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

A 24-month prospective trial was carried out in 100 periclimacteric women to study the effects of a combination product containing estradiol valerate and levonorgestrel. After three months of treatment, 93% to 98% of women experienced relief of five of the seven signs and symptoms of the periclimacteric syndrome. Twenty-three percent of the women reported increased libido during the first year of treatment. The maturation index, atrophic at the start of the study, became normal in all patients after one to two months of treatment. No evidence of thromboembolic disorders, endometrial hyperplasia, or endometrial cancer was found during the 24 months of treatment, nor did any serious adverse reactions occur.
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PMID:Effect of cyclic estradiol valerate/levonorgestrel on periclimacteric syndrome and endometrial cytology. 393 15

A population-based case-control study of histologically confirmed endometrial neoplasia was conducted in Toronto, Canada, between 1977 and 1978. Pathologic slide review resulted in classification of patients to diagnostic categories of endometrial carcinoma, endometrial carcinoma in situ, and endometrial hyperplasia. This report concerns the subset of patients classified as having adenomatous endometrial hyperplasia. Two age-matched neighborhood controls were selected for each case, and analyses included only those case-control sets in which the case and at least one control were concordant on menopausal status. Among postmenopausal women (87 cases and 151 controls), noncontraceptive estrogen use was a statistically significant risk factor (adjusted odds ratio (OR) = 6.7), as was heavy body weight relative to height (Quetelet index) (adjusted OR = 3.2). Long-term (5+ years) estrogen use conferred an estimated relative risk of more than 20, but use of oral contraceptives did not alter risk significantly. Among premenopausal women (62 cases and 97 controls), a high Quetelet index appeared to be a significant protective factor, even when adjusted for oral contraceptive use (adjusted OR = 0.2). While oral contraceptive use was not associated with a change in risk, long duration of use was highly, but statistically not significantly, protective against hyperplasia. The data for pre- and postmenopausal women indicate that both endogenous and exogenous estrogen exposure are important factors in the etiology of adenomatous endometrial hyperplasia.
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PMID:Risk factors for adenomatous endometrial hyperplasia: a case-control study. 394 78

In a review of the most important examination methods for diagnosis of endometrial carcinoma so far published the efficacy of each of the individual methods is assessed according to uniform criteria. Only the specimens diagnosed as positive were taken as a basis for the rate of correct diagnosis, in order to facilitate comparison of the efficacy of the methods with one another. The validity of the methods is briefly outlined. Cytological diagnosis of endometrial carcinoma is appreciably less reliable than that of cervical carcinoma, regardless of the method used. The cytodiagnostic problems are different, depending whether exfoliative cytology or endouterine biopsy techniques have been used. Cancers of highly differentiated tumor cells are most seldom identified by the conventional smear techniques. Taking the endometrial carcinoma and endometrial hyperplasia patients at Erlangen University Gynecological Clinic between 1963 and 1981 as a basis, and limiting the scope of the study to high-risk adipose patients aged over 45, one-fifth of the carcinomas and one-fourth of the precancerous patients would not be included in a program based on risk factors. Of the Erlangen patients, a 5-year survival probability of 95% and more was calculated for women with tumors from cytologically highly differentiated cancer cells in histological stage I. It is particularly difficult to identify these patients cytologically, and the prognosis for them can hardly be improved further. Cytological nucleus grading proved a reliable prognosis factor, in particular for histologically undifferentiated tumors.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Possibilities and limits of a cytologic early detection program for endometrial cancer]. 408 58

A new endometrial sampling device, the Endopap, was tested in a series of 851 patients. This sampler is of simple design, without moving parts, inexpensive and easy to use. Cellular samples proved adequate in 90% of the cases, usually with very abundant material. Endometrial cancer shed atypical cells in all 20 cases studied. However, only about half the patients with adenomatous hyperplasia were correctly identified by the endometrial sample. This fact seems to reflect the lack of adequate morphologic criteria for the recognition of endometrial hyperplasia; this situation prevails with all types of endometrial cell samplers.
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PMID:Endometrial hyperplasia and neoplasia. Cytologic screening with the Endopap endometrial sampler. 615 83

