Endometrial cancer

Endometrial cancer.
Other namesUterine cancer
A diagram of the location and development of endometrial cancer
The location and development of endometrial cancer
SpecialtyOncology, gynecology
SymptomsVaginal bleeding, pain with urination or sexual intercourse, pelvic pain[1]
Usual onsetAfter menopause[2]
Risk factorsObesity, excessive estrogen exposure, high blood pressure, diabetes, family history[1][3]
Diagnostic methodEndometrial biopsy[1]
TreatmentAbdominal hysterectomy, radiation therapy, chemotherapy, hormone therapy[4]
PrognosisFive-year survival rate ~80% (US)[5]
Frequency3.8 million (total affected in 2015)[6]
Deaths89,900 (2015)[7]

Endometrial cancer is a cancer that arises from the endometrium (the lining of the uterus or womb).[1] It is the result of the abnormal growth of cells that have the ability to invade or spread to other parts of the body.[8] The first sign is most often vaginal bleeding not associated with a menstrual period.[1] Other symptoms include pain with urination, pain during sexual intercourse, or pelvic pain.[1] Endometrial cancer occurs most commonly after menopause.[2]

Approximately 40% of cases are related to obesity.[3] Endometrial cancer is also associated with excessive estrogen exposure, high blood pressure and diabetes.[1] Whereas taking estrogen alone increases the risk of endometrial cancer, taking both estrogen and a progestogen in combination, as in most birth control pills, decreases the risk.[1][3] Between two and five percent of cases are related to genes inherited from the parents.[3] Endometrial cancer is sometimes called "uterine cancer", although it is distinct from other forms of cancer of the uterus such as cervical cancer, uterine sarcoma, and trophoblastic disease.[9] The most frequent type of endometrial cancer is endometrioid carcinoma, which accounts for more than 80% of cases.[3] Endometrial cancer is commonly diagnosed by endometrial biopsy or by taking samples during a procedure known as dilation and curettage.[1] A pap smear is not typically sufficient to show endometrial cancer.[4] Regular screening in those at normal risk is not called for.[10]

The leading treatment option for endometrial cancer is abdominal hysterectomy (the total removal by surgery of the uterus), together with removal of the Fallopian tubes and ovaries on both sides, called a bilateral salpingo-oophorectomy.[4] In more advanced cases, radiation therapy, chemotherapy or hormone therapy may also be recommended.[4] If the disease is diagnosed at an early stage, the outcome is favorable,[4] and the overall five-year survival rate in the United States is greater than 80%.[5]

In 2012, endometrial cancers newly occurred in 320,000 women and caused 76,000 deaths.[3] This makes it the third most common cause of death in cancers which only affect women, behind ovarian and cervical cancer.[3] It is more common in the developed world[3] and is the most common cancer of the female reproductive tract in developed countries.[4] Rates of endometrial cancer have risen in a number of countries between the 1980s and 2010.[3] This is believed to be due to the increasing number of elderly people and increasing rates of obesity.[11]

Video overview of endometrial cancer[12]
  1. ^ a b c d e f g h i "General Information About Endometrial Cancer". National Cancer Institute. 22 April 2014. Archived from the original on 3 September 2014. Retrieved 3 September 2014.
  2. ^ a b Kong A, Johnson N, Kitchener HC, Lawrie TA (April 2012). Kong A (ed.). "Adjuvant radiotherapy for stage I endometrial cancer". The Cochrane Database of Systematic Reviews. 2012 (4): CD003916. doi:10.1002/14651858.CD003916.pub4. PMC 4164955. PMID 22513918.
  3. ^ a b c d e f g h i International Agency for Research on Cancer (2014). World Cancer Report 2014. World Health Organization. Chapter 5.12. ISBN 978-92-832-0429-9.
  4. ^ a b c d e f "Endometrial Cancer Treatment (PDQ®)". National Cancer Institute. 23 April 2014. Archived from the original on 3 September 2014. Retrieved 3 September 2014.
  5. ^ a b "SEER Stat Fact Sheets: Endometrial Cancer". National Cancer Institute. Archived from the original on 6 July 2014. Retrieved 18 June 2014.
  6. ^ GBD 2015 Disease and Injury Incidence and Prevalence Collaborators (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  7. ^ GBD 2015 Mortality and Causes of Death Collaborators (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  8. ^ "Defining Cancer". National Cancer Institute. 17 September 2007. Archived from the original on 25 June 2014. Retrieved 10 June 2014.
  9. ^ "What You Need To Know: Endometrial Cancer". NCI. National Cancer Institute. Archived from the original on 8 August 2014. Retrieved 6 August 2014.
  10. ^ Hoffman BL, Schorge JO, Schaffer JI, Halvorson LM, Bradshaw KD, Cunningham FG, eds. (2012). "Endometrial Cancer". Williams Gynecology (2nd ed.). McGraw-Hill. p. 823. ISBN 978-0-07-171672-7. Archived from the original on 4 January 2014.
  11. ^ Hoffman BL, Schorge JO, Schaffer JI, Halvorson LM, Bradshaw KD, Cunningham FG, eds. (2012). "Endometrial Cancer". Williams Gynecology (2nd ed.). McGraw-Hill. p. 817. ISBN 978-0-07-171672-7. Archived from the original on 4 January 2014.
  12. ^ "Uterine Cancer - Cancer Stat Facts". SEER. Retrieved 3 February 2019.