THE NATIONAL CANCER DATA-BASE REPORT ON ENDOMETRIAL CANCER

Background: Previous Commission on Cancer data from the National Cance r Data Base (NCDB) have examined time trends in stage of disease, trea tment patterns, and survival for selected cancers. The most current (1 992) data for endometrial cancer are described here. Methods: Four cal ls for data have yielded a total of 560,455 cancer cases diagnosed in 1986-1987, and 599,597 cancer cases diagnosed in 1992, from hospital c ancer registries across the United States, Results: Data were received for 35,341 endometrial cancer patients, No significant change in stag e distribution for patients who were staged was noted with time, howev er, markedly fewer patients were reported with unknown stage in 1992 ( 15.6%) compared with 1986-1987 (45.1%). Blacks and low income groups w ere more likely to present with advanced stage disease, A 12.6% increa se in patients undergoing nodal dissection as part of their surgical t reatment occurred during this time period. More patients received surg ery only as part of their treatment in 1992 (53.8% vs, 42.6%). Advanci ng age, minority status, low income, and increasing grade all had a ne gative impact on survival. Blacks experienced a 25% reduction in survi val compared to non-Hispanic Whites and Hispanics, Conclusions: Lack o f improvement in detecting early disease indicates the lack of an acce ptable screening methodology for this disease. Blacks present with mor e advanced disease and subsequently have a decreased survival compared to non-Hispanic Whites. Time trends indicate that nodal dissection is becoming a more common surgical practice in this disease, and that ra diation therapy is utilized less often. The current American Joint Com mittee on Cancer staging accurately reflects differences in prognosis by stage. (C) 1996 Wiley-Liss, Inc.