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

The number of users of oral contraceptives in Sweden has decreased since 1983. This decrease has been accompanied by a rise in the number of abortions, leading to the conclusion that abortion is increasingly selected as the contraceptive of choice. Surveys have shown that some of the decrease in use of oral contraceptives arises from concern about side effects, primarily breast cancer. This article summarizes the results of some recent large scale studies on the connection between oral contraceptives and breast cancer in order to give Swedish midwives the factual information they need to advise their patients. In summary, these studies have shown a connection between oral contraceptives and breast cancer with a moderate increase in risk after use over a very long period. In 1 study the relative risk was 1.74 after 8 years use of oral contraceptives, in a 2nd study the relative risk was 2.2 after 12 years use, and in a 3rd large study the relative risk was 1.5 after 8 years use. All 3 studies found no risk related to age at beginning of use or whether use began before the birth of the 1st child. The author suggests that midwives bring these considerations and positive health aspects of oral contraceptives such as protection against salpingitis, endometrial cancer and ovarian cancer to the attention of their patients as well as the medical risks of pregnancy. The author concludes that at present midwives may recommend oral contraceptives to women in good conscience as a reliable contraceptive.
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PMID:[Which are the commonest questions about contraceptives and how shall we answer them?]. 236

Oral contraceptives (OCs) not only prevent pregnancy but also have a number of advantages which, as a rule, receive less attention than the drawbacks. Use of OCs by women with menorrhagia can prevent iron deficiency anemia. Irregular menstrual cycles can be regulated and dysmenorrhea disappears in many instances with OC use. A number of studies have brought to light the fact that endometrial carcinoma and mammary cysts occur less often in women using the pill. Since Ocs suppress ovulation, the incidence of functional ovarian cysts is reduced considerably. Moreover, the use of OCs proves to decrease the risk of ovarian carcinoma development and the occurrence of salpingitis. A study of the literature justifies the conclusion that the advantages of OC use by young women outweigh the disadvantages. (author's modified)
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PMID:[The "other" advantages of the pill]. 688 95

A review of prospective and retrospective epidemiologic studies of oral contraceptives (OCs) shows that in addition to pregnancy prevention, OCs provide other health benefits resulting from the antiestrogenic action of the progestin in the pills and from its main action, inhibition of ovulation. The antiestrogenic effects include reduction of risk of iron deficiency anemia by about 50% because of reduced menstrual blood loss. The Royal College of General Practitioners (RCGP) study reports that OCs protect about 7 of 1000 pill users/year from iron deficiency anemia, and that OC use significantly reduces the incidence of menstrual disorders (menorrhagia, irregular menses, intermenstrual bleeding). Other studies report elimination of endometrial hyperplasia (Sturdee et al.), 50% reduction in risk of endometrial cancer (Weiss and Sayvetz, Boston University Epidemiologic Survey), and reduction in incidence of benign breast diseases (at least 12 published studies). The noncontraceptive benefits resulting from inhibition of ovulation include significant reduction in the incidences of dysmenorrhea (RCGP study), functional ovarian cysts (RCGP study, Boston Collaborative Surveillance Program, Ory), and ovarian cancer (Beral et al., Casagrande et al.) OCs are also found to protect against rheumatoid arthritis (RCGP, Rochester Epidemiologic Project), and salpingitis or pelvic inflammatory disease (PID). 6 epidemiologic studies show that the relative risk of developing PID among pill users compared with nonusers ranges from 0.3 - 0.9. Increased OC use by the population at greatest risk--sexually active women between 15-24 years old--would significantly reduce PID with its high cost of treatment and resulting infertility. It is hoped that healthy young women will realize that OCs provide benefits (including prevention of unwanted pregnancy) that far outweigh their more widely publicized, infrequent risks.
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PMID:Noncontraceptive health benefits of oral steroidal contraceptives. 706 59

Hormonal contraception was pioneered by Gregory Pincus in the 1950s. Today, hormonal contraception is accepted as having a highly favorable benefit/risk profile. There is, however, a need for the development of new contraceptive methods to broaden the range of choices and enhance motivation and compliance in users. With the staggering rate of increase in the world's population, the number of contraceptive users in developing countries is expected to increase from 381 million in 1990 to 567 million in the year 2000. This will require substantial supplies of inexpensive contraceptives and the development of new and improved methods. The use of contraceptives is an asset to women's health, which can be jeopardized by the risks of pregnancy, as well as to the psychological and social well-being of mother and child. Oral contraceptives also have noncontraceptive health benefits such as protecting against endometrial cancer, uterine fibroids, menorrhagia, benign breast disease, anemia, ovarian cancer, functional ovarian cysts, dysmenorrhea, ectopic pregnancy, salpingitis, and bone loss. The new low-dose formulations are considered to be very safe for most healthy, nonsmoking women of reproductive age. Therefore, current research efforts are focused on new delivery methods, such as vaginal rings, rather than on the development of new hormonally active steroids. Nonoral contraceptive methods which avoid first-pass effects on the liver are being developed or improved. These include implants, vaginal rings, vaginally applied pills, and progestogen-containing IUDs. Contraceptive research is also focusing on immunologic interference with the hypothalamic-pituitary-gonadal axis in both men and women. This may spawn as yet unforseen methods of molecular modulation of sperm-ovum interactions which would result in the inhibition of implantation.
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PMID:Hormonal contraception. Current status and future perspectives. 797 25

