In 2007, an estimated 39,080 women will be diagnosed with uterine cancer, and approximately 7,400 women will die from this type of cancer.
The most common symptom of this type of cancer is abnormal uterine bleeding (such as someone who experiences vaginal bleeding after menopause). If a woman is still menstruating, the symptoms may include a change in her menstrual pattern such as heavier flow or spotting between periods.
The lining of the uterus, or endometrium, grows with exposure to estrogen. Therefore, prolonged exposure to estrogen increases a women's risk of endometrial cancer. Women who started their periods at a young age, experienced late menopause, who are obese, use estrogen hormone therapy alone (without progesterone), and/or have polycystic ovary syndrome (a hormonal syndrome associated with infrequent menstrual cycles, decreased fertility, increased hair growth, acne and sometimes obesity) are at greater risk for developing uterine/endometrial cancer. Women who have a family history of hereditary nonpolyposis colon cancer are also at increased risk of developing uterine/endometrial cancer.
Prevention strategies minimize a women's exposure to excess estrogen over her lifetime. Maintaining a healthy body weight and using progesterone during hormone replacement therapy, when a woman still has her uterus, decreases the risk of endometrial cancer. The use of oral contraceptive pills also decreases a women's risk because they stop ovulation (when a mature egg is released from the ovary) and decrease the total amount of estrogen to which a women is exposed. Interestingly, each time a woman gets pregnant her risk of endometrial cancer decreases. During pregnancy, progesterone levels are higher relative to estrogen and therefore the women's lifetime exposure to estrogen is lower.
Women at high risk for endometrial cancer (individuals 35 years of age and older with a family history of hereditary nonpolyposis colon cancer) are the only people who need to be screened routinely.
Diagnosis and Treatment:
If a woman experiences abnormal uterine bleeding, the initial evaluation is usually an endometrial biopsy. An endometrial biopsy is performed during a pelvic exam and a small sample of the lining of the uterus is taken for laboratory examination. The biopsy procedure is usually relatively painless, but it may cause some mild cramping.
If abnormal cells are noticed with the biopsy, a Dilatation and Curettage (D&C) may be performed (a procedure where the lining of the uterus is scraped). Typically, a woman is asleep during a D&C, but she often will go home that day. Often, endometrial cancer is diagnosed when the disease is local (confined to the uterus) and can be treated with surgical removal of the cancer. However, depending on how far the cancer has advanced, surgery, radiation, hormone therapy and chemotherapy may also be necessary.
Because a woman's first symptoms of endometrial cancer are usually uterine bleeding, many women are diagnosed with this cancer before it has spread. Therefore, there is usually a good prognosis. 92% of women will survive 1 year after being diagnosed with this type of cancer. The survival rate for women 5 years out from diagnosis is 96% if the cancer was diagnosed locally. If the endometrial cancer has spread to other areas in the pelvis (e.g., ovaries) at the time of diagnosis, then a woman's chance of living 5 years is 67%. However, if the cancer already metastasized (spread throughout the body) then a woman's chance of living 5 years is 23%