Mortality trends of endometrial cancer in the female adult population of the United States from 1999 to 2020.

Objective: To examine trends in endometrial cancer (EC) mortality among U.S. adult women from 1999 to 2020, with particular attention to the acceleration after 2013, and to assess disparities by race/ethnicity, urbanization, age, and geography. Methods: EC mortality data (ICD-10: C54) were extracted from the CDC WONDER database. Age-adjusted mortality rates (AAMRs) per 100,000 (2000 U.S. standard population) were calculated annually from 1999 to 2020. Joinpoint regression was used to estimate annual percent changes (APCs) and identify inflection points. Subgroup analyses were stratified by race/ethnicity, urbanization level (2013 NCHS classification), age group, and census region/state. Results: EC deaths increased 134% (2.34-fold), from 3,087 in 1999 to 7,230 in 2020. The joinpoint analysis showed stable phase from 1999 to 2013 (APC = -0.22; 95% CI, -0.49 to 0.04) followed by a sharp rise from 2013 to 2020 (APC = 6.25; 95% CI, 5.62 to 6.88). Black women had the highest mortality rate (5.41 per 100,000), followed by White, Asian, and American Indian/Alaska Native women. Age-related trends showed a significant rise in mortality, with the steepest increases observed in women aged 65+ years. Geographic variation was also observed, with the Northeast and Urban areas exhibiting high mortality rates. Conclusion: Endometrial cancer (EC) mortality among women has increased markedly since 2013, in particular for Black women, older people (aged 65+) and urban people. These findings underscore the urgent need for risk reduction and early detection strategies in high-burden populations.