Cancer By County
Endometrial Cancer
(Uterine Corpus)3,5

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Risk Factors

Estrogen is the major risk factor for the most common type of endometrial cancer. Exposures involving estrogen such as estrogen only replacement therapy, tamoxifen, starting menstruation early in life, late menopause, never having children, and a history of failure to ovulate have all been associated with an increased risk of endometrial cancer. Now, estrogen replacement therapy often is combined with progesterone to offset the effect of the estrogens. Women with Stein-Leventhal syndrome (a rare condition with multiple ovarian cysts, excessive production of estrogen, and infertility) are at high risk for endometrial cancer.

Obesity is a risk factor, as are certain diseases related to obesity: diabetes, high blood pressure, and gallbladder disease. There is some evidence that a diet high in fat increases the risk of endometrial cancer. Many births (4 or more children) and the use of oral contraceptives appear to protect against the development of endometrial cancer.

Prevention and Control

The American Cancer Society recommends that women age 40 and over have an annual pelvic examination by a health professional. Women at high risk of getting endometrial cancer should have counseling on how to reduce their risk and should have annual pelvic examinations with immediate intervention for postmenopausal or irregular bleeding. Appendix I has recommendations for screening for endometrial cancer.

Incidence and Mortality in the U.S.

About 36,100 newly diagnosed cases of endometrial cancer are estimated for 1998 among women in the U.S. and it is the fourth most common cancer among women. The incidence rate for endometrial cancer has been stable since the mid 1980's. Before that there was a steady increase in the incidence rate until 1975 and then a decline. This incidence pattern is believed to be due to the widespread use of estrogen replacement therapy among post-menopausal women in the late 1960s and early 1970s and then a modification of estrogen replacement therapy in the late 1970s to include progesterone which is believed to offset the increased risk of using only estrogen. Endometrial cancer is rare in women younger than age 45, but the risk rises greatly among women in their late 40s to mid 60s. White women have about twice the rate of endometrial cancer as do black women. The one-year survival rate for endometrial cancer is 92 percent. The five-year survival rate if diagnosed at an early stage is 96 percent; if diagnosed at the later, regional stage the five-year survival rate is 66 percent. Six thousand three hundred (6,300) deaths due to endometiral cancer are estimated among U.S. women for 1998. The mortality rates have been constant since 1989.

Incidence in New Jersey - 1986-1996

Tables 21 through 23 show the incidence data by county for endometrial cancer for the years 1986 through 1996. Figure 9 shows statewide trends. Statewide, white women had higher rates than black women (see Figure 9). This was true for each county (see Table 23). In general, the rates increased over the years for both white and black women (see Figure 9).

Conclusion

The increase in endometrial cancer in New Jersey since 1986 points to the continued need for screening for endometrial cancer and for continued research on the use of hormone replacement therapy in post-menopausal women.

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Table 21.
Endometrial (Uterine Corpus) Cancer Incidence
By County, White Females, New Jersey - 1986-19961

COUNTY 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996
(Prelim.)

