Language selection

Government of Canada / Gouvernement du Canada

Search

Chapter 4: Cancer incidence in Canada: trends and projections (1983-2032) – Cancer of the body of the uterus - HPCDP: Volume 35, Supplement 1, Spring 2015

Chapter 4: Projections by Cancer Site

12. Cancer of the body of the uterus

Uterine cancer, or endometrial cancer specifically, which arises in the body of the uterus, is the fourth most common cancer in Canadian females and the most frequently diagnosed gynecological malignancy. The likelihood of developing uterine cancer is 1 in 39, and the lifetime probability of dying from the disease is 1 in 173.Endnote 1 In 2003–2007, the average annual number of new uterine cancer cases was 4105, or 5.5% of all cancer cases in females (Table 4.12.1).

TABLE 4.12.1
Observed (2003–2007) and projected average annual new cases by age and province/territories combined (TC), cancer of body of uterus, Canada, 2003–2032
Period Age New cases
CA BC AB SK MB ON QC NB NS PE NL TC
2003–07 <45 220 25 25 5 10 90 40 5 5 0 5 0
45–54 730 100 75 20 35 275 170 15 20 5 15 0
55–64 1355 170 135 40 55 530 320 30 45 5 20 0
65–74 970 120 85 30 40 400 225 25 30 5 15 0
75–84 630 80 45 20 30 255 165 15 20 0 10 0
85+ 205 25 15 10 5 70 60 5 5 0 0 0
Total 4105 520 380 130 175 1620 980 95 125 20 60 5
2008–12 <45 230 35 25 5 10 95 40 5 5 0 5 0
45–54 810 110 85 25 35 320 180 20 20 5 15 0
55–64 1685 220 160 50 70 675 380 35 50 5 25 5
65–74 1200 165 105 35 45 480 285 30 35 5 15 0
75–84 640 80 50 20 25 265 165 15 20 5 10 0
85+ 250 35 15 5 10 90 75 5 10 0 0 0
Total 4815 640 445 145 195 1925 1125 105 140 20 70 10
2013–17 <45 245 35 20 5 10 100 40 5 5 0 5 0
45–54 840 120 95 20 35 350 170 10 20 5 15 0
55–64 1915 255 190 55 75 785 420 45 45 5 25 5
65–74 1610 225 140 50 60 645 375 35 50 5 20 5
75–84 715 90 55 25 30 295 180 15 20 5 10 0
85+ 260 35 20 5 10 100 75 5 10 0 0 0
Total 5590 760 520 160 215 2275 1260 120 150 20 80 10
2018–22 <45 275 35 20 5 10 110 45 5 5 0 5 0
45–54 835 135 85 20 35 355 155 10 20 5 15 0
55–64 2105 275 225 55 80 900 435 40 45 10 25 5
65–74 1975 280 175 60 70 800 440 45 55 10 30 5
75–84 885 115 70 30 35 360 225 20 30 5 15 0
85+ 290 40 20 10 10 115 85 5 10 0 0 0
Total 6370 885 595 175 240 2640 1385 130 165 25 90 10
2023–27 <45 285 40 25 5 10 120 45 5 5 0 5 0
45–54 860 130 75 20 35 360 155 10 20 5 15 0
55–64 2145 300 240 50 85 950 400 30 55 5 30 5
65–74 2235 315 205 65 80 930 485 60 50 10 25 5
75–84 1205 155 100 35 45 490 295 25 40 5 20 0
85+ 340 50 25 10 10 135 100 10 10 0 5 0
Total 7065 985 665 190 265 2980 1485 140 180 25 95 15
2028–32 <45 295 45 25 5 15 125 45 5 5 0 5 0
45–54 970 140 80 25 40 395 170 10 20 5 15 0
55–64 2105 310 220 45 85 950 375 25 45 5 25 5
65–74 2440 335 245 65 85 1055 500 55 60 10 30 5
75–84 1465 190 120 45 50 605 345 35 45 5 25 5
85+ 430 60 35 10 15 165 125 10 15 5 5 0
Total 7700 1080 720 200 285 3295 1560 140 190 30 100 15

Abbreviations: AB, Alberta; BC, British Columbia; CA, Canada; MB, Manitoba; NB, New Brunswick; NL, Newfoundland and Labrador; NS, Nova Scotia; ON, Ontario; PE, Prince Edward Island; QC, Quebec; SK, Saskatchewan; TC, All Territories (Yukon, Northwest Territories and Nunavut).

Note: Totals may not add up due to rounding.

