Skip to main content

Endometrial Cancer: Screening, Diagnosis, and Surgical Staging

  • Chapter
Uterine Cancer

Part of the book series: Current Clinical Oncology ((CCO))

  • 578 Accesses

Abstract

Environmental and hereditary factors contribute to increased risk of developing endometrial cancer. An understanding of risk factors can guide screening modalities in premenopausal and postmenopausal women. Attention is drawn to certain anatomic abnormalities that prevent vaginal bleeding—the most common symptom related to cancer. Diagnostic tests that are available to pursue various aspects of the diagnosis in a sequential fashion are described, the most important of which is the endometrial biopsy. Recommendations for screening and diagnosis in the asymptomatic as well as the symptomatic patients are summarized. Surgical staging represents the final event in the diagnostic workup. Instances when such staging can be modified to deal with various comorbidities are delineated.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics 2016. CA Cancer J Clin. 2016;66(1):7–30.

    Article  Google Scholar 

  2. Ferlay J, Shin HR, Bray F, et al. GLOBOCAN 2008 v1.2, Cancer Incidence and mortality worldwide: IARC CancerBase No. 10 [Internet] Lyon. France: International Agency for Research on Cancer; 2010. Available from: http://globocan.iarc.fr.

    Google Scholar 

  3. Bokhman JV. Two pathogenetic types of endometrial carcinoma. Gynecol Oncol. 1983;15(1):10–7.

    Article  CAS  Google Scholar 

  4. Doll A, Abal M, Rigau M, et al. Novel molecular profiles of endometrial cancer-new light through old windows. J Steroid Biochem Mol Biol. 2008;108(3–5):221–9.

    Article  CAS  Google Scholar 

  5. Mutter GL, Zaino RJ, Baak JP, et al. Benign endometrial hyperplasia sequence and endometrial intraepithelial neoplasia. Int J Gynecol Pathol. 2007;26(2):103–14.

    Article  Google Scholar 

  6. Felix AS, Weissfeld JL, Stone RA, et al. Factors associated with Type I and Type II endometrial cancer. Cancer Causes Control. 2010;21(11):1851–6.

    Article  Google Scholar 

  7. Hale GE, Hughes CL, Cline JM. Endometrial cancer: hormonal factors, the perimenopasual “window at risk”, and isoflavones. J Clin Endocrinol Metab. 2002;87:3–15.

    CAS  PubMed  Google Scholar 

  8. Salilew-Wondim D, Wang Q, Tesfaye D, et al. Polycystic ovarian syndrome is accompanied by repression of gene signatures associated with biosynthesis and metabolism of steroids, cholesterol and lipids. J Ovarian Res. 2015;8:24.

    Article  Google Scholar 

  9. Ezeh U, Yildiz BO, Azziz R. Referral bias in defining the phenotype and prevalence of obesity in polycystic ovary syndrome. J Clin Endocrinol Metab. 2013;98(6):E1088–96.

    Article  CAS  Google Scholar 

  10. Schlechte J, Sherman B, Halmi N, et al. Prolactin-secreting pituitary tumors in amenorrheic women: a comprehensive study. Endocr Rev. 1980;1(3):295–308.

    Article  CAS  Google Scholar 

  11. Rosato V, Zucchetto A, Bosetti C, et al. Metabolic syndrome and endometrial cancer risk. Ann Oncol. 2011;22:884–9.

    Article  CAS  Google Scholar 

  12. Trabert B, Wentzensen N, Felix AS, et al. Metabolic syndrome and risk of endometrial cancer in the United States: a study in the SEER-Medicare linked database. Cancer Epidemiol Biomarkers Prev. 2015;24(1):261–7.

    Article  Google Scholar 

  13. Lindemann K, Vatten LJ, Ellstrom-Engh M, et al. Body mass, diabetes and smoking, and endometrial cancer risk: a follow-up study. Br J Cancer. 2008;98:1582–5.

    Article  CAS  Google Scholar 

  14. Haroon S, Zia A, Idrees R, et al. Clinicopathological spectrum of ovarian sex cord-stromal tumors; 20 years’ retrospective study in a developing country. J Ovarian Res. 2013;6:87.

    Article  Google Scholar 

  15. Silva KR, Liechocki S, Carneiro JR, et al. Stromal-vascular fraction content and adipose stem cell behavior are altered in morbid obese and post bariatric surgery ex-obese women. Stem Cell Res Ther. 2015;6(1):72.

    Article  Google Scholar 

  16. Park SL, Goodman MT, Zhang ZF, et al. Body size, adult BMI gain and endometrial cancer risk: the multiethnic cohort. Int J Cancer. 2010;126(2):490–9.

