Epidemiology Of Endometrial Cancer Research Articles

Description of Endometrial Cancer Epidemiology at Sabratha National Cancer Institute, Western Libya: A 3-Year Data Analysis

Background: Endometrial cancer is the sixth most common cancer in women worldwide and the most frequent gynecological cancer in developed countries. Endometrial cancer mortality rates are high in low- and middle-income countries. Objectives: The current study aims to provide valuable insights into the epidemiology of endometrial cancer at Sabartha cancer institute over three-years periods, with the goal of identifying trends, risk factors, and potential areas for intervention. Methodology: This study is descriptive study, using data which were collected from the all primary endometrial cancers that were diagnosed or treated in the Sabratha National Cancer Institute,Western Libya. The data were collected by hospital cancer registry from 2020 to 2022. The demographic and clinical features of the patients were abstracted included registration number, age, parity, place of residence, family history, and past medical history. Descriptive statistics in form of percentage with 95% CI was used to explain distribution of cancer cases by study variables. The data was compared using Chi-Square using SPSS Statistics for Windows, Version 26. Results: The results showed that over three years period, 82 confirmed cases of endometrial cancer were registered at Sabratha National Cancer Institute. The average age of cases was 57 years. Analysis of the cases by the age group showed that about 21% of cases were from 46-55years group while over 64% were aged above 50 years. Almost of cases (25%) came from Tripoli while only 6% came from Sabratha which is the place of cancer institute. Analysis of study results by parity showed that both nulliparous women and parous women ( > 6 child) represent almost more than 50% of endometrial cancer cases during study period. Also, analysis of study results by family history of endometrial cancer showed that only 14% of cases had family history of the cancer. Conclusion: It can be concluded that the findings of this 3-year data analysis on endometrial cancer epidemiology provide valuable insights into the trends and patterns of this disease. The study highlights the importance of continued surveillance and research to better understand the risk factors, incidence rates, and outcomes associated with endometrial cancer. This information can help inform public health strategies, early detection efforts, and treatment approaches to improve patient outcomes and reduce the burden of this disease. Further research is needed to explore potential interventions and preventive measures that can address the growing impact of endometrial cancer on global health.

Endometrial Cancer. Guideline of the DGGG, DKG and DKH (S3-Level, AWMF Registry Number 032/034-OL, September 2022). Part 1 with Recommendations on the Epidemiology, Screening, Diagnosis and Hereditary Factors of Endometrial Cancer, Geriatric Assessment and Supply Structures.

Summary The S3-guideline on endometrial cancer, first published in April 2018, was reviewed in its entirety between April 2020 and January 2022 and updated. The review was carried out at the request of German Cancer Aid as part of the Oncology Guidelines Program and the lead coordinators were the German Society for Gynecology and Obstetrics (DGGG), the Gynecology Oncology Working Group (AGO) of the German Cancer Society (DKG) and the German Cancer Aid (DKH). The guideline update was based on a systematic search and assessment of the literature published between 2016 and 2020. All statements, recommendations and background texts were reviewed and either confirmed or amended. New statements and recommendations were included where necessary. Aim The use of evidence-based risk-adapted therapies to treat women with endometrial cancer of low risk prevents unnecessarily radical surgery and avoids non-beneficial adjuvant radiation therapy and/or chemotherapy. For women with endometrial cancer and a high risk of recurrence, the guideline defines the optimum level of radical surgery and indicates whether chemotherapy and/or adjuvant radiation therapy is necessary. This should improve the survival rates and quality of life of these patients. The S3-guideline on endometrial cancer and the quality indicators based on the guideline aim to provide the basis for the work of certified gynecological cancer centers. Methods The guideline was first compiled in 2018 in accordance with the requirements for S3-level guidelines and was updated in 2022. The update included an adaptation of the source guidelines identified using the German Instrument for Methodological Guideline Appraisal (DELBI). The update also used evidence reviews which were created based on selected literature obtained from systematic searches in selected literature databases using the PICO process. The Clinical Guidelines Service Group was tasked with carrying out a systematic search and assessment of the literature. Their results were used by interdisciplinary working groups as a basis for developing suggestions for recommendations and statements which were then modified during structured online consensus conferences and/or additionally amended online using the DELPHI process to achieve a consensus. Recommendations Part 1 of this short version of the guideline provides recommendations on epidemiology, screening, diagnosis, and hereditary factors. The epidemiology of endometrial cancer and the risk factors for developing endometrial cancer are presented. The options for screening and the methods used to diagnose endometrial cancer are outlined. Recommendations are given for the prevention, diagnosis, and therapy of hereditary forms of endometrial cancer. The use of geriatric assessment is considered and existing structures of care are presented.

