Uterine Cancer is the most common gynecologic cancer in the United States. About 65,950 new cases of uterine cancer are diagnosed in the United States each year. The incidence and the mortality rate have been increasing since 2007. This rise in uterine cancer rates is attributed to the rise of obesity. Obesity is the leading risk factor for uterine cancer. It is most commonly diagnosed between the ages of 55 and 64.There are 2 main categories of uterine cancer. 97percent are endometrial cancers ( a cancer that forms in the lining, also called the endometrium ,of the uterus) and 3 percent are sarcomas. This article concentrates on the more common endometrial cancer.
Risk factors for the development of uterine cancer are influenced by hormones. Starting menstruation before the age of 12, never having a pregnancy or giving birth for the first time after the age of 30, and late menopause all expose the body to estrogen for a longer period of time and raise the risk for uterine cancer development. Lynch syndrome, also called hereditary nonpolyposis colorectal cancer (HNPCC) is an inherited disorder that can be passed from parent to child and is associated with a genetic predisposition to different cancer types including uterine cancer. Women who are positive for BRCA1 gene mutation are at a higher risk for uterine cancer.The use of Tamoxifen for breast cancer patient treatment has about a 1 in 500 risk , obesity (a BMI >30) and increasing age are all risks. Diabetes, chronic anovulation ( having four or less menstrual periods in a year before starting perimenopause), PCOS, and estrogen replacement therapy after menopause given without adequate progesterone,and diets such as a high glycemic index diet, high saturated fat intake, proinflammatory diets and high meat consumption are all risks for uterine cancer formation. A family history of uterine cancer increases the risk in 1st degree relatives.
Alcohol intake has no known risk for uterine cancer. Postmenopausal women who smoke cigarettes have a decreased risk of developing uterine cancer (although cigarettes contribute to formation of other cancers).The use of aspirin has been shown to decrease the risk of uterine cancer particularly in obese women. Pregnancy is protective, as is the use of contraceptives like progesterone containing IUDs and the use of oral contraceptive pills ( the longer you take the pill in your lifetime the greater the benefit with 4 years of pill taking cutting the risk of uterine cancer in half) . Tubal sterilization decreases the risk as well as maintaining a healthy weight and being physically active.
Common symptoms of uterine cancer are postmenopausal bleeding, bleeding between menstrual periods, and pelvic pain or pelvic pressure. There is no screening test for uterine cancer. Consult a gynecologist if you are experiencing any of these symptoms.
The diagnosis of uterine cancer occurs with a physical exam, pelvic ultrasound and a biopsy of the uterus ( endometrial biopsy).
Uterine cancer is treated in a number of different ways including surgery, chemotherapy, and radiation.