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 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In recent years the incidence in endometrial cancer is rising. The relation of cervical to endometrial cancer has shifted to almost 1:1. The peak of age distribution is between 50 and 60 years of age. Accompanying diseases are obesity, diabetes and hypertension. The endometrial cancer has its precancerous stages. The pertinent estrogenic stimulus is probably significant for the development of precancerous lesions: adenomatous hyperplasia of the endometrium without atypias is known as an optional, that with atypia as an obligatory precancerous lesion. The range of morphologic variation extends from mature endometrial adenocarcinoma with favorable prognosis to immature neoplasias with unfavorable outcome. Besides various other parameters of neoplastic disease the depths of infiltration into the myometrium is known to be significant. The leading sign of endometrial cancer is uterine bleeding. The histological diagnosis is established by the examination of the tissue produced by curettage from the cervical canal and from the uterine cavity. A true early diagnosis--in comparison to the early detection of cervical cancer--does still not exist for endometrial cancer. Exfoliative cytology from the uterine cavity or ultrasonography does still not allow the final and definite diagnosis. Among the therapeutic alternatives abdominal hysterectomy in combination with bilateral adnexectomy plays the most important role. Depending from more specific morphologic criteria of a given case additional pelvic and paraaortic lymphnode-dissection is advised. Surgical therapy in general accounts for a 10 to 20 percent better survival. In patients who cannot surgically be treated because of the local extension of the tumor or due to a general high risk situation the primary therapy is pelvic irradiation both by packing and percutaneously. Disseminated neoplasms, adenocarcinomas in particular, respond well to large dosages of progestins, whereas combinations of cytostatics have failed to show favorable results, perhaps with the exception of those containing adriamycin. All endometrial cancer patients need special posttreatment care, because early recurrences still have a certain chance of survival when recognized and appropriately treated.
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PMID:[Precancerous conditions and cancer of the endometrium]. 269 33

A case-control study was conducted among 150 woman suffered from endometrial cancer (EC) in Beijing from 1982.1.1-1985.12.31 and matched with two controls from the neighbourhood to explore the risk factors for EC. The data were analysed with X2 test and Linear Logistic Regression. Result of the study are listed. The risk factors directly related to EC might be obesity, nulliparity and low parity, early menarche, liver diseases. The risk factors indirectly related to EC might be irregular menstruation, premenstrual tension, dysfunctional uterine bleeding. The oral combined contraceptives showed a protective effect on EC. The results of the study support the EC etiology hypothesis of 'unopposed action of estrogen'.
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PMID:[A case-control study of endometrial cancer in Beijing]. 280 53

Previous epidemiological studies have demonstrated that obesity increases endometrial cancer risk two- to 10-fold. To test the hypothesis that abdominal adiposity further increases this relative risk, we conducted a nested case-control study of endometrial cancer incidence in a cohort of 41,873 women ages 55-69 years. Women were recruited by mail and asked to have a friend measure circumferences of several body parts using a tape measure and written instructions. Two-year follow-up for cancer incidence was conducted using a state-wide cancer registry. Compared to random controls (n = 1,274), cases (n = 63) had higher age-adjusted mean values of waist-to-hip circumference ratio (P = 0.10) and trunk-to-limb circumference ratio (waist plus hip circumferences divided by arm plus calf circumferences, P = 0.008). Other anthropometric variables, including current body mass index and current weight, were also greater (P less than 0.001) in cases than controls. After accounting for the association with body mass index, neither the waist-to-hip ratio nor the trunk-to-limb ratio remained associated with endometrial cancer incidence (P greater than 0.40). A 5 kg/m2 increase in body mass index was associated with an adjusted relative risk of endometrial cancer of 1.80 [95% CI = 1.46, 2.22] when other significant risk factors, namely age, education level, extended use of exogenous estrogens, and age at menopause, were taken into account. We conclude that endometrial cancer risk is increased in relation to the amount but not the distribution of adiposity. This is in contrast with several other diseases in which, in addition to overall body mass, the distribution of adiposity is also important.
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PMID:Association of incident carcinoma of the endometrium with body weight and fat distribution in older women: early findings of the Iowa Women's Health Study. 281 22