Fact sheet: epidemiology of endometrial cancer in Germany from 2009 to 2019

Fact sheet: epidemiology of endometrial cancer in Germany from 2009 to 2019

ENDOMETRIAL CARCINOMA: NARRATIVE REVIEW

Endometrial cancer is the most common gynecological malignancy in developed countries and its incidence has been increasing over recent years. Symptoms include postmenopausal bleeding, abnormal vaginal bleeding, pelvic pain, and dyspareunia. Risk factors include obesity, unopposed estrogen exposure, family history of endometrial or ovarian cancer, and Lynch syndrome. Diagnosis is conrmed through endometrial biopsy, hysteroscopy, or dilation and curettage. Treatment options depend on the stage and grade of the cancer and may include surgery, radiation therapy, chemotherapy, or a combination. This review article summarizes the current state of knowledge on endometrial cancer, including its epidemiology, risk factors, clinical presentation, diagnostic methods, and treatment options. Recent advancements in the eld, including emerging biomarkers and targeted therapies, are highlighted. The authors conducted a systematic search of the literature on endometrial cancer, and the results were synthesized and presented using a narrative synthesis approach. The epidemiology of endometrial cancer underscores the importance of preventive mea

Epidemiology of Endometrial Cancer at a Tertiary Cancer Hospital, Hyderabad

Epidemiology of Endometrial Cancer at a Tertiary Cancer Hospital, Hyderabad

Abstract PO-150: Epidemiology of endometrial cancer as a second primary malignancy in Florida

Abstract Background: According to cancer registry data, nearly 20% of Endometrial Cancer (EC) cases in the US are second or higher-order primary cancers. Little is known in regard to the epidemiology of EC as a Second Primary (ECSP) cancer. Purpose: To compare ECSPs and EC as a first primary in relation to histological types and cause- specific survival; examine survival of ECSP according to original primary site, and treatment received for the first primary. Methods: All cases of EC diagnosed from 2005-2016 were obtained from the Florida Cancer Data System. Chi-square tests, Kaplan-Meier methods and Cox Regression were used in the analysis. Results: Of 9,002 initial ECSPs, 73% were not “clinically independent”, i.e. without treatment distinctions between first and second cancers. These included ECSPs of different histologies from a first EC, and ECSPs following ovarian and cervical cancers (<1 year). After excluding these, there were 2,401 ECSPs and 37,128 ECs as a first primary; 1,260 ECSPs followed breast cancer (BC), 299 followed colorectal cancer (CRC), and other sites(n=842). The 5-year, age-standardized cause-specific survival was 72.2% (95%CI: 71.8-72.7) for first ECs and 60.7% for ECSPs (95%CI: 58.5-63.0). However, after adjusting for age, race/ethnicity, histology, and stage there was no significant difference between ECSP and first EC (HR 0.92, 95%CI: 0.83-1.03). Post- colorectal ECSPs had lower 5-year survival (55.3%, 95%CI: 48.9-61.7) than post- breast cancer ECSPs (64.8%, 95%CI: 61.8-67.9), and significantly higher risk of EC- specific death (HR 1.78, 95%CI:1.23-2.58) in multivariable analysis. Lastly, women who had chemotherapy for both ECSP and a preceding BC did not have a higher EC- specific risk of death (HR 0.79, 95% CI: 0.46-1.36) compared to those who only received chemotherapy for EC as a first primary. Conclusions: ECSP survival is similar to that of EC as a first primary. However, ECs post-CRC may constitute a population of interest with much worse survival than those post-BC. There was no information to separately assess Lynch syndrome cases or those receiving tamoxifen as part of BC treatment. Lastly, chemotherapy for a previous BC does not seem to affect the effectiveness of chemotherapy for ECSPs. Further research is needed in the epidemiology of second cancers. Citation Format: Heidy N. Medina, Matthew P. Schlumbrecht, Paulo S. Pinheiro. Epidemiology of endometrial cancer as a second primary malignancy in Florida [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-150.

