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Gynecologic Cancer Awareness Month Draws Attention to Disparities in Endometrial Cancer

September 22, 2022

Every year, more than 100,000 women are diagnosed with gynecologic cancer. These cancers can affect women of all ages, ethnicity, and lifestyle regardless of family history. It is important to know the risk factors, steps for prevention, and symptoms that may lead to decreased incidence and increased survival.

Gynecologic cancer is any cancer that starts in a woman’s reproductive system, including:

  • Cervical Cancer: Cervical cancer is the only gynecological cancer type with a screening test. Pap smears can detect cervical cancer, and women should talk to their doctors about the frequency in which they should be getting pap smears, depending on their age and risk.
  • Ovarian Cancer: Ovarian cancer is the leading cause of gynecologic cancer deaths. A woman’s lifetime risk of developing ovarian cancer is one in 78.
  • Vaginal Cancer: Vaginal cancer is rare and accounts for one to two percent of gynecologic cancers.
  • Vulvar Cancer: In the United States, vulvar cancer accounts for nearly six percent of cancers of the female reproductive organs and 0.7 percent of all cancers in women.
  • Endometrial Cancer: Endometrial cancer is the most common gynecologic cancer, and the only one that is increasing in both incidence and deaths. The mortality rate for endometrial cancer is also twice as high for Black women as it is for white women.

The mortality rate of endometrial cancer has been increasing by nearly two percent per year, with even sharper spikes among Black, Hispanic, and Asian women. In recognition of Gynecologic Cancer Awareness Month (GCAM) in September, Noelle Cloven, M.D., a gynecologic oncologist at Texas Oncology–Fort Worth Cancer Center, shares how endometrial cancer disproportionately affects women of color and what women can do to lower their risk of endometrial cancer.

Black women with endometrial cancer have an increased risk of death compared to white women. Why is that? Is race a risk factor for endometrial cancer?

Black women are frequently diagnosed at later stages with more aggressive subtypes of endometrial cancer (including non-endometroid uterine cancer), but some studies show the increased risk of death persists regardless of stage or subtype of uterine cancer. The disparity in endometrial cancer deaths is not fully understood, but it may relate to genetic or socioeconomic factors such as the disproportionate accessibility to cancer care. It is imperative Black women are included in clinical trials so new cancer therapies and management strategies are effective across ethnically diverse populations.

What type of treatments are available for endometrial cancer and how has treatment evolved?

There have been significant advances in endometrial cancer treatment which allow for more individualized care and improved quality of life. Surgery for newly diagnosed endometrial cancer is now typically performed using minimally invasive methods leading to a faster recovery with less post-operative pain. Also, sentinel lymph node mapping allows surgeons to remove fewer lymph nodes with less risk of long-term complications, such as lymphedema. For women whose endometrial cancer is advanced or recurrent, treatment has evolved toward more targeted therapies such as immunotherapy or hormonal therapy, which are based off the specific factors identified by genetic and molecular testing.

What can women do to lower their risk of endometrial cancer?

Obesity is the biggest contributing factor to the development of endometrial cancer. Maintaining a healthy weight and active lifestyle not only decreases your chances of developing endometrial cancer but may also decrease the risk of recurrence in women who were previously diagnosed. Although most cases are sporadic, approximately 10 percent of endometrial cancers are hereditary. Therefore, it is important for women to know their family history and consider genetic testing if one or more first-degree family members have been treated for endometrial, ovarian, or colon cancer.

The use of combination-type birth control pills may lower the risk of endometrial cancer by 40 percent. Additionally, if you are post-menopausal and on hormone replacement therapy, it is highly encouraged to also take progesterone, as unopposed estrogen significantly increases the risk of endometrial cancer.

What resources are available to patients who have been diagnosed with gynecologic cancer?

As a result of clinical trials, there have been three new drugs approved for endometrial cancer in the last few years. Texas Oncology is currently offering clinical trials for patients with endometrial cancer, and other resources to help locate clinical trials include ClinicalTrials.gov, GOG Foundation, and U.S. Oncology’s Trial Finder. Additionally, the Foundation for Women’s Cancer provides support and educational resources for women with gynecological cancer.

For upcoming webinars visit www.TexasOncologyFoundation.org.