Hormonal Interactions in Endometrial Cancer 

 Endocrine-Related Cancer V.7, I.4 Dec00

G Emons, G Fleckenstein, B Hinney, A Huschmand, and W Heyl

Introduction

Endometrial cancer (EC) is the most common malignancy of the female genital tract. In western industrialized countries, annual incidence rates between 10 per 100 000 women (UK, Spain, France) and 25 per 100 000 women (USA, Canada) are observed (Parazzini et al. 1991). In the US, for 1998, an estimated 36 000 new cases and 6300 deaths will be attributed to endometrial cancer (Podratz et al. 1998). In Sweden, carcinoma of the endometrium is the third most frequent cause of cancer death in women, next after breast and colon cancer. In the USA, EC is ranked at four after breast, lung and colon cancer (Li et al. 1999). The lifetime risk of a woman to develop EC is 1 in 38 in the US The incidence increases steadily with age and peaks between ages 70 and 74 years (112/100 000 women) before slightly falling (Ball & Elkadry 1998) making the disease a significant factor in women’s health in an aging population. EC is relatively uncommon in the younger age group and women below the age of 45 represent only 2 – 14% of all cases (Vinker et al. 1999). About 20 – 25% of women with EC, however, are premenopausal (Creasman 1997). Prognosis of EC is excellent in early stages , when the tumor is confined to the endometrium (stage Ia: 5 year survival 91%) or to the inner 50% of the myometrium (stage Ib: 5 year survival 88%) (Creasman et al. 1998). 5 year survival decreases to 81% when the tumor infiltrates the outer half of the myometrium (stage Ic), to 77 – 67% when the cervix is engaged (stage II) and to 60 – 52% when there are tumor manifestations outside the uterus (stage III) (Creasman et al. 1998). In stage IVb (distant metastases) only 5% of affected women survive 5 years (Creasman et al. 1998). Fortunately, most patients with EC present at early stage disease due to typical early symptoms (bleeding disorders or vaginal discharge) resulting in an overall 5 year survival rate for EC of 73% (Creasman et al. 1998).

source: Endocrine-Related Cancer http://journals.endocrinology.org/erc/007/erc0070227.htm 14 Apr 2005

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