Interdisciplinary Diagnosis, Therapy and Follow-up of Patients with Endometrial Cancer. Guideline (S3-Level, AWMF Registry Nummer 032/034-OL, April 2018) - Part 1 with Recommendations on the Epidemiology, Screening, Diagnosis and Hereditary Factors of Endometrial Cancer.

Summary The first German interdisciplinary S3-guideline on the diagnosis, therapy and follow-up of patients with endometrial cancer was published in April 2018. Funded by German Cancer Aid as part of an Oncology Guidelines Program, the lead coordinators of the guideline were the German Society of Gynecology and Obstetrics (DGGG) and the Gynecological Oncology Working Group (AGO) of the German Cancer Society (DKG). Purpose The use of evidence-based, risk-adapted therapy to treat low-risk women with endometrial cancer avoids unnecessarily radical surgery and non-useful adjuvant radiotherapy and/or chemotherapy. This can significantly reduce therapy-induced morbidity and improve the patientʼs quality of life as well as avoiding unnecessary costs. For women with endometrial cancer and a high risk of recurrence, the guideline defines the optimal surgical radicality together with the appropriate chemotherapy and/or adjuvant radiotherapy where required. The evidence-based optimal use of different therapeutic modalities should improve survival rates and the quality of life of these patients. The S3-guideline on endometrial cancer is intended as a basis for certified gynecological cancer centers. The aim is that the quality indicators established in this guideline will be incorporated in the certification processes of these centers. Methods The guideline was compiled in accordance with the requirements for S3-level guidelines. This includes, in the first instance, the adaptation of source guidelines selected using the DELBI instrument for appraising guidelines. Other consulted sources include reviews of evidence which were compiled from literature selected during systematic searches of literature databases using the PICO scheme. In addition, an external biostatistics institute was commissioned to carry out a systematic search and assessment of the literature for one area of the guideline. The identified materials were used by the interdisciplinary working groups to develop suggestions for Recommendations and Statements, which were then modified during structured consensus conferences and/or additionally amended online using the DELPHI method with consent being reached online. The guideline report is freely available online. Recommendations Part 1 of this short version of the guideline presents recommendations on epidemiology, screening, diagnosis and hereditary factors, The epidemiology of endometrial cancer and the risk factors for developing endomentrial cancer are presented. The options for screening and the methods used to diagnose endometrial cancer including the pathology of the cancer are outlined. Recommendations are given for the prevention, diagnosis, and therapy of hereditary forms of endometrial cancer.

Breastfeeding and Endometrial Cancer Risk: An Analysis From the Epidemiology of Endometrial Cancer Consortium.

To investigate the association between breastfeeding and endometrial cancer risk using pooled data from 17 studies participating in the Epidemiology of Endometrial Cancer Consortium. We conducted a meta-analysis with individual-level data from three cohort and 14 case-control studies. Study-specific odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for the association between breastfeeding and risk of endometrial cancer using multivariable logistic regression and pooled using random-effects meta-analysis. We investigated between-study heterogeneity with I and Q statistics and metaregression. After excluding nulliparous women, the analyses included 8,981 women with endometrial cancer and 17,241 women in a control group. Ever breastfeeding was associated with an 11% reduction in risk of endometrial cancer (pooled OR 0.89, 95% CI 0.81-0.98). Longer average duration of breastfeeding per child was associated with lower risk of endometrial cancer, although there appeared to be some leveling of this effect beyond 6-9 months. The association with ever breastfeeding was not explained by greater parity and did not vary notably by body mass index or histologic subtype (grouped as endometrioid and mucinous compared with serous and clear cell). Our findings suggest that reducing endometrial cancer risk can be added to the list of maternal benefits associated with breastfeeding. Ongoing promotion, support, and facilitation of this safe and beneficial behavior might therefore contribute to the prevention of this increasingly common cancer.