    Article  CAS  Google Scholar 

  17. Weiderpass E, Adami H-O, Baron JA, et al. Risk of endometrial cancer following estrogen replacement with and without progestins. J Natl Cancer Inst. 1999;91(13):1131–7.

    Article  CAS  Google Scholar 

  18. Zacharias BT, Coelho JC, Parolin MB, et al. Hypothalamic-pituitary-gonadal function in men with liver cirrhosis before and after liver transplantation. Rev Col Bras Cir. 2014;41(6):421–5.

    Article  Google Scholar 

  19. Rydén L, Heibert Arnlind M, Vitols S, et al. Aromatase inhibitors alone or sequentially combined with tamoxifen in postmenopausal early breast cancer compared with tamoxifen or placebo - meta-analyses on efficacy and adverse events based on randomized clinical trials. Breast. 2016;26:106–14.

    Article  Google Scholar 

  20. ACOG. American College of Obstetrician Gynecologists. Committee opinion no. 663: aromatase inhibitors in gynecologic practice. Obstet Gynecol. 2016;127(6):e170–4.

    Article  Google Scholar 

  21. Lowry KP, Turan EA, Eisenberg J, et al. Projected effects of radiation-induced cancers on life expectancy in patients undergoing CT surveillance for limited-stage Hodgkin lymphoma: a Markov model. AJR Am J Roentgenol. 2015;204(6):1228–33.

    Article  Google Scholar 

  22. Mills AM, Longacre TA. Lynch syndrome: female genital tract cancer diagnosis and screening. Surg Pathol Clin. 2016;9(2):201–14.

    Article  Google Scholar 

  23. ACOG American College of Obstetrician Gynecologists. Committee on practice bulletins-gynecology and society of gynecologic oncology. ACOG practice bulletin No. 147: lynch syndrome. Obstet Gynecol. 2014;124:1042–54.

    Article  Google Scholar 

  24. Levine DA, Lin O, Barakat RR, et al. Risk of endometrial cancer associated with BRCA mutation. Gynecol Oncol. 2001;80:395–8.

    Article  CAS  Google Scholar 

  25. Neto N, Cunha TM. Do hereditary syndrome-related gynecologic cancers have any specific features? Insights Imaging. 2015;6(5):545–52.

    Article  Google Scholar 

  26. Anderson B. Diagnosis of endometrial cancer. Clin Obstet Gynecol. 1986;13:739–50.

    CAS  Google Scholar 

  27. Pellerin GP, Finan MA. Endometrial cancer in women 45 years of age or younger: a clinicopathological analysis. Am J Obstet Gynecol. 2005;193(5):1640–4.

    Article  Google Scholar 

  28. Argall E, Jovanovic A, Figueroa R, et al. Effects of endometrial ablation on treatment planning in women with endometrial cancer. J Minim Invasive Gynecol. 2016;23(2):281–5.

    Article  Google Scholar 

  29. ACOG. American College of Obstetrician Gynecologists. Committee Opinion No. 557. Management of acute abnormal uterine bleeding in nonpregnant reproductive-aged women. Obstet Gynecol. 2013;121(4):891–6.

    Article  Google Scholar 

  30. Havig K. The health care experiences of adult survivors of child sexual abuse: a systematic review of evidence on sensitive practice. Trauma Violence Abuse. 2008;9(1):19–33.

    Article  Google Scholar 

  31. Kingnate C, Tangiitgamol S, Khunnarong J, et al. Abnormal uterine cervical cytology in a large tertiary hospital in Bangkok metropolis: Prevalence, management, and outcomes. Indian J Cancer. 2016;53:67–73.

    Article  CAS  Google Scholar 

  32. Serdy K, Yildiz-Aktas I, Li Z, et al. The value of papanicolaou tests in the diagnosis of endometrial carcinoma: a large study cohort from an academic medical center. Am J Clin Pathol. 2016;145(3):350–4.

    Article  CAS  Google Scholar 

  33. Goodman A. Human papillomavirus infection and cervical cancer. BMJ. 2015;350:h2372.

    Article  Google Scholar 

  34. Clark TJ, Mann CH, Shah N, et al. Accuracy of outpatient endometrial biopsy in the diagnosis of endometrial cancer: a systemic quantitative review. BJOG. 2002;109:313–21.

    Article  Google Scholar 

  35. Gungorduk K, Asicioglu O, Ertas IE, et al. Comparison of the histopathological diagnoses of preoperative dilatation and curettage and Pipelle biopsy. Eur J Gynaecol Oncol. 2014;35(5):539–43.