Thirteen postmenopausal women with benign endometrial changes including proliferative, secretory and polypous endometrium, endometrial hyperplasia and atypia (group I) and 13 randomly selected age-matched controls with normal atrophic endometrium (group II) were studied with respect to serum levels of dehydroepiandrosterone (DHA) and its sulfate (DHAS), testosterone, total estrone, estradiol-17 beta, progesterone, FSH and prolactin. Serum levels of DHA, DHAS, testosterone and total estrone were significantly higher in group I than in group II; otherwise no significant differences were found. Mean values for body weight and for Broca's index, respectively, were almost identical in the two groups. It is speculated that the adrenal androgens may affect the endometrium in two ways, viz. via peripheral conversion to estrogens and/or via direct interaction with endometrial steroid receptors. The results give further support to the hypothesis of an association between adrenocortical hyperactivity and endometrial abnormalities including endometrial carcinoma.
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PMID:Peripheral hormone levels and the endometrial condition in postmenopausal women. 622 73

Our present knowledge of the role of sex steroids in the development and prevention of endometrial cancer is reviewed. Factors which increase the exposure of the uterus to unopposed estrogens, either exogenous or endogenous, are associated with increased risk of endometrial adenocarcinoma. However, there is increasing evidence that progestogens can reverse endometrial hyperplasia and protect against the development of endometrial cancer. The mechanisms to explain the antiestrogenic effects of progestogens include changes in enzyme activity and steroid receptors in endometrial tissue. Postmenopausal women treated with combined estrogen and progestogen have the lowest incidence of endometrial carcinoma. Oral contraceptives containing both estrogen and progestogen in each tablet are protective against adenocarcinoma of the endometrium, while the sequential pills afforded less protection. The risks and benefits of these hormone therapies are discussed in relation to the etiology and prevention of endometrial cancer.
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PMID:Role of estrogens and progesterone in the etiology and prevention of endometrial cancer: review. 630 50

Endometrial cancer is the cause of considerable morbidity among women, but the disease has been underrated and its management more casual than its virulence warrants. Endometrial carcinoma is the most frequently diagnosed invasive neoplasm of the female genital tract in the US, and is third in incidence after breast and colonic cancer. The white population of the US has the highest age standardized incidence of endometrial cancer in the world, India and Japan have the lowest, and the European countries occupy intermediate positions. Between 75% and 80% of women diagnosed with endometrial cancer are postmenopausal, and the mean age at diagnosis is about 60 years. In many cases endometrial hyperplasia is misdiagnosed as frank malignancy. The predisposing factors for endometrial cancer seem to be obesity, hypertension, diabetes mellitus or an abnormal glucose tolerance curve, and prolonged or unopposed estrogen stimulation. Raised estrogen levels may occur in the following situations: 1) women with functioning ovarian tumors that produce estrogen; 2) women with polycystic ovarian disease; 3) women with ovarian dysgensis (Turner's syndrome) managed with estrogen replacement therapy; 4) women taking high estrogen sequential oral contraceptives (OCs); and 5) women undergoing estrogen replacement therapy. There is an increased risk of endometrial carcinoma associated with nulliparity. Carcinoma of the endometrium occurs in a variety of subtypes, the most frequent being adenocarcinoma, followed by adenocanthoma, adenosquamous carcinoma, clear cell carcinoma, papillary adenocarcinoma, and secretory carcinoma. Overall 5-year survival rates are 72% for adenocarcinoma, 68% for adenocanthoma, and 26% for adenosquamous carcinoma. The true extent of endometrial cancer can be ascertained only after exploratory laparotomy and then various therapies may be used according to the stage of the disease.
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PMID:Carcinoma of the endometrium. 637 16