Abstract 1751: Coffee and tea intake and risk of endometrial cancer in the Epidemiology of Endometrial Cancer Consortium (E2C2)

Abstract Background: Endometrial cancer (EC) is the most common gynecological malignancy in developed countries. Well-known risk factors for EC include obesity and elevated levels of estrogen and insulin. Coffee and tea are the most widely consumed beverages in the world, after water. Both are a complex mixture of chemicals with potential antimutagenic and antioxidant properties. Previous studies have reported an inverse association between coffee consumption and circulating levels of estrogen and C-peptide, a marker of insulin secretion, both involved in endometrial carcinogenesis. The presence of antioxidants and other chemopreventive compounds in coffee and tea may have an anticarcinogenic effect. Thus, coffee and tea drinking may decrease the risk of EC. Objective: To examine the association between coffee and tea intake and endometrial cancer risk. Patients and Methods: We combined individual-level data from 24 epidemiologic studies (10 Cohort studies, 14 Case-Control studies) from the Epidemiology of Endometrial Cancer (E2C2) Consortium and performed a pooled analysis of 11,424 endometrial cancer cases and 28,388 controls. Logistic regression models were used to calculate ORs and the corresponding 95% CI. All models were adjusted for potential confounders. Results and Conclusions: Increased coffee consumption was associated with a reduced risk of endometrial cancer: compared to non-coffee drinkers, the pooled OR for those who drank more than 1 cup of coffee per day was 0.79 (95%CI = 0.71-0.87, p = 5.48×10−6). The association is mainly observed in cohort studies and remains significant after adjusting for potential confounders. We found no association between tea consumption and endometrial cancer risk. Citation Format: Marta Crous-Bou, Epidemiology of Endometrial Cancer Consortium (E2C2), Immaculata De Vivo. Coffee and tea intake and risk of endometrial cancer in the Epidemiology of Endometrial Cancer Consortium (E2C2). [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1751.

Epidemiology and Investigations for Suspected Endometrial Cancer

ObjectiveTo review the evidence relating to the epidemiology of endometrial cancer and its diagnostic workups. OptionsWomen with possible endometrial cancer can undergo an endometrial evaluation by office biopsy, hysteroscopy, or dilatation and curettage. To assist in treatment planning, pelvic ultrasound, CT scan, or MRI may be considered. OutcomesThe identification of optimal diagnostic tests to evaluate patients with possible endometrial cancer. EvidencePublished literature was retrieved through searches of PubMed, CINAHL, and The Cochrane Library, using appropriate controlled vocabulary (e.g., endometrial neoplasms) and key words (e.g., endometrium cancer, endometrial carcinoma). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and incorporated in the guideline to December 31, 2011. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, national and international medical specialty societies, and recent conference abstracts. ValuesThe quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table). Benefits, harms, and costsThis document is intended to guide the development of a standardized cost-effective investigation of patients with suspected endometrial cancer. ValidationThe guideline was reviewed for accuracy by experts in pathology, radiation oncology, and medical oncology. Guideline content was also compared with relevant documents from the American Congress of Obstetricians and Gynecologists.

Hormonal carcinogenesis.