    CAS  PubMed  Google Scholar 

  36. Bredella MA, Feldstein VA, Filly RA, et al. Measurement of endometrial thickness at US in multicenter drug trials: value of central quality assurance reading. Radiology. 2000;217:516–20.

    Article  CAS  Google Scholar 

  37. Kim M-J, Kim J-J, Kim SM. Endometrial evaluation with transvaginal ultrasonography for the screening of endometrial hyperplasia or cancer in premenopausal and perimenopausal women. Obstet Gynecol Sci. 2016;59(3):192–200.

    Article  Google Scholar 

  38. Love CD, Muir BB, Scrimgeour JB, et al. Investigation of endometrial abnormalities in asymptomatic women treated with tamoxifen and an evaluation of the role of endometrial screening. J Clin Oncol. 1999;17:2050–4.

    Article  CAS  Google Scholar 

  39. Schwartz LB, Snyder J, Horan C, et al. The use of transvaginal ultrasound and saline infusion sonohysyerography for the evaluation of aymptomatic postmenopausal breast cancer patients on tamoxifen. Ultrasound Obstet Gynecol. 1998;11:48–53.

    Article  CAS  Google Scholar 

  40. Chawla I, Tripathi S, Vohra P, et al. To evaluate the accuracy of saline infusion sonohysterography (SIS) for evaluation of uterine cavity abnormalities in patients with abnormal uterine bleeding. J Obstet Gynaecol India. 2014;64(3):197–201.

    Article  CAS  Google Scholar 

  41. Arnaiz J, Muñoz AB, Verna V, et al. Magnetic resonance imaging for the pre-surgical assessment of endometrial cancer: results in a routine clinical setting, outside dedicated trials; a cross-sectional study. Anticancer Res. 2016;36(4):1891–4.

    PubMed  Google Scholar 

  42. Signorelli M, Crivellaro C, Buda A, et al. Staging of high-risk endometrial cancer with PET/CT and sentinel lymph node mapping. Clin Nucl Med. 2015;40(10):780–5.

    Article  Google Scholar 

  43. Mutch DG. The new FIGO staging system for cancers of the vulva, cervix, endometrium, and sarcomas. Gynecol Oncol. 2009;115:325–8.

    Article  Google Scholar 

  44. Creasman WT, Morrow CP, Bundy BN, et al. Surgical pathologic spread patterns of endometrial cancer. Cancer. 1987;60:2035–41.

    Article  CAS  Google Scholar 

  45. Liang LW, Perez AR, Cangemi NA, et al. An assessment of prognostic factors, adjuvant treatment, and outcomes of stage IA polyp-limited versus endometrium-limited type II endometrial carcinoma. Int J Gynecol Cancer. 2016;26(3):497–504.

    Article  Google Scholar 

  46. Mäenpää MM, Nieminen K, Tomás EI, et al. Robotic-assisted versus traditional laparoscopic surgery for endometrial cancer: A Randomized Controlled Trial. Am J Obstet Gynecol. 2016; pii: S0002–9378(16)30314–3.

    Google Scholar 

  47. Wright JD, Burke WM, Tergas AI, et al. Comparative effectiveness of minimally invasive hysterectomy for endometrial cancer. J Clin Oncol. 2016;34(10):1087–96.

    Article  CAS  Google Scholar 

  48. Hall TR, Lee S, Boruta DM, Goodman A. Medical device safety and surgical dissemination of unrecognized uterine malignancy: morcellation in minimally invasive gynecologic surgery. Oncologist. 2015;20(11):1274–82.

    Article  Google Scholar 

  49. Soliman PT, Slomovitz BM, Broaddus RR, et al. Synchronous primary cancers of the endometrium and ovary: a single institution review of 84 cases. Gynecol Oncol. 2004;94:456–62.

    Article  Google Scholar 

  50. Convery PA, Cantrell LA, Santo ND, et al. Retrospective review of an intraoperative algorithm to predict lymph node metastasis in low-grade endometrial adenocarcinoma. Gynecol Oncol. 2011;123:65–70.

    Article  Google Scholar 

  51. Clark LH, Soper JT (2016) Endometrial cancer and the role of lymphadenectomy. Obstet Gynecol Surv 71(6):353–360

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Annekathryn Goodman .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Goodman, A. (2016). Endometrial Cancer: Screening, Diagnosis, and Surgical Staging. In: Muggia, F., Santin, A.D., Oliva, E. (eds) Uterine Cancer. Current Clinical Oncology. Springer, Cham. https://doi.org/10.1007/7631_2016_14

Download citation

  • DOI: https://doi.org/10.1007/7631_2016_14

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-47267-6

  • Online ISBN: 978-3-319-47269-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics