Endometrial cancer is the most common gynecologic forms of cancer in high-income countries. It also a common form of gynecologic cancer in the world population when high and low-income countries are put into consideration. The common form of endometrial cancer is uterine cancer as approximately 90 percent of uterine cancers are endometrial meaning that they originate from the epithelium. The aim of this paper is to discuss the epidemiology, morbidity, pathophysiology, subjective and objective presentation, differential diagnosis, and clinical management of endometrial cancer.
Epidemiology
Endometrial cancer is the fourth most common cancer in high-income countries. The countries that are put into consideration are Australia, Canada, and the United States where there are collectively more than 57,000 women that are diagnosed every year (Jordan et al., 2017). It is anticipated that there are approximately more than 320,000 women that are diagnosed with the disease every year. It thus accounts for approximately 4.8% of all the cancers among women.
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Morbidity and Mortality
The estimation is that there are approximately 12,590 deaths of the disease that take place every year. The cancer has a 5-year survival rate of between 85 and 91%. The 5-year survival rate is used to rate the number of women that live 5 years after the cancer has been found. Endometrial cancer is thus usually easily detected at the early states due to the nature of the disease as it causes vaginal or uterine bleeding. Approximately 73% of the patients are usually diagnosed at stage I while the diagnosis could be made at stage II of the disease in approximately 10% of the patients (Khazaei et al., 2018).
Pathophysiology
Endometrial cancer comes about from the endometrium which are the linings of the uterus or womb. It comes about from an abnormal growth of cells which spread and invade other parts of the body. One of the most common first signs is vaginal bleeding which is not usually associated with the menstrual period. There are two types of endometrial cancer and they include the estrogen dependent or type II and the estrogen independent or type II. The most common form of cancer is type I where approximately 85% of the cancers are estrogen dependent type I (Jindal, 2017). The type of tumor, tumor grade, and the surgical stage is the biggest influence of the prognosis.
Subjective and Objective Presentation
Endometrial cancer can have either subjective and objective assessment. The subjective assessment has been confirmed as the most reliable method as it can be used to assess myometrial invasion effectively (Frühauf et al., 2017). This is achieved through the use of ultrasound-based subjective evaluation by experts.
Differential Diagnosis
At the early stages of endometrial cancer, it should be differentiated from other diseases that could cause abnormal uterine bleeding and also an endometrial thickening on ultrasound. Examples of such diseases that make the differential diagnosis include endometrial polyp, endometrial hyperplasia, and submucosal uterine leiomyoma. Bleeding from the uterus can also be caused by several types of benign lesions such as endometritis or polyps or a hormone replacement therapy.
Clinical Management
The most common form of treatment and clinical management of endometrial cancer is surgery that involves total hysterectomy. There can be a subsequent therapy that is mostly dependent on the characteristics of the patient. Lymphadenectomy has also been found effective in the clinical management of this type of cancer. For the treatment, it can involve removal of the pelvic and para-artic lymph nodes (Frost et al., 2017). However, the treatment is still controversially and requires adequate investigation.
Conclusion
The analysis of endometrial cancer shows that it is highly prevalent and that it affects a large percentage of women. The cancer involves symptoms that include vaginal bleeding that can help in the early diagnosis. Women should thus beware about the cancer and go for an early treatment to prevent further complications.
References
Frost, J. A., Webster, K. E., Bryant, A., & Morrison, J. (2017). Lymphadenectomy for the management of endometrial cancer. Cochrane Database of Systematic Reviews , (10).
Frühauf, F., Zikan, M., Semeradova, I., Dundr, P., Nemejcova, K., Dusek, L., ... & Fischerova, D. (2017). The diagnostic accuracy of ultrasound in assessment of myometrial invasion in endometrial cancer: subjective assessment versus objective techniques. BioMed research international , 2017 .
Jindal, A. (2017). Pathophysiology of Endometrial Carcinoma. In Current Concepts in Endometrial Cancer (pp. 29-39). Springer, Singapore.
Jordan, S. J., Na, R., Johnatty, S. E., Wise, L. A., Adami, H. O., Brinton, L. A., ... & Freudenheim, J. L. (2017). Breastfeeding and endometrial cancer risk: an analysis from the epidemiology of endometrial cancer consortium. Obstetrics and gynecology , 129 (6), 1059.
Khazaei, Z., Dehkordi, A. H., Amiri, M., Adineh, H. A., Sohrabivafa, M., Darvishi, I., ... & Goodarzi, E. (2018). The incidence and mortality of endometrial cancer and its association with body mass index and human development index in Asian population. World Cancer Research Journal , 5 (4), 11.