Hormone-related cancers, namely breast, endometrium, ovary, prostate, testis, thyroid and osteosarcoma, share a unique mechanism of carcinogenesis. Endogenous and exogenous hormones drive cell proliferation, and thus the opportunity for the accumulation of random genetic errors. The emergence of a malignant phenotype depends on a series of somatic mutations that occur during cell division, but the specific genes involved in progression of hormone-related cancers are currently unknown. In this review, the epidemiology of endometrial cancer and breast cancer are used to illustrate the paradigms of hormonal carcinogenesis. Then, new strategies for early detection and prevention of hormonal carcinogenesis are discussed. This includes developing polygenic models of cancer predisposition and the further development of safe and effective chemopreventives that block target sequence activity. We developed polygenic models for breast and prostate cancer after hypothesizing that functionally relevant sequence variants in genes involved in steroid hormone metabolism and transport would act together, and also interact with well-known hormonally related risk factors, to define a high-risk profile for cancer. A combination of genes each with minor variation in expressed activity could provide a degree of separation of risk that would be clinically useful as they could yield a large cumulative difference after several decades. The genes included in the breast cancer model are the 17beta-hydroxysteroid dehydrogenase 1 (HSD17B1) gene, the cytochrome P459c17alpha (CYP17) gene, the aromatase (CYP19) gene, and the estrogen receptor alpha (ER) gene. The prostate cancer model includes the androgen receptor gene (AR), steroid 5alpha-reductase type II (SRD5A2), CYP17 and the 3beta hydroxysteroid dehydrogenase (HSD3B2) gene. We present data from our multi-ethnic cohort to support these models.

Diet in the epidemiology of endometrial cancer in western New York (United States).

We examined diet and risk of endometrial cancer among women in the Western New York Diet Study (1986-1991). Self-reported frequency of use of 172 foods and beverages during the 2 years before the interview and other relevant data were collected by detailed interviews from 232 endometrial cancer cases and 639 controls, frequency-matched for age and county of residence. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by unconditional logistic regression, adjusting for age, education, body mass index (BMI), smoking history, hypertension, diabetes, age at menarche, parity, oral contraceptive use, menopausal status, menopausal estrogen use, and energy. Risks were reduced for women in the highest quartiles of intake of protein (OR 0.4, 95% CI: 0.2-0.9), dietary fiber (OR 0.5, 95% CI: 0.3-1.0), phytosterols (OR 0.6, 95% CI: 0.3-1.0), vitamin C (OR 0.5, 95% CI: 0.3-0.8) folate (OR 0.4, 95% CI: 0.2-0.7), alpha-carotene (OR 0.6, 95% CI: 0.4-1.0), beta-carotene (OR 0.4, 95% CI: 0.2-0.6), lycopene (OR 0.6, 95% CI: 0.4-1.0), lutein + zeaxanthin (OR 0.3, 95% CI: 0.2-0.5) and vegetables (OR 0.5, 95% CI: 0.3-0.9), but unrelated to energy (OR 0.9, 95% CI: 0.6-1.5) or fat (OR 1.6, 95% CI: 0.7-3.4). Our results support previous findings of reduced endometrial cancer risks associated with a diet high in plant foods.

Endometrial cancer.

Endometrial cancer is the most common gynecologic malignancy in the United States, with 37,400 new cases and 6400 deaths estimated to occur in 1999. The epidemiology of endometrial cancer has been widely characterized; nevertheless, efforts continue to more precisely define risk factors for the disease. Accurate epidemiologic risk factor profiles or focused screening efforts may ultimately facilitate the primary prevention of endometrial cancer. Currently, standard management of women with endometrial cancer includes surgical exploration with total hysterectomy and bilateral salpingo-oophorectomy. Uterine histopathologic characteristics and intraoperative findings continue to provide the primary indications for surgical staging in endometrial cancer. The addition of serum CA125 and selected imaging techniques (eg, transvaginal sonography with color Doppler and MR imaging) to the preoperative assessment may ultimately improve the sensitivity and specificity with which patients are selected for pathologic nodal evaluation. Various clinicopathologic factors have been evaluated as predictors of the clinical course of endometrial cancer and as selection criteria for patients most likely to benefit from adjuvant therapy. Histologic measurement of the tumor microvessel density is a promising technique for identifying patients at high risk for recurrence. Although uterine papillary serous carcinoma of the endometrium represents only 3% to 4% of endometrial cancer cases, it is of particular interest because of the aggressive clinical course and poor prognosis associated with this disease.

