As years go by, most women who have surgery for endometrial cancer (EC) are increasingly likely to die from other causes than from the disease, a study published in Scientific Reports found, highlighting the importance of long-term care beyond cancer surveillance.
Researchers analyzed data on 255,104 women who underwent hysterectomy-based definitive surgery (uterus removal) for EC between 2000 and 2021.
Sign up here to get the latest news, perspectives, and information about endometrial cancer sent directly to your inbox. Registration is free and only takes a minute.
The study aimed to determine when the cumulative risk of dying from other causes overtakes that of dying from EC, and how this timing varies across patient groups. It also assessed the risk of death from different causes among women who had already survived five or 10 years after diagnosis.
Read more about EC prognosis
For the study population overall, the cumulative risk of death from other causes overtook the risk of death from EC at 5.6 years after diagnosis — meaning that after about five and a half years, women were more likely to die from a cause other than EC.
This happened earlier in women with stage I or II disease, at 4.8 years. In women with stage III or IV disease, however, this shift did not occur within the analysis’ cap of 15 years after diagnosis — after 15 years, they were still more likely to die of EC than other causes.
For women in the study overall, at 15 years after diagnosis the cumulative risk of death from EC was 7.4%, compared with 28.3% from other causes. Other causes of death included cardiovascular disease, other cancers and other noncancer causes.
Among women who had survived 10 years after diagnosis, the risk of dying from EC over the next five years was 0.4%, compared with 15.3% for other causes. Cardiovascular disease alone accounted for a 7.7% risk of death.
The database lacked detailed information on existing health conditions, lifestyle and cancer recurrence, so the analysis could not account for how these factors may have contributed to the deaths. The study also included only women who underwent surgery and whose cancer hadn’t spread to distant organs or lymph nodes, so the results do not apply to all women with EC.
The authors suggested that alongside cancer follow-up, doctors should address cardiovascular and metabolic risk factors, such as high blood pressure, elevated blood sugar and abnormal cholesterol levels. “These results support cardiometabolic prevention from diagnosis alongside risk-adapted oncologic surveillance,” they wrote.
