Incidence of endometrial carcinoma in King County, Washington: a standardized histologic review

Previously diagnosed tumor specimens from 35- to 74-year-old female patients with endometrial cancer who were residents of King County, Washington, during the first 6 months of 1975 were reviewed by a single pathologist using uniform criteria for the assessment of cancer. Routinely reported incidence of this tumor in this population was judged to be inflated, the annual incidence rate (excluding carcinoma in situ) falling from 108.2 to 88.5 per 100,000 women after the exclusion of cases found not to be unequivocally malignant. This rate nonetheless represented a large increase over the rate of 47.3 per 100,000 observed in the U.S. Third National Cancer Survey just 5 years earlier. We concluded that U.S. pathologists in the 1970's may have been using more liberal criteria by which to diagnose endometrial cancer, but that such a change could only account for a small part of the rising incidence of the disease.