Epidemiology of adenocarcinoma of the cervix

There is general evidence that the incidence of adenocarcinoma of the cervix has been rising, particularly among younger women. The determinants of these trends, however, remain largely unknown. We have reviewed the epidemiology of adenocarcinoma of the cervix using descriptive data from cancer registration and clinical series and two main sources of analytical data: clinical studies comparing cervical adenocarcinoma (AC) and squamous carcinoma (SC) and formal case-control and cohort epidemiological studies. In both the United States and northern Europe there is evidence of the rising frequency of AC in absolute and relative terms as compared to SC. These trends are generally restricted to younger women: under-age-35 AC incidence approximately doubled from the early 1970s to the early 1980s. Available data, although scanty, consistently show that the frequency of cervical adenocarcinoma rises with the number of partners and with decreasing age at first intercourse, suggesting a potential role for sexually transmitted (viral) factors. In clinical series, nulliparity was reported more frequently in AC than in SC cases but an inconsistent association was found in three formal epidemiological studies. Similarities with the epidemiology of endometrial cancer are also suggested from the association with overweight, while a possible relation with hypertension and diabetes is based on clinical series only and hence more difficult to interpret. Thus, adenocarcinoma of the cervix appears to share epidemiological characteristics with both adenosquamous cancer of the cervix and adenocarcinoma of the endometrium, although uncertainties in classification and registration leave several questions unanswered.

Epidemiology of endometrial cancer

SummaryThis brief review of the epidemiology of endometrial cancer is in three sections. The first considers recent trends in incidence and mortality in the United Kingdom and in the United States, the second summarises what is known about ‘risk factors’, and the third deals with the evidence that combined oral contraceptives protect against the disease. Although not strictly correct, the terms ‘endometrial cancer’ and ‘corpus cancer’ have had to be regarded as equivalent in this article. This is because much of the available vital statistical information relates to corpus cancer in general rather than to endometrial cancer alone.

The epidemiology of endometrial cancer in young women.

A case-control study was conducted in Los Angeles County, California, of 127 endometrial cancer cases aged 45 years or less at diagnosis, to investigate the role of fertility, obesity and exogenous oestrogens in the development of the disease in young women. Use of sequential oral contraceptive (SOCs) or oestrogen replacement therapy (ERT) for greater than or equal to 2 years was strongly associated with increased risk of endometrial cancer. After excluding these cases, since the SOC or ERT use was probably the cause of their disease, we were left with 110 case-control pairs for further study. Among these remaining case-control pairs increasing parity was strongly associated with decreased risk (relative risk of 0.12 for women of parity 3 compared to nulliparous women, P less than 0.001). Current weight was associated with increased risk (relative risk of 17.7 for women weighing greater than or equal to 190 lbs compared to women weighing less than 130 lbs, P less than 0.001). Combination oral contraceptive (COC) use was associated with a decreased risk, which decreased with duration of COC use (relative risk of approximately 0.28 at 5 years of use, P less than 0.001), but the estimate of the protective effect was reduced and became statistically non-significant when allowance was made for weight and parity. The protective effect of COC use was only clearly evident in women who had less than 3 live-births and weighed less than 170 lbs. These results provide further support for the "unopposed" oestrogen hypothesis of the aetiology of endometrial cancer.

A case-control study of cancer of the endometrium.

A hospital-based case-control study of the epidemiology of endometrial cancer in women aged 45-74 years was carried out in Connecticut from 1977 to 1979. In total, 167 cases and 903 controls were included. Elevated risks were associated with the following factors: overweight, nulliparity, few pregnancies, use of estrogen replacement therapy, older age at menopause, and a history of ovarian or endometrial cancer in mother or a sister. Whites were more frequently affected than blacks, and better-educated women more often than less-educated women. Use of oral contraceptives was associated with a decreased risk, although the decrease did not reach statistical significance.