The risk of endometrial cancer in relation to nutrition and frequency of consumption of a few selected dietary items was evaluated in a case-control study of 206 patients with endometrial cancer and 206 control subjects with acute conditions unrelated to any of the established or potential risk factors for endometrial cancer. Obesity was strongly and positively associated with the risk of endometrial cancer, and several conditions related to body weight, such as early menarche, diabetes mellitus, or hypertension were more common in cases. The risk of endometrial cancer was elevated in subjects reporting (on a subjective basis) greater fat (butter, margarine, and oil) intake (relative risk estimate for the higher compared to the lower scores equals 5.65, with 95% confidence interval of 2.76-11.55). Cases reported less frequent intake of green vegetables, fruit, and whole-grain foods: thus, the risk of endometrial cancer appeared inversely related to indices of beta-carotene and fiber intake. Furthermore, cases consumed milk, liver and fish less frequently than controls. No significant difference was noted between cases and controls in the frequency of intake of carrots, meat, eggs, ham, and cheese. Alcohol consumption was somewhat larger among the cases, but this trend in risk was not significant. Dietary information collected in this study probably is too limited and inconsistent to permit analysis of biologic correlates of these findings or discussion of their potential implications in terms of prevention on a public health scale. Nonetheless, the mere existence of differences in reported diet between endometrial cancer cases and controls is of interest, and may warrant further, more detailed investigation.
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PMID:Nutrition and diet in the etiology of endometrial cancer. 300

A longitudinal population study of 1462 women, aged 38-60 years, was carried out in Gothenburg, Sweden, in 1968-69. In univariate analysis anthropometric variables indicating centrally localized adipose tissue (waist circumference, the ratio of waist to hip circumference and the subscapular skinfold) showed significant age-standardized positive associations with the occurrence (prevalence + incidence data) of endometrial carcinoma. Incidence data suggested that measurements of centrally localized adipose tissue might be of predictive value for this malignancy as well as for ovarian carcinoma. In contrast, measurements of generalized obesity (body weight or body mass index) or peripherally localized adipose tissue (triceps skinfold) showed no associations to these malignancies. No relationship was observed between the anthropometric variables studied and breast carcinoma. The association observed between endometrial and ovarian carcinomas with central adipose tissue did, however, not remain in multivariate analysis when generalized obesity was taken into account. Centrally localized adipose tissue is known to be associated with endocrine abberations including irregular ovulation and menstruation, re-emphasizing the importance of endocrine factors for the pathogenesis of endometrial and ovarian carcinomas. No positive association was found between development of the carcinomas and initial measurements of blood glucose, serum lipids or blood pressure, found to be elevated in cross-sectional studies. An increase in these variables therefore probably are parallel phenomena rather than predictors. The women with endometrial or breast carcinomas smoked more than the remaining women. Although the number of end-points observed was limited these results suggest that measurements of adipose tissue distribution might be a valuable addition to the predictors of endometrial and ovarian carcinomas.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Adipose tissue distribution and female carcinomas. A 12-year follow-up of participants in the population study of women in Gothenburg, Sweden. 305 18

A case-control study on 150 cases and 300 non-neoplastic controls admitted to the Obstetric and Gynaecologic Clinic B of the University of Palermo from 1977 to 1986 was carried out in order to assess the risk factors of corpus uteri cancer in Palermo area. Age at menarche less than 11, menopausal status, nulliparity, diabetes and obesity were found significantly associated with the risk of cancer; family history of neoplastic disease was slightly under statistical significance. It can be concluded that the same etiologic factors of endometrial cancer, as in other areas, may be operating in Palermo women.
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PMID:Risk factors of endometrial cancer in Palermo. 323 54

Endometrial cancer occurs more than twice as frequently as cervical cancer. The main risk factors are age, estrogen use, and obesity. Increasing life expectancy and more liberal use of estrogen to prevent postmenopausal bone loss will probably increase the magnitude of the problem. Endometrial cancer is a heterogeneous disease. Good prognosis is associated with obesity and estrogen use and with carcinomas preceded by precancerous hyperplasia. A bad prognosis may be found in women without major risk factors and is associated with a normal or atrophic endometrium. Because of a high prevalence of asymptomatic disease (6.9 per 1,000) and because the group with a poor prognosis is usually asymptomatic, all postmenopausal women should be screened at least one time. For screening, the use of one of the cytologic instruments is recommended; these instruments are safe, easy to handle, and can be used in the office setting without anesthesia. Yields are comparable to dilation and curettage. Family physicians are encouraged to familiarize themselves with cytologic instruments and to use them for screening postmenopausal women in their office.
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PMID:Detection of and screening for endometrial cancer. 327 9

Cancer of the colon, rectum, prostate, breast, ovaries and endometrium may be associated with obesity. The present paper reviews both prospective and retrospective studies of the potential associations between obesity and these cancers. This research is especially difficult because of the complex interrelations between weight and diet, physical activity, cigarette smoking, and other conditions. Epidemiological studies of body weight are subject not only to biases of sampling, selection, and confounding but also to marked difficulties in definition and measurement. Bearing in mind the methodological shortcomings, there is a distinct and reproducible association between obesity and cancer of the endometrium and postmenopausal breast cancer. The studies of cancer of the colon, rectum, prostate, and ovaries are too inconclusive to elucidate whether obesity implies an increased risk. It is recommended that future studies in this field include a standardised assessment of the distribution of fat tissue, the onset and duration of the condition, and the associated confounding factors. It is concluded that obesity, especially in females, should be avoided as a part of the general cancer preventive effort.
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PMID:Obesity and cancer. A review of epidemiological studies on the relationship of obesity to cancer of the colon, rectum, prostate, breast, ovaries, and endometrium. 331 76

The elements of the poor prognosis of endometrial cancer are well known: grade, degree of infiltration of the myometrium, isthmal localization, pelvic and lumboaortic node invasion. But the ways of improving the results are less known: extension of the surgical procedure and the combination surgery-radiotherapy do not improve survival, except in case of grade 3 tumors invading more than half of the myometrium. However, vaginal curietherapy decreases the number of vaginal recurrences. Additional progesterone therapy is the subject of conflicting results. Preventive therapy consists in avoiding exogenous hyper-estrogenias by an adequate prescription of hormone therapy, in an early diagnosis of hyperplasias in risk patients (obesity, dys-ovulation) by a test with progesterone-like substances and endo-uterine smears, and in treating these hyperplasias with a medical treatment, curettage or hysterectomy, according to the circumstances.
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PMID:[Current treatment of endometrial cancer]. 331 60

The 'unopposed oestrogen hypothesis' for endometrial cancer maintains that risk is increased by exposure to endogenous or exogenous oestrogen that is not opposed simultaneously by a progestagen, and that this increased risk is due to the induced mitotic activity of the endometrial cells. Investigation of the mitotic rate during the menstrual cycle shows that increases in plasma oestrogen concentration above the relatively low levels of the early follicular phase do not produce any further increase in the mitotic rate of endometrial cells. A modification of the unopposed oestrogen hypothesis which includes this upper limit in the response of endometrial cells to oestrogen is consistent with the known dose-effect relationships between endometrial cancer risk and both oestrogen replacement therapy and postmenopausal obesity; it also suggests that the mechanism by which obesity increases risk in premenopausal women involves progesterone deficiency rather than oestrogen excess, and that the protective effect of cigarette smoking may be greater in postmenopausal than in premenopausal women. Detailed analysis of the age-incidence curve for endometrial cancer in the light of this hypothesis suggests that there will be lifelong effects of even short duration use of exogenous hormones. In particular, 5 years of combination-type oral contraceptive use is likely to reduce a woman's lifetime risk of endometrial cancer by some 60%; whereas 5 years of unopposed oestrogen replacement therapy is likely to increase her subsequent lifetime risk by at least 90%; and even 5 years of 'adequately' opposed therapy is likely to increase subsequent lifetime risk by at least 50%.
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PMID:The dose-effect relationship between 'unopposed' oestrogens and endometrial mitotic rate: its central role in explaining and predicting endometrial cancer risk. 335 13


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