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18 - Endometrial cancer: prevention, screening, and early detection

from Part IV - Cancer prevention

Published online by Cambridge University Press:  21 August 2009

By
Ellen Sakornbut
Edited by
Jo Ann Rosenfeld
Ellen Sakornbut
Affiliation:
University of Iowa
Jo Ann Rosenfeld
Affiliation:
The Johns Hopkins University
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Summary

Case: T.H. is a 48-year-old woman who has not had a menstrual period in seven months, when she comes into the office with a sudden heavy menstrual period that has already lasted ten days. She has had to use three boxes of pads, and up to one pad an hour at its most heavy flow. She has had no pain but wonders what is happening to her. She does not smoke, is moderately overweight (body mass index (BMI) 31.0), and had normal thyroid tests three months ago.

Introduction

Endometrial carcinoma is one of the most common cancers in women, with an incidence of 2.6%. It ranks behind breast cancer and colon cancer in incidence, but it is seen more commonly than ovarian cancer. Endometrial carcinoma may be preceded by endometrial hyperplasia. Hyperplasia, as a potentially precancerous condition, and endometrial carcinoma meet criteria for conditions that benefit from early detection. Effective, reasonably tolerated treatments of endometrial hyperplasia and early-stage endometrial carcinoma are available. Early treatment has a significant impact on outcome.

Endometrial carcinoma and hyperplasia present most frequently with abnormal uterine bleeding, either in the premenopausal and perimenopausal age group, or in postmenopausal women. This is a common complaint in mid-life women. The presence of vaginal bleeding is also monitored in many women during mid life by clinicians concerned with the side effects of hormonal therapy or in high-risk women, such as those undergoing treatment with tamoxifen following breast cancer diagnosis.

Keywords

endometrial biopsyendometrial carcinomaendometrial hyperplasiahormonetherapyPipellesalpingoophorectomyunopposed estrogenhysterectomy
Type
Chapter
Information
Women's Health in Mid-Life
A Primary Care Guide
 , pp. 293 - 310
Publisher: Cambridge University Press
Print publication year: 2004

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