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

Atlantic

24

19.9

26

22.6

23

17.4

15

14.2

27

22.9

33

24.5

30

24.2

37

31.2

35

27.9

26

21.4

22

18.0

Bergen

123

20.6

136

24.1

121

20.6

115

20.2

98

16.7

161

29.2

135

23.9

125

22.3

139

24.6

126

22.6

138

23.9

Burlington

26

13.7

41

22.1

31

15.9

40

19.2

42

21.3

38

19.3

35

18.0

59

28.9

57

26.8

57

28.2

47

22.3

Camden

50

18.8

43

15.1

50

19.3

61

22.2

61

23.0

61

23.8

55

21.9

45

18.3

55

22.0

64

26.7

54

22.6

Cape May

14

18.4

11

12.5

17

20.8

19

23.5

11

14.8

20

31.6

19

26.2

16

22.6

17

21.5

17

24.6

9

12.4

Cumberland

18

23.2

17

22.7

13

15.7

13

16.3

24

29.8

19

27.1

28

34.4

30

39.1

15

24.0

11

15.0

31

44.0

Essex

83

23.5

80

21.8

97

27.3

82

23.8

62

18.4

60

18.7

76

24.2

87

28.8

81

26.4

72

21.6

69

24.2

Gloucester

21

20.4

25

22.9

33

30.8

16

13.0

23

19.7

19

15.7

27

21.3

23

18.9

36

32.6

35

31.9

28

24.0

Hudson

60

19.1

65

19.1

74

23.5

65

21.6

79

26.2

74

25.1

72

23.3

65

21.0

53

18.3

55

18.9

65

22.2

Hunterdon

15

25.7

10

18.9

10

17.7

11

19.7

16

27.9

23

38.8

17

28.6

13

22.0

17

29.5

15

27.0

17

28.7

Mercer

41

22.1

35

19.0

44

24.8

43

24.7

54

32.2

48

26.5

47

28.3

53

33.0

47

29.7

52

28.6

42

26.4

Middlesex

78

22.3

77

21.5

109

29.8

81

21.8

90

23.9

77

19.5

77

21.4

88

23.7

99

26.7

93

24.2

99

26.7

Monmouth

66

21.6

64

21.3

72

22.3

74

23.0

72

22.7

87

28.4

69

21.9

62

18.6

69

21.4

92

27.9

76

24.9

Morris

60

25.5

35

14.6

53

22.6

50

21.0

59

24.4

52

22.3

74

29.5

65

27.5

59

24.6

71

31.8

61

25.3

Ocean

78

24.7

74

22.4

73

21.0

87

23.1

96

28.3

83

23.9

94

23.7

85

19.2

119

31.3

98

27.0

107

29.9

Passaic

52

18.8

56

22.0

64

24.1

58

24.3

57

23.9

58

22.2

66

27.7

55

20.6

60

23.2

67

26.1

60

24.5

Salem

6

16.8

8

24.2

9

22.3

---

---

11

30.4

5

12.4

11

24.9

7

16.6

7

15.3

14

40.8

8

19.7

Somerset

23

19.1

31

24.6

21

16.8

25

19.8

43

32.9

36

27.5

25

19.1

25

19.1

34

23.9

21

14.7

35

25.2

Sussex

12

19.4

19

31.0

14

22.0

21

35.1

21

31.9

17

28.9

23

37.5

28

43.3

16

27.2

21

39.5

21

27.1

Union

76

24.8

76

23.8

64

19.5

73

23.7

86

27.9

70

22.6

79

26.9

70

24.7

64

21.7

67

22.7

82

28.6

Warren

21

37.4

23

41.0

17

29.3

9

12.2

21

38.8

21

37.4

17

35.4

27

42.3

19

31.4

23

41.6

16

24.8

STATE

948

21.4

953

21.5

1010

22.4

959

21.4

1053

23.8

1062

24.2

1076

24.4

1065

24.0

1098

24.8

1100

25.2

1087

24.8


1Incidence rates - per 100,000 females, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. The dashes indicate fewer than five cases. Source: New Jersey State Cancer Registry.

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Table 22.
Endometrial (Uterine Corpus) Cancer Incidence
By County, Black Females, New Jersey - 1986-1990 And 1991-19961

COUNTY

1986-1990

1991-1996

Number

Rate2

Number

Rate2

Atlantic

13

11.4

21

13.4

Bergen

15

14.1

29

18.8

Burlington

11

10.1

28

20.9

Camden

25

13.6

35

14.4

Cumberland

15

30.0

6

8.3

Essex

115

14.7

146

14.6

Gloucester

5

8.9

10

14.0

Hudson

25

15.6

44

20.1

Mercer

21

14.3

28

14.2

Middlesex

8

9.5

24

18.4

Monmouth

21

16.3

27

15.0

Morris

---

---

8

19.1

Ocean

---

---

7

23.3

Passaic

19

14.8

29

15.6

Salem

---

---

7

17.2

Somerset

---

---

8

18.1

Union

22

9.9

52

17.3

STATE

331

13.8

519

16.0


1Incidence rates - per 100,000 females, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. Counties with fewer than five cases in each time period were removed from the table - Cape May, Hunterdon, Sussex, and Warren counties. The dashes indicate fewer than five cases. Source: New Jersey State Cancer Registry.
2Average annual rate.

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Table 23.
Endometrial (Uterine Corpus) Cancer Incidence By County
And Race, Females, New Jersey - 1986-1996 Combined1

COUNTY

WHITE

BLACK

Number

Rate2

Number

Rate2

Atlantic

298

22.2

34

12.5

Bergen

1417

22.6

44

16.9

Burlington

473

21.5

39

16.5

Camden

599

21.1

60

14.1

Cape May

170

20.8

6

19.0

Cumberland

219

26.4

21

17.5

Essex

849

23.6

261

14.6

Gloucester

286

22.7

15

11.9

Hudson

727

21.5

69

18.2

Hunterdon

164

25.8

---

--

Mercer

506

26.8

49

14.2

Middlesex

968

23.8

32

14.8

Monmouth

803

23.0

48

15.4

Morris

639

24.4

12

17.1

Ocean

994

25.0

9

17.6

Passaic

653

23.3

48

15.3

Salem

87

20.6

10

14.3

Somerset

319

22.1

12

17.1

Sussex

213

31.1

---

---

Union

807

24.2

74

14.2

Warren

214

33.8

---

---

STATE

11411

23.4

850

15.1

Figure 9.

Figure 9
*1996 data are preliminary. Source: New Jersey State Cancer Registry.