Uterine cancer is rarely seen before age 45 (2.0 per 100 000), but the incidence increased sharply with age, peaked at 82.0 per 100 000 in the 65–74 age group, and subsequently decreased gradually (Table 4.12.2). Approximately 57% of the new cases were diagnosed in women aged 55 to 74. Uterine cancer has the highest 5-year relative survival rate among all main gynecological cancers (including cervix, ovarian, vaginal and vulvar) in Canada, at 85% for 2006–2008.Endnote 1

TABLE 4.12.2
Observed (2003–2007) and projected age-standardized incidence rates (ASIRs) by age and province/territories combined (TC), cancer of body of uterus, Canada, 2003–2032
Period Age ASIRs
CA BC AB SK MB ON QC NB NS PE NL TC
2003–07 <45 2.0 1.9 2.1 2.4 3.1 2.1 1.7 1.6 2.1 2.8 3.1 2.5
45–54 28.8 28.6 30.1 30.4 39.8 29.0 27.2 27.8 22.7 27.6 30.1 34.0
55–64 76.1 71.2 89.7 82.6 90.7 79.7 68.9 60.9 76.4 77.5 66.7 50.7
65–74 82.0 76.5 86.3 85.5 91.7 87.9 74.1 79.7 82.9 74.8 64.8 83.7
75–84 73.1 66.9 70.5 60.8 83.1 75.6 75.8 73.9 64.7 52.8 60.7 0.0
85+ 59.5 54.5 53.3 54.8 42.4 56.9 75.5 58.7 55.9 75.1 19.6 96.5
Total 19.9 18.7 21.4 20.6 23.9 20.7 18.6 18.1 19.0 19.3 17.9 16.4
2008–12 <45 2.3 2.4 2.2 1.9 3.2 2.3 1.8 1.4 2.2 2.3 3.2 1.8
45–54 29.1 29.0 30.2 30.9 35.4 30.0 27.1 26.4 22.2 25.7 30.1 23.7
55–64 78.8 73.4 83.2 80.5 92.6 84.0 71.4 62.3 71.0 64.4 67.2 64.3
65–74 88.6 88.9 92.6 96.7 101.8 93.2 82.2 90.1 83.7 78.3 68.1 72.2
75–84 71.7 65.6 69.5 72.6 79.1 75.6 71.7 63.9 72.7 67.0 67.8 58.4
85+ 57.1 57.4 49.1 41.0 49.3 55.8 70.7 61.8 66.9 80.0 29.0 46.6
Total 20.7 20.1 21.2 21.2 24.3 21.7 19.2 18.2 19.0 18.4 18.6 16.9
2013–17 <45 2.4 2.3 1.7 1.9 3.2 2.4 1.8 1.4 2.2 2.3 3.3 1.9
45–54 30.5 32.8 32.6 30.1 38.1 31.6 27.0 18.8 27.7 25.7 36.8 24.9
55–64 78.7 74.4 79.6 75.3 90.1 85.1 71.4 73.4 57.8 64.5 63.3 64.1
65–74 95.3 95.6 96.2 105.2 104.1 100.8 88.1 86.4 92.3 82.4 71.0 77.7
75–84 96.9 96.3 92.1 103.2 105.8 103.7 89.4 89.9 87.0 82.5 74.7 79.0
85+ 50.8 51.5 48.8 41.2 39.5 50.4 61.3 54.1 60.9 64.0 30.9 41.4
Total 21.4 21.1 21.1 21.8 24.7 22.7 19.7 18.3 19.1 18.6 19.2 17.5
2018–22 <45 2.5 2.4 1.7 1.9 3.1 2.5 1.9 1.4 2.2 2.3 3.3 2.1
45–54 32.5 37.2 30.6 30.5 41.8 33.8 28.6 18.9 27.8 25.7 37.5 26.5
55–64 79.5 74.3 84.5 74.5 89.6 86.8 70.7 66.0 59.3 64.5 64.2 64.8
65–74 96.9 96.3 92.1 103.2 105.8 103.7 89.4 89.9 87.0 82.5 74.7 79.0
75–84 79.5 75.1 74.9 90.5 88.9 84.3 79.0 77.4 78.2 76.1 71.9 64.8
85+ 51.1 52.9 44.4 46.2 44.0 52.3 59.1 47.9 66.4 59.0 31.2 41.6
Total 22.1 21.9 21.2 21.8 25.2 23.5 20.0 18.1 19.1 18.8 19.8 18.0
2023–27 <45 2.5 2.5 1.7 2.0 3.1 2.5 1.9 1.4 2.2 2.3 3.3 2.0
45–54 33.5 34.6 25.4 30.7 41.7 34.4 28.3 18.9 27.8 25.7 37.9 27.3
55–64 82.4 81.2 90.9 72.2 97.0 90.2 70.4 51.9 70.3 64.5 73.8 67.2
65–74 96.2 95.0 90.8 97.8 103.8 104.6 88.9 104.6 70.7 82.5 67.6 78.4
75–84 85.0 78.2 78.6 99.0 92.5 90.7 84.0 73.2 86.1 79.4 72.7 69.2
85+ 54.5 56.0 48.5 57.3 49.8 55.6 64.4 60.0 64.2 62.0 29.7 44.4
Total 22.6 22.3 21.2 21.7 25.9 24.2 20.1 17.8 19.2 19.0 20.3 18.4
2028–32 <45 2.5 2.6 1.7 2.0 3.1 2.6 1.9 1.4 2.2 2.3 3.4 2.0
45–54 35.2 35.3 25.2 31.0 41.5 35.8 28.6 18.9 27.8 25.7 38.2 28.7
55–64 85.7 86.7 85.2 72.6 104.0 94.2 72.7 51.9 70.4 64.5 74.5 69.9
65–74 96.4 92.7 97.1 95.3 103.9 105.6 86.5 91.0 77.6 82.5 70.3 78.6
75–84 85.0 76.8 74.6 94.1 93.6 91.9 83.8 77.7 79.9 79.4 76.8 69.3
85+ 56.9 58.3 51.5 55.1 48.7 57.9 65.2 61.8 72.1 71.9 33.9 46.4
Total 23.1 22.7 21.0 21.4 26.5 24.8 20.2 17.1 19.5 19.1 20.7 18.8