Recent studies have demonstrated new benefits of pill use, reduced risks associated with the minipill, and the possibility of screening out high risk women. The minipill is as effective as other formulations except in cases of chronic malnutrition or concomitant use of antibiotics or anticonvulsives. Oral contraceptives (OCs) frequently lessen menstrual problems. They prevent functional cysts in the ovaries, and reduce the incidence of benign breast tumors and the relative risk of developing ovarian cancer after 3 years of use. Combined OCs reduce the risk of endometrial cancer although sequentials increase it. OCs offer protection against salpingitis and other pelvic infections, against tubal pregnancies, and against chronic rheumatoid arthritis. Minipills appear to be less frequently associated with bothersome side effects than other OCs. The most significant risk of OCs is of death due to thrombo emboli of venous origin, myocardial ischemia, cerebrovascular accidents, and hypertension in women over 35, particularly those who smoke heavily. In 1981 the 2 British studies reported a reduced risk from these causes compared to results published in 1977. Estrogens are clearly responsible for some of the complications, apparently due to a weakening of the fibrinolytic systems, but progestagens or estrogen-progestagen combinations are also implicated. Arterial hypertension and cerebral and cardiac accidents appear to be due to the effect of progestagens on arterial tension, glucose metabolism, and the level of high density lipoprotein cholesterol. Risks of some liver diseases are elevated in pill users, but the question of tumors of the pituitary is not yet resolved. The incidence of uterine cancer appears to be elevated in pill users although the association is obscured by other factors. Some evidence exists of an association between estrogen-progestagen formulations and melanoma. No increase in abortion or fetal malformations except possibly an increase in twin pregnancies is noted after discontinuation of the pill. Pills should not be prescribed for smokers over 35 or any women over 45. Pills are possibly acceptable for women 35-44 in good health with no signs of diabetes, hypertension, or hyperlipoproteinemia. They should be followed up more frequently and should recognize the signs of complications.
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PMID:[Oral contraception in 1983 (author's transl)]. 1231 9

Some controversies regarding currently used contraceptive methods are reviewed. There are no newly available estrogens for oral contraceptives (OCs), but 2 progestins are coming into use: cyproterone acetate, which has a potent antiandrogenic action, and desogestrel, which combines a strong inhibitory effect on ovulaion and a marked peripheral progestin activity with very weak androgenic and anabolizing activity. New systems of administration will be used in the future to avoid the serum "peaks" observed in oral administration. The lack of agreement on the effects and secondary effects of various progestins will be a continuing source of discussion. 2 aspects of combined OCS, residual ovarian activity and androgenicity, are attracting increasing attention. Among new preparations, the combination of 2 mg cyproterone acetate and 50 mcg of ethinyl estradiol (EE) has been shown in multicenter European studies to have good effects on acne and satisfactory acceptance despite some hyperestrogenic secondary effects, which may be improved by a new dosage schedule. Triphasic preparations have given good results with significantly reduced steroid doses. There have been few recent findings concerning risks of OCs. The triphasic formulations and those containing desogestrel are too recent to have been subjected to epidemiologic study. The noncontraceptive benefits of OCs are becoming more apparent; they include protection against ovarian and endometrial cancer, functional ovarian cyst, ectopic pregnancy, salpingitis, benign breast disease, dysmenorrhea, rheumatoid arthritis, menorrhagia, and premenstrual syndrome. Improved knowledge of the mechanisms of action and local effects of IUDs permitted improved utilization. Ultastructural studies and endometrial exploration have show that non-fundally located IUDs entail greater risk of failure and complications. The question of early pregnancy with IUD use is still unresolved. Copper IUDs are now the most widely used type, but there are differences of apinion about whether the copper content should be increased or whether silver should be added to the core of the copper thread. IUDs with natural or synthetic progesterone may reduce bleeding and have other beneficial effects. Currently it is impossible to identify 1 particualr IUD as superior. IUD performance is improved by careful patient selection, choice of IUDs, and follow-up to identify and treat problems at an early stage. Improved spermicides such as Benzalkonjum chloride attracted greater attention to vaginal methods. The posibility of increased risk of toxic shock syndrome and teratogenic effects remain to be evaluated. Post-coital contraception continues to be important as yet no satisfactory new male methods have been developed. The US office of Technology Assessment has published a list of contraceptive developments or improvements expected by the year 2000.
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PMID:[Current issues in contraception]. 1233 71

With the recent advances in reproductive medicine, hysterosalpingography has become a relatively quick and noninvasive examination to evaluate fallopian tubes and uterine cavity. It remains the best modality to image fallopian tubes. Congenital uterine malformations, technical artefacts and pathological findings are depicted. Pathological findings that can be detected on hysterosalpingography include salpingitis isthmica nodosa, tubal blockage, peritubal adhesion, submucosal leiomyoma, endometrial polyp, endometrial carcinoma, synechiae and adenomyosis.
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PMID:Hysterosalpingography: current applications. 1738 89

Xanthogranulomatous inflammation is a rare, non-neoplastic variant of chronic inflammation. Of the 15 reported cases of Xanthogranulomatous endometritis, majority (60%) were accompanied by endometrial carcinoma. We herein report a case of a postmenopausal woman presenting with recurrent pyometra who was suspected to be case of cervical tuberculosis and treated for the same. Inspite of antitubercular therapy, she had cervical stenosis and developed recurrent pyometra over the next 2 years requiring repeated drainage. She then underwent hysterectomy and was found to have co-existent Xanthogranulomatous salpingitis (XGS) on histopathological examination. Xanthogranulomatous inflammation is a rare pathological diagnosis that gynecologists need to be aware of while managing such patients.
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PMID:Recurrent pyometra and xanthogranulomatous salpingitis: A rare pathologic association in a postmenopausal lady. 2531 3

Iron is a well-documented carcinogen based on both animal models and observational studies in humans. There are limited published data on pseudoxanthomatous salpingitis, an uncommon condition characterized by the accumulation of histiocytes containing iron and iron-related compounds-lipofuscin and hemosiderin-in the lamina propria of the fallopian tube. The clinical and pathologic features of 49 consecutive cases were evaluated. The mean patient age was 53. A history of endometriosis was found in 20%, infertility in 17%, and tubal ligation in 7%. Thirteen (27%) had endometrial cancer and 2 patients had prior radiation therapy for cervical carcinoma. Histologic evidence of endometriosis other than tubal pigment deposition was identified in 65%, and in the fallopian tubes in 35%. Pigment deposition was unilateral in 65% and multifocal or diffuse in 80%. Plasma cells, eosinophils, and neutrophils were present in the tubal lamina propria in 57%, 18%, and 24%, respectively. Hydrosalpinx was present in 51%. An iron stain was positive in pseudoxanthoma cells lacking hemosiderin in 14 of 18 cases (78%). By immunohistochemistry, 2 of 22 cases displayed p53 signatures. The Ki67 proliferation index was elevated (>10%) in 11 of 22 cases, with a mean index of 32% in those cases. An elevated proliferation index did not correlate with inflammation. In summary, these findings characterize the clinical and pathologic features of pseudoxanthomatous salpingitis and confirm its close association with endometriosis, occasional association with radiation therapy, and the presence of iron in the histiocytes. In view of the evolving paradigm shift implicating the fallopian tubal epithelium as the site of origin of high-grade extrauterine serous carcinoma, the presence of iron and iron-related compounds in the fallopian tube provides an opportunity to study the early events in high-grade serous carcinogenesis in a setting characterized by a well-documented carcinogen in close anatomic proximity to the putative epithelium of origin.
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PMID:Pseudoxanthomatous salpingitis as an ex vivo model of fallopian tube serous carcinogenesis: a clinicopathologic study of 49 cases. 2576 Sep 5

Serous tubal intraepithelial carcinoma (STIC), the putative precursor of the majority of extrauterine high-grade serous carcinomas, has been reported in both high-risk women (those with a germline BRCA mutation, a personal history of breast carcinoma, and/or family history of breast or ovarian carcinoma) and average risk women from the general population. We reviewed grossly normal adnexal specimens from 388 consecutive, unselected women undergoing surgery, including those with germline BRCA mutation (37 patients), personal history of breast cancer or family history of breast/ovarian cancer (74 patients), endometrial cancer (175 patients), and a variety of other conditions (102 patients). Among 111 high-risk cases and 277 non-high-risk cases, 3 STICs were identified (0.8%), all in non-high-risk women (high risk vs. non-high risk: P=not significant). STIC was found in 2 women with nonserous endometrial carcinoma and 1 with complex atypical endometrial hyperplasia. Salpingoliths (mucosal calcifications), found in 9% of high-risk cases, and fimbrial adenofibromas in 9.9% of high-risk cases, were significantly more common in high-risk as compared with non-high-risk women (1.8% and 2.5%, respectively; P<0.007). Mucinous metaplasia was found in 3.1%, salpingitis isthmica nodosa in 3.4%, hemosiderin or pseudoxanthoma cells in 4.9%, and fibrous luminal nodules in 4.1%. None of these latter features differed significantly in the high-risk versus non-high-risk groups. These findings suggest a possible association between STIC and endometrial hyperplasia and carcinoma, and clarify the frequency of non-neoplastic tubal findings in grossly normal fallopian tubes.
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PMID:Incidental Serous Tubal Intraepithelial Carcinoma and Non-Neoplastic Conditions of the Fallopian Tubes in Grossly Normal Adnexa: A Clinicopathologic Study of 388 Completely Embedded Cases. 2663 Feb 21


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