A review is given of the comparative pathology of endometrial carcinomas regarding the incidence, the morphology, and the relation with endometrial hyperplasia. Compared to man, endometrial carcinomas in animals are fairly rare, except in rabbits, in cattle, and in a stock of Han: Wistar rats. In rabbits the endometrial carcinomas are mostly primary multiple and present in both horns. Histologically they are almost always adenocarcinomas. The histological structure can vary considerably with regard to the degree of differentiation. In cattle the endometrial carcinomas are mostly singular. Histologically they are mostly adenocarcinomas, often accompanied by formation of much dense fibrous tissue. In rats the endometrial carcinomas are mostly primary multiple adenocarcinomas. In man as well as in the rabbit and in the rat, relationships have been described between endometrial hyperplasia and endometrial carcinoma. It is striking that in the dog, a species in which endometrial hyperplasia very often occurs, endometrial carcinomas should be rare. The endometrial carcinoma in the rabbit as an animal model for human endometrial carcinoma is discussed extensively. In both species there are signs indicating relationships between endometrial carcinomas and sex hormones, especially oestrogens. The incidence in rabbits is very high. Endometrial carcinomas in rabbits can be transplanted subcutaneously in the same rabbit. They can also be cultured in vitro. Moreover the rabbit is a suitable species to study the progesterone/progesterone-receptor complex by determining the synthesis of the progesterone-induced protein uteroglobin which may be important in studying endometrial carcinomas. Uteroglobin is a good marker for a functional 'Progesterone-PR-DNA-mRNAug-Uteroglobin- System' (or PUG-System).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparative pathology of endometrial carcinoma. 638 39

Cancer is the presumed complication of oral contraceptive (OC) use that is of greatest concern to the public, although with the exception of cancer of the endometrium, which was linked to 1 specific type of sequential preparation, Oracon, there is no convincing evidence linking OCs and cancer. Oracon was found in detailed study to be strongly associated with subsequent risk for cancer, while other sequentials and combination pills were found to reduce the risks. Oracon was different from other sequentials in that it contained a large amount of estrogen, 100 mcg of ethinyl estradiol, with only a weak progestin, 25 mg of dimethisterone, too little to reverse estrogen-induced endometrial hyperplasia. Proctection appears to increase with duration of use of combined OCs. The Centers for Disease Control (CDC) estimates that approximately 2000 cases of endometrial cancer are prevented each year in the US due to the present level of OC use. Evidence is strong that OCs are a means of preventing ovarian cancer, the 4th leading cause of cancer deaths among women in the US. Case-control studies show that women with ovarian cancer are less likely to have used OCs than are controls without cancer. Physiologically, the risk for cancer of the ovary seems to be related to what has been described as "incessant ovulation". Until recently, most women throughout history have been either pregnant or lactating for most of the time. Time spent pregnant or on OCs, with resulting blockage of ovulation, is now established as protective against ovarian cancer. The longer a women has been taking OCs, the greater the protection. Researchers at the CDC estimate that 1700 ovarian cancer deaths are prevented each year in the US by the use of OCs. Results of epidemiologic studies exploring the connection between OC use and cervical cancer are incolclusive because of methodological problems of preventing bias and controlling for confounding variables. Women taking OCs are more likely to have regular cervical cytology, giving rise to selection bias. Use of women emloying barrier contraception as a control group is another source of bias because barrier contraceptives reduce the rise of cervical neoplasia. Sexual behavior, especially age at onset of sexual activity and number of partners over time, is an important determinant of cervical cancer risk and therefore an inportant confounder that is difficult to control. On balance, there appears to be no or very little increased risk of cervical cancer from OC use; given the confounding factors, a final answer may never be obtained. The risk of developing hepatocellular adenoma is about 30 cases/million women per year.
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PMID:Oral contraceptives and neoplasia. 648 5

The authors propose a test consisting of the administration of a progestogen for 7 days in women menopausal for more than two years, with the aim of detecting occult endometrial hyperplasia. Given the frequent association between hyperplasia and cancer, further investigations are carried out in every case in which bleeding occurs. The value of this trial is discussed and compared with other methods put forward for endometrial cancer screening.
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PMID:[Detection of hyperplasia and cancer of the endometrium]. 653 25


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