Endometrium cancer

Alternative names

Endometrial/uterine adenocarcinoma; Uterine cancer; Adenocarcinoma of the endometrium/uterus; Cancer - uterine; Cancer - endometrial

Definition

Endometrial cancer involves cancerous growth of the endometrium, the lining of the uterus.

Causes, incidence, and risk factors

Endometrial cancer is the most common type of uterine cancer. Although the exact cause of endometrial cancer is unknown, increased levels of estrogen appear to have a role. One of estrogen's normal functions is to stimulate the buildup of the epithelial lining of the uterus. Excess estrogen administered to laboratory animals produces endometrial hyperplasia and cancer.

The incidence of endometrial cancer in women in the U.S. is 1 - 2%. The incidence peaks between the ages of 60 and 70 years, but 2 - 5% of cases may occur before the age of 40 years. Increased risk of developing endometrial cancer has been noted in women with increased levels of natural estrogen.

Associated conditions include the following:

• Obesity
  
• Hypertension
  
• Polycystic ovarian disease
  

Increased risk is also associated with the following:

• Nulliparity (never having carried a pregnancy)
  
• Infertility (inability to become pregnant)
  
• Early menarche (onset of menstruation)
  
• Late menopause (cessation of menstruation)
  

Women who have a history of endometrial polyps or other benign growths of the uterine lining, postmenopausal women who use estrogen-replacement therapy (specifically if not given in conjunction with periodic progestin), and those with diabetes are also at increased risk.

Tamoxifen, a drug used to treat breast cancer, may also increase the risk of developing endometrial cancer.

Symptoms

• Abnormal uterine bleeding, abnormal menstrual periods
  o Bleeding between normal periods in premenopausal women
  o Vaginal bleeding or spotting in postmenopausal women
  
• In women older than 40: extremely long, heavy, or frequent episodes of bleeding (may indicate premalignant changes)
  
• Lower abdominal pain or pelvic cramping
  
• Thin white or clear vaginal discharge in postmenopausal women
  

A pelvic examination is frequently normal, especially in the early stages of disease. Changes in the size, shape or consistency of the uterus or its surrounding, supporting structures may exist when the disease is more advanced.