Endometrial cancer has continued to see a rising incidence in the US over the years. The main aim of this study was to assess current trends in patients’ characteristics and outcomes of treatment for endometrial carcinoma over 16 years. A dataset from the National Cancer Database (NCDB) for patients diagnosed with endometrial carcinoma from 2005 to 2020 was used in this retrospective, case series study. The main outcomes and measures of interest included tumor characteristics, hospitalization, treatments, mortality, and overall survival. Then, 569,817 patients who were diagnosed with endometrial carcinoma were included in this study. The mean (SD) age at diagnosis was 62.7 (11.6) years, but 66,184 patients (11.6%) were younger than 50 years, indicating that more patients are getting diagnosed at younger ages. Of the patients studied, 37,079 (6.3%) were Hispanic, 52,801 (9.3%) were non-Hispanic Black, 432,058 (75.8%) were non-Hispanic White, and 48,879 (8.6%) were other non-Hispanic. Patients in the 4th period from 2017 to 2020 were diagnosed more with stage IV (7.1% vs. 5.2% vs. 5.4% vs. 5.9%; p < 0.001) disease compared with those in the other three periods. More patients with severe comorbidities (Charlson Comorbidity Index score of three) were seen in period 4 compared to the first three periods (3.9% vs. ≤1.9%). Systemic chemotherapy use (14.1% vs. 17.7% vs. 20.4% vs. 21.1%; p < 0.001) and immunotherapy (0.01% vs. 0.01% vs. 0.2% vs. 1.1%; p < 0.001) significantly increased from period 1 to 4. The use of laparotomy decreased significantly from 42.1% in period 2 to 16.7% in period 4, while robotic surgery usage significantly increased from 41.5% in period 2 to 64.3% in period 4. The 30-day and 90-day mortality decreased from 0.6% in period 1 to 0.2% in period 4 and 1.4% in period 1 to 0.6% in period 4, respectively. Over the period studied, we found increased use of immunotherapy, chemotherapy, and minimally invasive surgery for the management of endometrial cancer. Overall, the time interval from cancer diagnosis to final surgery increased by about 6 days. The improvements observed in the outcomes examined can probably be associated with the treatment trends observed.

Opioids and benzodiazepines (BZD) are commonly prescribed for older cancer survivors with co-occurring pain and anxiety. The prescribing rate of gabapentinoids (GABA), Selective Serotonin Reuptake Inhibitors (SSRIs), and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) in the general population has increased as opioid/BZD alternatives, but little is known on temporal/regional trends in use of these alternatives among older cancer survivors. A retrospective cohort study using SEER-Medicare data was conducted. Patients aged ≥ 66 years, diagnosed with breast, colorectal, prostate, or lung cancer as their first cancer diagnosis any time from 2000 to 2015 and who were alive more than 5 years after cancer diagnosis, were eligible for inclusion. Temporal trends varied by region (p < 0.0001) and opioid-naïve status (p < 0.0001). Compared to 2013, GABA and SNRI use increased, while BZD and opioid use decreased. All regions experienced declines in opioid use. From 2013 to 2018, all regions saw an increase in GABA use, with a decline in 2020. GABA prescriptions increased more in opioid-naïve groups compared to non-opioid-naïve patients. The yearly trends in GABA and SSRI/SNRI use varied by region among older cancer survivors. Clinical practice variation suggests needs for further research on improving consistency and quality of cancer care.