Uterine Cancer on the Rise in the U.S.

Jun 20, 2022

Cancer of the uterus is becoming a greater health problem in the U.S., both in terms of the number of cases and the number of deaths. Public health experts expect that by 2040, uterine cancer will become the third most common cancer and the fourth leading cause of deaths from cancer among women.

Cancer, as with most diseases, is not simply the result of individual behaviors or individual exposures. It is a social problem. While uterine cancer is on the rise for women in general, it is more common among black women than among white women and is even more likely to be deadly among black women.

A recent study by Dr. Megan Clarke of the National Cancer Institute found that while black women make up about 13% of all women in the U.S., they made up 18% of deaths from uterine cancer from 2000 to 2017. The difference in death rates is even greater with age. Among women 40 years and older, the death rate for black women is 31 per 100,000 compared to 15 per 100,000 for white women.

Public health experts are still trying to determine the reasons for the increase in rates of uterine cancer and for disparities by race. Increases in obesity likely contribute to the increase, but one type of uterine cancer that is not linked with obesity, non-endometrioid cancer, is also on the rise. Non-endometrioid is both more deadly and more common among black women.

Black women are more likely to die from uterine cancer both because they have less access to medical care and are less likely to receive the most effective treatments even when they do get treatment. Women who had no health insurance have found that doctors were more likely to dismiss their complaints as unrelated to cancer.

For now, one of the most effective treatments for uterine cancer is a complete hysterectomy, and black women are less likely to receive one. Doctors are also less likely to properly take biopsies of the lymph nodes of black women with uterine cancer than of white women, which is how they check whether the cancer has spread to other parts of the body. In addition, they are less likely to administer chemotherapy to black women.

Ultrasound to measure the thickness of the uterine wall is one method doctors used to diagnose uterine cancer. But ultrasound is less accurate with non-endometrioid cancers and when women have uterine fibroids, both of which are more common among black women. If doctors don’t observe a thickening of the uterine wall, they are less likely to take a biopsy that would allow them to detect the cancer at an early stage.

Another reason for the increase in uterine cancers is that many women are not aware of the danger or the signs to look for. Abnormal bleeding is one common symptom. But women who have not reached menopause, but experience erratic menstrual cycles, are less likely to get checked for uterine cancer than are women who are close to reaching menopause. Some women dismiss unusual bleeding as simply a symptom of menopause.

Some of the disparities experienced by black women are probably likely also experienced among poor and working class white women, but class is not very commonly measured in the U.S. Nevertheless, the disparities are also linked with racism in access to care and to unacceptable and reactionary attitudes the medical profession brings to the treatment of black women.

A society truly concerned with health of its people would at the least ensure that all had the means to be seen regularly by medical specialists and screened for chronic diseases like cancer. It would work to counteract the health outcomes that result from every form of inequality. The system of for-profit healthcare in this country, and continuous cuts in government spending on public health, take society in the completely opposite direction.