Laura J. Havrilesky

Supplemental Table 5: Objective function inputs.

Supplemental Table 8: Observed and predicted uterine cancer incidence-based mortality.

Supplemental Table 2: Histologic groupings from SEER 18.

Supplemental Table 3: Variables available to define extent of disease and AJCC stage.

Supplemental Table 1: Model characteristics.

Supplemental Table 9: Observed and projected incidence and 5-year survival of uterine cancer overall and stratified by histology with projected trends in obesity and hysterectomy rates.

Supplemental Figure 1: Projected age adjusted uterine cancer incidence and incidence-based mortality among women aged 40+ stratified by race and ethnicity to 2050.

Background: To develop a natural history model for uterine cancer calibrated to population-based incidence and mortality data to project future trends in the disease through 2050. Methods: We developed a state-transition microsimulation model of uterine cancer. The model begins at 18 years of age and simulates Black and White patients, includes transition states for precursor lesions, and separately models endometrioid and nonendometrioid tumors. The model was calibrated to population-based incidence and mortality data using parameter extrapolation. Results: The model closely fit population-based incidence and mortality data of uterine cancer. From 2020 to 2050, the incidence of uterine cancer is projected to increase in White women to 74.2 cases per 100,000 (compared with 57.7 cases per 100,000 in 2018) and increase to 86.9 per 100,000 (compared with 56.8 cases per 100,000 in 2018) in Black women. Among White women, incidence-based mortality will increase from 6.1 per 100,000 in 2018 to 11.2 per 100,000 in 2050, whereas incidence-based mortality in Black women will increase from 14.1 per 100,000 to 27.9 per 100,000. Endometrioid tumors are expected to increase considerably in both White and Black women; White women will experience only a slight increase in nonendometrioid tumors, whereas the incidence of these tumors will increase substantially in Black women. Conclusions: The incidence and mortality of uterine cancer are projected to increase substantially over the next three decades. Black women will experience a disproportionate increase in the disease. Impact: Projecting the incidence and mortality of uterine cancer can facilitate future cancer control efforts.

Supplemental Table 4: Transition bounds within the model.