Abbreviations: AB, Alberta; BC, British Columbia; CA, Canada; MB, Manitoba; NB, New Brunswick; NL, Newfoundland and Labrador; NS, Nova Scotia; ON, Ontario; PE, Prince Edward Island; QC, Quebec; SK, Saskatchewan; TC, All Territories (Yukon, Northwest Territories and Nunavut).

Overall rates of uterine cancer decreased marginally in the 1980s and have gradually risen slightly (Figure 4.12.1).

FIGURE 4.12.1
Age-standardized incidence rates (ASIRs) by region, cancer of body of uterus, 1983–2032

figure 4.12.1

[Click to enlarge]

[FIGURE 4.12.1, Text Equivalent]

Figure 4.12.1 shows that the rates of uterine cancer are predicted to increase slightly in each region and that geographical variation in rates is not considerable.

During 1998– 2007, the ASIRs increased significantly by 0.7% per year (Figure 3.2). Uterus cancer incidence in females younger than 45 has stabilized (Figure 4.12.2).

FIGURE 4.12.2
Age-standardized incidence rates (ASIRs) for cancer of body of uterus by age group, Canada, 1983–2032

figure 4.12.2

[Click to enlarge]

[FIGURE 4.12.2, Text Equivalent]

Figure 4.12.2 shows that the increase in the overall rates of uterine cancer will be less evident in younger females (<55) and substantial in women aged between 55 and 74. Incidence in women aged 75 to 84 will fall slightly in the first period and then increase markedly. The rates in the oldest women will decrease in the first 2 periods and then increase gradually.

The rates in women aged 45 to 64 have risen steadily since 1988–1992, being less evident in the 45–54 age range. Incidence in women aged 65 to 74 fell substantially until 1998–2002 and then increased slightly. The rates in women aged 75 or older have decreased since 1998–2002, with relatively pronounced decreases in women aged 75 to 84. Figure 4.12.1 indicates that Quebec used to have the highest rates of uterus cancer, but the rates have decreased substantially and approached the lowest level of the regions in 2003–2007. The rates in other regions have been relatively stable through the observation periods.

Figure 4.12.2 shows that the increase in the overall rates of uterine cancer will be less evident in younger females (<55) and substantial in women aged between 55 and 74. Incidence in women aged 75 to 84 will fall slightly in the first period and then increase markedly. The rates in the oldest women will decrease in the first 2 periods and then increase gradually. Figure 4.12.1 shows that the rates are predicted to increase slightly in each region and that geographical variation in rates is not considerable.

From 2003–2007 to 2028–2032, the ASIRs for uterine cancer in Canadian females are projected to increase by 16%, from 19.9 to 23.1 per 100 000 (Table 4.12.2). The annual number of newcases is projected to increase by 88%, from 4105 to 7700 (Table 4.12.1).

Comments

Excessive exposure to estrogen unopposed by progesterone is the most widely accepted hypothesis on the etiology of uterine cancer. Such exposure to estrogen can explain the related risk factors: early menarche, late menopause, nulliparity, hormone replacement therapy and obesity. Endnote 86 Combined oestrogen–progestagen oral contraceptives appear to have a protective effect.Endnote 174

Convincing epidemiological evidence links excess body mass and lack of sufficient physical activity to increased risk of uterine cancer. Excess weight accounts for approximately 50% of uterine cancer cases in Europe and the US,Endnote 70, Endnote 175 and obesity accounts for 40% of uterine cancer incidence worldwide.Endnote 86 A meta-analysis of 18 studies published between 1989 and 2011 suggests that overweight and obese females have 32% and 154% higher risk of uterine cancer, respectively.Endnote 176 Postmenopausal obese women have higher levels of estradiol than postmenopausal normal-weight women.Endnote 175 In Canada, the prevalence rates of obesity have nearly doubled in adults from 1978/79 to 2012.Endnote 51, Endnote 72, Endnote 73 In addition, there is considerable evidence that a lack of sufficient physical activity, independent of BMI, is associated with an increased risk of uterine cancer.Endnote 177, Endnote 178

Changes in prevalence of overweight and obesity may partially account for the observed and predicted increase in uterine cancer incidence.Endnote 179, Endnote 180 Stable prevalence rate of oral contraceptive useEndnote 181 could explain why incidence rates of uterine cancer have stabilized in females younger than 45.Endnote 182

Maintaining a healthy weight and being physically active may represent opportunities for modifying the risk of uterine cancer in Canada.

Page details

Date modified: