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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Publicity associated with recent reports of a greater frequency of adenocarcinoma of the endometrium among women who take exogenous estrogens has created confusion among physicians and fear among patients. An objective review of available data on estrogen effects and current epidemiologic evidence suggests that estrogen may play an indirect role in the development of endometrial carcinoma. Until definitive data are available, physicians should exercise caution in prescribing estrogens, monitoring the status of the endometrium at regular intervals by sampling and pathologic analysis.
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PMID:ARS Presidential Address: Estrogen therapy: a causal role in endometrial cancer? 99 25

The relatively restricted use of hormone replacement therapy in the United Kingdom has frequently been noted. It is possible that low prescribing rates may, in part, be due to the difficulty in interpreting the wealth of research evidence relating to the risks and benefits of hormone replacement therapy. Conflicting conclusions from research can cause considerable uncertainty and confusion. This paper reviews the evidence relating to hormone replacement therapy and the risks of breast cancer, endometrial cancer and cardiovascular disease and discusses the issues which require critical assessment. This should add to the information base available to general practitioners and thus assist in decision-making in the context of uncertainty.
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PMID:Hormone replacement therapy and breast cancer, endometrial cancer and cardiovascular disease: risks and benefits. 149 29

Questionnaires were sent to 1000 general practitioners (GPs) in the Yorkshire Region to obtain information about their approach to the use of hormone-replacement therapy (HRT) in the menopause. A total of 310 GPs returned completed questionnaires. These showed widely varying views. The majority of GPs estimated that less than 10% of their perimenopausal patients had taken HRT at some time. There was confusion about the reported effects of HRT, on the risks of endometrial carcinoma and on ischaemic heart disease. Thus, while 86% correctly judged that HRT was protective against osteoporosis, 70% concluded against prevailing opinion that combined preparations increase the risk of endometrial cancer. In contrast to the bulk of evidence, nearly 50% of respondents believed that the risk of ischaemic heart disease was also increased by HRT. A number of GPs considered lack of an authoritive lead from epidemiology to be their greatest difficulty in forming an opinion on the desirability of HRT. The general approach to HRT was cautious in respect of both the frequency and the duration of the therapy. Less than a quarter of the GPs were sympathetic to the idea of prophylactic HRT and only 7% routinely discussed this possibility with menopausal patients, while the majority felt that the duration of therapy should be limited to 2 years or less. Most respondents also showed intuitive resistance to the idea of 'mass therapy' at the menopause and expressed concern at the idea of 'interfering with nature'.
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PMID:General practitioners use of hormone-replacement therapy in Yorkshire. 237 79

There is considerable variation and a good deal of confusion surrounding definitions and nomenclature for premalignant lesions of the endometrium. A unifying concept, based on the model of cervical intraepithelial neoplasia, is proposed to provide a uniform, practical basis for the diagnosis and management of the precursors of endometrial cancer. Lesions would be classified as glandular epithelial neoplasia (GIN) Grades, 1, 2 and 3. Illustrated examples, and comparisons with other classifications are provided.
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PMID:Glandular intraepithelial neoplasia (GIN)--a unifying concept of the precursors of endometrial adenocarcinoma. 632 34

Dr. David Grimes, professor and vice-chair of the Department of Obstetrics/Gynecology and Reproductive Sciences, University of California at San Francisco, spoke to the American Medical Association's Thirteenth Annual Science Reporters Conference in Seattle on November 7, concerning the health benefits of taking oral contraceptives. The risk of getting ovarian cancer decreases the longer the pill is used; this protection lasts at least 15 years after use has ended. Women who take the pill for a decade or longer reduce their risk of developing this cancer by 80%. The pill reduces the risk of endometrial cancer by as much as 50%; the protection is strongest in those at highest risk and lasts at least 15 years after use. The pill cuts the risk of pelvic inflammatory disease in half. The danger of ectopic or tubal pregnancy is reduced by 90%. By reducing menstrual flows, oral contraceptives increase the quality of life for women and reduce the risk of iron deficiency anemia. The progestin present in oral contraceptives substantially reduces the risk of benign breast disease. Oral contraceptives may protect against toxic shock syndrome, rheumatoid arthritis, and osteoporosis. A Gallup poll conducted in 1985 and early this year indicates gross misinformation and confusion about the pill among American women. While the pill should not be "pushed" on women by physicians, patients should be educated about the beneficial effects of taking the pill.
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PMID:Report: the pill's health benefits appear to far outweigh its risks. 789 51

There has been little research concerning the health effects of whole grain intake in humans. We have synthesized 15 american and European case-control and prospective studies of whole grain intake. Most subjects were middle aged or older. The studies employed disparate dietary methods, and the foods referred to and quantities eaten are ill defined. Nevertheless there is a striking consistency in reduced risk for colorectal and gastric cancers associated with intake of whole grain, also found in isolated studies of endometrial cancer and coronary heart disease. Because reduced risk was not associated with refined grain intake, these findings do not appear to be confounded by participant confusion concerning refined vs. whole grains. The independence of these findings from reduced risk associated with fruit and vegetable intake is not established. There should be further research to establish whether whole grain intake is protective against chronic disease.
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PMID:Whole grain intake and cancer: a review of the literature. 861 41

Central nervous system (CNS) involvement by endometrial carcinoma is uncommon. Among 1069 patients registered for endometrial carcinoma at our institution between 1982 and 1994, 10 (0,9%) developed brain metastases. Median age at the time of CNS metastasis diagnosis was 59 years. Median interval between diagnosis of endometrial cancer and documentation of brain involvement was 26 months. Clinical manifestation of brain metastasis included headache (80%), motor weakness (50%), seizures (20%), confusion (10%), balance (10%), and visual disturbances (10%). All lesions (4 multiple, 6 single) were contrast enhancing on computed tomography (CT) scans, and were located in the cerebrum in seven cases, in the cerebellum in one case, and in both in two cases. The CNS was the only site of detectable disease in six patients with recurrent disease. Nine patients died and one is alive with disease 3 months after surgical resection of a single cerebral deposit. Median survival from diagnosis of brain metastases for the entire series was 1 month (range 1-83). Six patients receiving only steroids died within 1 month from the diagnosis. One patient received radiotherapy (survival, 3 months) and two underwent surgical resection of solitary metastasis followed by radiotherapy (survival = 28 and 83 months). Prognosis of patients with CNS metastases from endometrial carcinoma appears poor; however, in a selected group of patients early diagnosis followed by multimodal treatment may result in a palliation of the disease.
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PMID:Brain metastases from endometrial carcinoma. 862 15

In 1988 we published three papers describing immunoassay results for urine beta-core fragment as a marker of gynecological cancers. Many other papers have been published since, and three commercial immunoassays have been established. beta-Core fragment is called beta-core, UGF, or UGP by different commercial vendors. To avoid confusion we call it beta-core/UGF/UGP here. In this 7-year report, we compare the three commercial assays, establish cutoff limits, and use the Ciba-Corning kit for two large studies. The first was a retrospective study, measuring beta-core/UGF/UGP in gynecological cancer and control urines accumulated in our freezers (n = 486). The second is a first prospective study, testing over a 16-month period beta-core/UGF/UGP levels in urines of all new patients attending the Gynecology Oncology Clinic (n = 548). In the retrospective study, elevated beta-core/UGF/UGP levels ( > 1.9 ng/ml) were detected in 11% of urines from healthy individuals (n = 132), in 11% from women with benign gynecological disease (n = 196), in 44% from cervical cancer (n = 68), 56% from ovarian cancer (n = 54), and 47% from endometrial cancer (n = 38). Altogether, beta-core/UGF/UGP levels were elevated in 50% of 170 samples from gynecological cancers. Overall, sensitivity increased with advancing stage of malignancy. Sensitivity was 28% for stage I, 50% for stage II, 47% for stage III, and 68% for stage IV malignancies. In the prospective study very similar results were recorded. Elevated beta-core/UGF/UGP levels ( > 1.9 ng/ml) were detected in 11% of urines from healthy individuals (n = 99), 11% from individuals with benign gynecological disease (n = 196), 7% from women with carcinoma in situ (n = 28), in 42% of samples from cervical cancer (n = 69), 56% from ovarian cancer (n = 59), and 52% from endometrial cancer. Altogether, beta-core/UGF/UGP levels were elevated in 48% of 225 gynecological cancer samples. Overall, sensitivity increased with advancing stage of malignancy. Sensitivity was 29% for stage I, 66% for stage II, 60% for stage III, and 77% for stage IV malignancies. In both studies sensitivity for beta-core/UGF/UGP increased with advancing stage of disease. Sensitivity for cervical and endometrial cancers was slightly lower than that for ovarian malignancies. This difference may be due to the preponderance of advanced-stage-disease patients in the ovarian cancer group. beta-Core/UGF/UGP may be a general stage-dependent marker for all gynecological cancers. The same false-positive results and very similar sensitivity values were found in a retrospective and a prospective study. They confirm each other, and suggest a definitive false-positive rate and sensitivity of this tumor marker for gynecological cancers.
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PMID:Beta-core fragment (beta-core/UGF/UGP), a tumor marker: a 7-year report. 863 49

The risk of breast cancer is increased by an early menarche, late age at 1st birth, and by a late menopause which implicates ovarian steroids in the initiation or promotion of breast cancer, as some breast cancers are estrogen dependent. A study from the Centers for Disease Control found no association between breast carcinoma and duration of combined oral contraceptive (COC) use. A recent analysis of 27 reports published between 1980 and 1990 suggests that the risk of breast cancer may be slightly increased in younger, nulliparous women who have used the older, higher dose COCs for more than 8 years. The ever-decreasing doses of estrogen and progestogen cause confusion regarding COCs and the risk of breast cancer. Of 15 major publications, 8 have identified no increased risk of cervical neoplasia and 7 have found significant increased risk. The Oxford Family Planning Association Study showed that both cervical intraepithelial neoplasia (CIN) and invasive cervical carcinoma occurred more frequently in the oral contraceptive group related to the duration of use. The Royal College of General Practitioners' Study showed that women taking the COC for more than 10 years had an increased risk of cervical cancer. With the effects of sexual activity controlled, COC users had no increased risk of invasive cervical cancer, however, they had an increased risk of CIN. A reduction in risk of endometrial cancer (an estrogen-dependent tumor) by 20%, 40%, and 60% after COC pill use containing potent progestogens for 1, 2, and 4 or more years has been reported. Several studies confirm the protective effect of COCs against the risk of ovarian cancer. Hepatocellular carcinomas seem to occur more frequently in COC users than in nonusers. Depot medroxyprogesterone acetate has been implicated in causing breast tumors, but it was successful in the treatment of endometrial carcinoma. There is some evidence that the risk of CIN may be increased with COC use, but the risk of breast cancer is still no clear.
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PMID:Contraception and the big "C". 1234 24