Uterine Serous Carcinoma Is Almost Exclusively a Postmenopausal Disease

A large, population-based study presented at the Society of Gynecologic Oncology 2025 Annual Meeting on Women’s Cancer in Seattle, WA, revealed new information about uterine serous carcinoma (USC). Long considered a cancer associated with older women, new data from more than 740,000 cases in the National Cancer Database now clarifies that it is not simply age, but postmenopausal status itself, that delineates USC risk — a distinction with direct implications for risk assessment and early detection strategies.

Among 42,620 women diagnosed with USC from 2004 to 2021, only 2% were younger than 52 years of age — the average age of menopause — and 0.5% were younger than 45 years of age, the cutoff for early menopause. This pattern starkly contrasts with the age distributions of other gynecologic malignancies included in the analysis. For instance, 16.7% of endometrial endometrioid adenocarcinomas, 15.3% of high-grade serous ovarian cancers, 56.3% of cervical cancers, and 20.4% of vulvar squamous cell carcinomas were diagnosed before age 52. Even when stratified by race, the overwhelming postmenopausal predominance of USC held firm, including 98.5% of USC cases among Black women older than 52 years of age.

These findings demonstrate that USC is not merely associated with advancing age but with the postmenopausal state itself, unlike other endometrial cancers.

“This suggests postmenopausal status or related risk factors encountered during this timeframe may be etiologically relevant for USC risk,” the study authors wrote. “These findings should guide research in the early carcinogenic events specific to USC, and these data have implications for early detection and screening paradigms for this rare and aggressive disease.”

Reference:
Baker R. Is uterine serous carcinoma an exclusively postmenopausal disease? Unveiling a distinct age-specific oncologic pattern. Paper presented at: Society of Gynecologic Oncology 2025 Annual Meeting on Women’s Cancer; March 14-17, 2025; Seattle, WA. Accessed March 11, 2025. https://www.sgo.org/events/annual-meeting/