In a concerning projection, researchers warn that uterine cancer cases and deaths in the United States are on track to rise significantly over the next 25 years — with Black women bearing a much heavier burden compared to their white counterparts.
A study published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research (AACR), found that by 2050, mortality from uterine cancer among Black women is expected to be nearly three times higher than that of white women.
Growing Concern Despite Overall Cancer Progress
Unlike many other cancer types that have seen declining rates, uterine cancer is moving in the opposite direction. Between 2013 and 2022, cases increased by an average of 0.7% annually, and between 2014 and 2023, deaths rose by 1.6% each year, according to data from the National Cancer Institute’s SEER Program.
Black women already face an alarmingly higher death rate from uterine cancer — about double that of women from other racial or ethnic backgrounds — and the disparity is expected to widen even further.
How the Forecast Was Made
Dr. Jason D. Wright, chief of gynecologic oncology at Columbia University, led a team that developed a predictive model called the Columbia University Uterine Cancer Model (UTMO). Part of the NCI’s Cancer Intervention and Surveillance Modeling Network (CISNET), the model simulates uterine cancer trends by factoring in age, race, cancer subtype, cancer stage at diagnosis, and birth cohort.
To test its accuracy, the researchers compared their model’s projections for 2018 against real-world SEER data, finding close alignment. They then used UTMO to forecast uterine cancer trends through 2050.
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Key Findings
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For White Women: Uterine cancer cases are projected to increase from 57.7 per 100,000 in 2018 to 74.2 per 100,000 in 2050. Mortality is expected to rise from 6.1 to 11.2 per 100,000.
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For Black Women: Incidence will climb from 56.8 to 86.9 per 100,000, while deaths could nearly double — from 14.1 to 27.9 per 100,000.
The model also highlighted sharper increases in more aggressive cancer types, known as non-endometrioid tumors. These are expected to surge more dramatically among Black women (from 22.5 to 36.3 per 100,000) than white women (from 8.5 to 10.8 per 100,000).
Why the Disparity?
Wright cited multiple factors contributing to the racial gap, including a higher incidence of aggressive cancer subtypes in Black women, delayed diagnoses, and slower access to treatment.
“Black women often face later-stage diagnoses and more aggressive tumors,” Wright explained. “There are also documented delays in initiating treatment.”
Future Trends May Be Shaped by Obesity and Surgery Rates
The model also explored how external factors like obesity and hysterectomy trends could further influence cancer rates. Obesity, a known risk factor for uterine cancer, is on the rise — although the recent popularity of anti-obesity medications (like GLP-1s) could potentially reverse this trend. At the same time, hysterectomy rates — which reduce cancer risk — are projected to decline by over 25% from 2020 to 2035 due to a shift toward non-surgical treatments for gynecologic issues.
If these trends continue, both incidence and mortality rates for uterine cancer could rise even faster.
Could Early Screening Help?
To test possible interventions, Wright’s team ran simulations introducing hypothetical screening programs at age 55. These scenarios showed promising results, reducing incidence for up to 16 years in Black women and 15 years in white women.
“We currently don’t have a routine screening test for uterine cancer,” Wright noted. “But our model suggests that an effective screening tool could substantially reduce the burden.”
Study Limitations
While the findings are eye-opening, the researchers acknowledge some limitations. The model used population-level data that may not reflect all risk factors, especially for rarer cancer types like uterine sarcomas. It also did not include data on women outside the Black and white racial categories, limiting the scope of the projections.
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Funding and Disclosures
The research was supported by the National Cancer Institute. Dr. Wright disclosed receiving royalties from UpToDate, honoraria from ACOG, and research support from Merck.
Bottom Line: Without targeted interventions or the introduction of effective screening tools, uterine cancer is on track to become an even more deadly disease — especially for Black women — by 2050. The study underscores an urgent need for improved prevention, earlier detection, and more equitable treatment access.
