When Metabolism Meets Malignancy: Two Decades of Endometrial Cancer Mortality in the Context of Metabolic Syndrome Epidemic Among Postmenopausal Women [ID 3674]

INTRODUCTION: Various studies have reported direct associations between endometrial cancer (EC) risk and individual components of the metabolic syndrome (MetS), ie, obesity, diabetes, hypertension, and dyslipidemia. Still, few epidemiological studies have examined the association with MetS overall. This study aims to address this gap by identifying high-risk populations across racial and geographic lines. METHODS: Mortality data from CDC WONDER (1999–2023) were analyzed using Joinpoint regression to evaluate EC- and MetS-related deaths in U.S. women aged 65+. Age-adjusted mortality rates (AAMRs) per 100,000 and average annual percent change (AAPC) with 95% CIs were calculated. RESULTS: A total of 14,011 deaths occurred among older women (65+) with EC and MetS from 1999 to 2023. Thirty-seven percent were reported in the decedent’s residences. The overall AAMR more than doubled from 1.53 in 1999 to 3.75 in 2023 (AAPC: 3.04; P <.00001). Non-Hispanic (NH) Blacks had a 95% higher AAMR than NH Whites (3.9 versus 2.0), while NH Whites had a steeper rise over the study period (AAPC: 3.6 versus 2.8). Midwestern regions had the highest AAMR (2.63), while Western and Southern regions showed the steepest increases (AAPC: 3.9). Rural areas had higher AAMRs than urban areas (2.4 versus 1.8). However, metropolitan areas experienced a faster rise (AAPC: 2.7 versus 1.8). CONCLUSIONS/IMPLICATIONS: MetS-related mortality in postmenopausal women with EC has risen sharply over the past two decades, with marked racial and geographic disparities. These findings underscore the need for targeted prevention and management strategies in high-risk populations.