An Overview of Uterine Cancer

Introduction
Uterine cancer is the most common gynecologic malignancy in the United States and the 4th leading new cancer diagnosis in females. This year, an estimated 63,230 women will be diagnosed with uterine cancer. There is an 81.1% five -year survival rate and early detection is the key. If the cancer is found in stage one, the five-year survival rate is 94.9%. New uterine cancer rates are increasing an average of 1.3% every year and has been for the past 10 years.

Unlike many other cancers, uterine cancer (specifically endometrial cancer) has warning signs and can lead to early diagnosis and early treatment, which often leads to a complete cure.

What is endometrial cancer?
The most common form of uterine cancer is also called endometrial cancer. The lining of the uterus is known as the endometrium, and is the layer of the uterus that sheds when a female is menstruating. These cells can undergo hyperplasia if not shed regularly. After many years, this hyperplasia can become endometrial cancer.

Risk Factors

Age: Endometrial cancer usually begins in women over 50 and the average age of diagnosis is 60.

Obesity: Over 40% of uterine cancer is linked to obesity. Fat cells produce a weak estrogen that can make the lining of the uterus grow and become hyperplastic; which, in turn, can become endometrial cancer.

Race: Uterine cancer is more common in Caucasian females.

Genetics: Uterine cancer is typically not genetic but can run in families. For example, Lynch syndrome (also called hereditary non-polyposis colorectal cancer [HNPCC]) is genetic and has a link with endometrial cancer.

Diabetes: Women with diabetes have an increased risk.

Unopposed or extended exposure to estrogen: Early onset of periods, late menopause and no pregnancies can increase risk of uterine cancer.

Prevention
Preventing uterine cancer can include taking birth control pills, using a progestin IUD, and maintaining a healthy weight.

Signs/Symptoms of Uterine cancer
Endometrial cancer typically presents with abnormal uterine bleeding and is more common in postmenopausal women. If a postmenopausal woman has bleeding, she should be seen as soon as possible. Occasionally, endometrial cancer can be picked up on a routine pap smear—but this is not typical.

Diagnosis
Diagnosis is typically through an endometrial biopsy, which is usually done in the gynecologist's office. It can also be diagnosed from a dilation and curettage and sometimes diagnosed incidentally at the time of a hysterectomy. Imaging such as ultrasound, CT, or MRI can help locate uterine cancer, but it can only be diagnosed by tissue.

Treatment
As with most other cancers, treatment depends on staging of the disease at time of diagnosis. As mentioned previously, if the cancer is very early stage the survival rate is very high, and treatment would be a simple hysterectomy. If the disease has progressed, radiation and chemotherapy are done in addition to the surgical resection of cancer at time of staging.

Conclusion
Staying healthy and looking for warning signs are our best defenses against uterine cancer. Seeing your gynecologist on a regular basis and seeking help early are keys to survival.

References
American Cancer Society
Centers for Disease Control and Prevention
NIH National Cancer Institute Seer Database