics.

To validate the model, Wright and his team used UTMO to predict the median age of diagnosis, survival rate, and distribution of diagnosis by stage for uterine cancer in 2018, and found those projections were comparable to the actual SEER data from that year.

Following this validation, they estimated the future rates of uterine cancer based on publicly available sources through 2018.

Study outcome
Incidence was projected to increase from 57.7 cases per 100,000 in 2018 to 74.2 cases per 100,000 in 2050 for white women and from 56.8 cases per 100,000 to 86.9 cases per 100,000 for Black women. Incidence-based mortality was projected to increase from 6.1 per 100,000 to 11.2 per 100,000 among white women and from 14.1 per 100,000 to 27.9 per 100,000 among Black women.

Further, while the incidence of endometrioid tumors is projected to increase considerably in both Black (34.2 per 100,000 to 50.5 per 100,000) and white (49.2 per 100,000 to 63.4 per 100,000) women, the increased incidence of non-endometrioid tumors was more significant in Black (from 22.5 per 100,000 to 36.3 per 100,000) than white (from 8.5 per 100,000 to 10.8 per 100,000) women.

The model also showed that should hysterectomy rates continue to decrease and obesity rates continue to increase, the incidence and mortality rates for uterine cancer would increase more drastically for both white and Black women. Obesity is a known risk factor for uterine cancer, and while an increase in the use of obesity treatments like GLP-1s could instead cause obesity rates to decline, Wright explained it is hard to predict if that will be the case. Hysterectomy is known to reduce the risk of uterine cancer, but due to the availability of nonsurgical treatments for gynecologic disease, hysterectomy rates are projected to decline 25.7% from 2020 to 2035.

“There are likely a number of factors that are associated with the increased burden of uterine cancer in Black women,” Wright explained.

“They more commonly have aggressive types of uterine cancer, face delayed diagnosis resulting in later-stage disease at diagnosis, and there are often delays in their treatment,” he added.

Stress test
Wright and his colleagues also performed a stress test of the model by incorporating hypothetical screening and intervention methods that could detect uterine cancer and precancerous changes prior to clinical diagnosis. The screening and intervention methods were most effective when introduced at age 55 with declines in cancer incidence that lasted up to 15 years in white women and up to 16 years in Black women.

“The stress testing suggests that if there was an effective screening test, we may be able to substantially reduce the burden of disease,” Wright observed.

“While there is presently no screening or prevention that is routinely used for uterine cancer, we are currently examining the potential impact of integrating screening for this cancer into practice,” he further said.

Study limitations
Based on the study design and the available outcomes, the authors noted that limitations of the study include the fact that the model is based only on population-level estimates, and some of the risk factors, though representing the highest quality of data available, could be outdated. Additionally, not all potential risk factors for uterine cancer were incorporated into the model, but Wright said they are working to develop more precise estimates of other risk factors. Other limitations include the smaller number of annual cases of non-endometrioid tumors, lack of data on uterine sarcomas, and inclusion of data on only Black and white women.

Reference
[1] Wijayabahu AT, Shiels MS, Arend RC, Clarke MA. Uterine cancer incidence trends and 5-year relative survival by race/ethnicity and histology among women under 50 years. Am J Obstet Gynecol. 2024 Nov;231(5):526.e1-526.e22. doi: 10.1016/j.ajog.2024.06.026. Epub 2024 Jun 24. PMID: 38925206; PMCID: PMC11499002.
[2] Ferris JS, Prest MT, Hur C, Chen L, Elkin EB, Melamed A, Kong CY, Myers ER, Havrilesky LJ, Blank SV, Hazelton WD, Wright JD. Trends in uterine cancer incidence in the United States: The contribution of age, period and cohort effects. Gynecol Oncol. 2024 Aug;187:151-162. doi: 10.1016/j.ygyno.2024.04.026. Epub 2024 May 22. PMID: 38781746; PMCID: PMC11309905.
[3] Jason D. Wright, MD ,Cancer Epidemiology, Biomarkers & Prevention
[4] Siegel RL, Kratzer TB, Giaquinto AN, Sung H, Jemal A. Cancer statistics, 2025. CA Cancer J Clin. 2025 Jan-Feb;75(1):10-45. doi: 10.3322/caac.21871. Epub 2025 Jan 16. PMID: 39817679; PMCID: PMC11745215.
[5] Abel MK, Liao CI, Chan C, Lee D, Rohatgi A, Darcy KM, Tian C, Mann AK, Maxwell GL, Kapp DS, Chan JK. Racial disparities in high-risk uterine cancer histologic subtypes: A United States Cancer Statistics study. Gynecol Oncol. 2021 May;161(2):470-476. doi: 10.1016/j.ygyno.2021.02.037. Epub 2021 Mar 13. PMID: 33722415.
[6] Cote ML, Ruterbusch JJ, Olson SH, Lu K, Ali-Fehmi R. The Growing Burden of Endometrial Cancer: A Major Racial Disparity Affecting Black Women. Cancer Epidemiol Biomarkers Prev. 2015 Sep;24(9):1407-15. doi: 10.1158/1055-9965.EPI-15-0316. Epub 2015 Aug 19. PMID: 26290568.

Featured image: Doctor talking to a patient. Photo courtesy: © 2018 – 2025 Fotolia/Adobe. used with permission.

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