Epidemiological trends in uterine corpus malignancies in Belarus: A 30-year analysis (1993-2022)

The current study examined 30-year trends in uterine corpus malignancies (UCMs) in Belarus, where incidence rates (24.3 of 100 000) significantly exceed those in the United States (22.5 of 100 000; P < 0.001). Notably, 15%-25% of cases occurred in reproductive-aged women (15-49 years), presenting unique clinical challenges.

We analyzed population-based data from the Belarusian Cancer Registry, encompassing all UCM cases (International Classification of Diseases, Tenth Revision [ICD-10], codes C54-C55). The study included demographic, tumor, and treatment data, with 97.9% morphological verification. Statistical analyses comprised age-standardized incidence and mortality rates, 5-year relative survival estimates, and annual percentage changes for trend assessment.

The number of UCM cases increased 2.7-fold (from 928 in 1993-2539 in 2022; p < 0.001), with age-standardized incidence rates rising from 12.2 to 27.1 per 100 000 (+122.1%, p < 0.001). Among reproductive-aged women, incidence increased from 5.9 to 13.5 per 100 000 (+128.8%, p < 0.001), driven primarily by women aged 35-49 years. Early-stage (I or II) diagnoses improved significantly, from 78.5% in 1993 to 86.2% in 2022 (p = 0.003). The 5-year relative survival rate in reproductive-aged women rose from 82.5% (1993-1997) to 90.8% (2018-2022) (p < 0.001), reaching 100% in the youngest cohort (15-34 years) in 2018-2022. Younger women exhibited higher sarcoma rates (12.5% vs. 4.3% in older women; p < 0.001), while postmenopausal women more frequently presented with aggressive histological subtypes.

The current study highlights a significant increase in UCM incidence in Belarus, particularly among younger women, likely attributable to nondemographic factors (e.g., obesity and environmental exposures). Improved early detection and treatment have enhanced survival, especially in reproductive-aged women. However, unmet needs remain, including fertility-sparing approaches for younger patients and tailored therapies for older women. These findings underscore the importance of sustained cancer registry surveillance and policy adjustments to optimize UCM management.