Endometrial Cancer and Obesity Trends in the United States in the 21st Century.

5507 Background: Using two comprehensive national databases, we explore trends in obesity and endometrial cancer rates in the United States. Methods: Data on endometrial adenocarcinoma were obtained from the United States Cancer Statistics (USCS) from 2001-2018 and corrected for hysterectomy and pregnancy using Behavioral Risk Factor Surveillance System data. Data on obesity was collected from the National Health and Nutrition Examination Survey (NHANES) database from 1988-2018. Average annual percentage changes (AAPC) were used to describe trends. SEER*Stat 8.3.9.2 and Joinpoint regression program 4.9.0.0 were used for statistical analysis. Results: Using USCS data, 615,656 cases of endometrial adenocarcinoma were identified from 2001-2018. The annual increase in endometrial cancer is as follows: Hispanic 1.37% (p<0.0001), Black 1.30% (p<0.0001), and White: -0.17 (p=0.656). Women aged 20-29 have a 4.48% annual increase (p<0.0001) and women aged 30-39 have a 3.00% annual increase (p<0.0001). On intersection analysis, Hispanic women have the largest rate of increase in the 30-39 age group at 4.67% (p<0.0001), followed by Black women, 3.85% (p<0.0001), and White women 2.12% (p=0.02). In the 20-29 age group, rates of endometrial adenocarcinoma are increasing in White women at 4.79% (p<0.0001) and in Hispanic women 4.29% annually (p<0.0001) (Table). Using the NHANES data, the prevalence of obesity in 2018 in adult women is as follows: Black 56.8%, Hispanic 44.1%, and White 40.9%. Rates of obesity for all women are rising 4.6% yearly since 1988 (p<0.05). Class III obesity rates are rising at 9.19% annually (p<0.05). When looking at trends by age, the 20–29 year old women have the highest annual rise in obesity compared to other age groups (AAPC 7.36%, p<0.05). Rates of Class III obesity are increasing at the highest rate in this group as well (AAPC 14.22%, p<0.05). In the 30–39 year old age group, Class III obesity has been increasing 9.48% annually, p<0.05. Conclusions: The current data demonstrate a temporal association between the increasing incidence of endometrial cancer and obesity, and this effect disproportionately impacts younger women and women of color. While additional research is required to confirm a causal relationship, these data warrant targeted health services and public health interventions to stabilize and ultimately reverse the concomitantly rising rates of obesity and endometrial cancer. [Table: see text]