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Uterine (Endometrial) Cancer

Uterine cancer, also known as endometrial cancer, is a disease that forms in the endometrium, which is the tissue lining the uterus. Type 1 endometrial carcinomas are associated with obesity and excess estrogen; they tend to present at an early stage and have a better prognosis. Type 2 endometrial carcinomas are not due to estrogen stimulation and are more likely to be higher grade with a poorer prognosis. 

Uterine cancers that start in the muscle layer or connective tissue belong to another group of cancers called sarcomas. Cervical (uterine cervix) cancer begins in the cervix and can spread to the uterus, but is distinct from uterine cancer that starts in the uterus itself. 

Statistics

  • In 2023, 66,200 new cases of uterine cancer are expected to be diagnosed in the United States.
  • This year, 13,030 estimated deaths in the U.S. will occur due to uterine cancer. 
  • Among Texas women, 4,460 new cases of uterine cancer are expected to be diagnosed in 2023.
  • In Texas this year, 930 deaths are expected from uterine cancer. 

Risk Factors

  • Age: Uterine cancer is most prevalent in women over age 50; the average age at time of diagnosis is 60. 
  • Obesity or Being Overweight: Obesity is defined as body mass index (BMI) at or above 30 and can easily be determined with an online calculator. Excess adipose or fat tissue can increase a woman’s estrogen levels and increase the risk of endometrial cancer.  
  • Estrogen Exposure: Lifetime estrogen exposure can vary between women.  Women can experience increased estrogen exposure in a number of ways such as taking medications that contain estrogen during and after menopause, late onset menopause, having no history of pregnancy, starting menses before age 12, polycystic ovary syndrome, and granulosa cell tumors. 
  • Tamoxifen Usage: A prescription drug used to treat or reduce the risk of breast cancer, tamoxifen slightly raises risk of uterine cancer because it has an estrogen-like effect on the uterus.  
  • Previous Cancer: Previous breast, colon, or ovarian cancer correlates with increased risk for uterine cancer. Women with any of these cancers may have a genetic risk factor and should discuss genetic counseling and testing with their physician.   
  • Radiation Treatment: Previous pelvic radiation can increase the risk of a rare uterine cancer called a sarcoma. 
  • Family History and Health Conditions: Women with diabetes mellitus, metabolic syndrome, endometrial hyperplasia, or whose families have a history of endometrial cancer, Lynch syndrome, or hereditary non-polyposis colorectal cancer (HNPCC) are at a higher risk.

Symptoms

The following symptoms could be indications of uterine cancer, but may be related to other health conditions. A physician should be consulted immediately for further evaluation.

  • Abnormal uterine bleeding, spotting, or discharge, especially postmenopausal or intermenstrual bleeding.
  • Change in menstrual bleeding, usually heavier bleeding.
  • Pain during sex or urination, or pain in the abdomen or pelvic area.
  • Pain in the pelvic area or abdomen. 
  • Unexpected weight loss.

Tips for Prevention and Early Detection

To help prevent uterine cancer, women should maintain a healthy weight and exercise regularly. Intrauterine devices that deliver progestin, progestin-only oral contraceptives, pregnancy, and breast feeding also reduce risk. 

Pap tests are not used to screen for uterine cancer; however uterine cancer occasionally can be detected through Pap tests by finding abnormal glandular cells. Diagnosis of endometrial cancer is typically made by an endometrial biopsy done in a doctor’s office. Occasionally dilation and curettage (D&C) – the removal of tissue samples from the uterus – is required. Rarely a sonogram or CT scan may be included in the evaluation as well.

Treatment Options

Treatments used to fight uterine cancer include surgery, radiation therapy, chemotherapy, hormone therapy, immunotherapy, and targeted therapy. Women diagnosed with uterine cancer should consult with a medical or gynecologic oncologist to discuss best treatment options.

Sources: American Cancer Society, American College of Obstetricians and Gynecologists, American Society of Clinical Oncology, and National Cancer Institute


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