Endometrial Carcinoma 

  • Author: William T Creasman, MD; Chief Editor: Warner K Huh, MD   more...
 
Updated: Dec 7, 2011
 

Background

Corpus cancer is the most frequently occurring female genital cancer. Approximately 40,100 cases of corpus cancer were predicted to occur in the United States in 2008, making it the fourth most common cancer among women; of these women, approximately 7,400 will die from the disease.[1]

In developed countries, adenocarcinoma of the endometrium is the most common gynecological cancer; however, in developing countries, it is much less common than carcinoma of the cervix. In the United States in the early part of the 20th century, cancer of the cervix killed more women than any other cancer, but in the ensuing decades, the incidence for that malignancy decreased precipitously. This decrease has been credited to the impact of screening with the Papanicolaou test (Pap smear). In less-developed countries, screening for cervical cancer is performed very infrequently, and therefore, cancer of the cervix is quite prevalent.

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Epidemiology

Frequency

United States

The latest Surveillance, Epidemiology, and End Results (SEER) data note a total age-adjusted 25.2 incidence of 24.4 cases per 100,000 people, with the incidence in white women being cases per 100,000 persons and the incidence in black women being 22.6 cases per 100,000 persons.[1]

Mortality/Morbidity

  • Approximately 40,100 cases of corpus cancer were predicted to occur in the United States in 2008, making it the fourth most common cancer among women; of these women, approximately 7,400 will die from the disease.[1]

Race

  • Mortality is higher in black women than in white women, with a mortality ratio of 7.3 deaths per 100,000 persons in black women and only 3.8 deaths per 100,000 persons in white women.

Sex

  • Endometrial carcinoma occurs only in females.

Age

  • Endometrial adenocarcinoma occurs during the reproductive and menopausal years.
  • The median age of persons with this malignancy is early in the seventh decade of life, although most patients are aged 50-59 years. Approximately 5% of women younger than 40 years have adenocarcinoma, and 20-25% of women are diagnosed before menopause.
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Contributor Information and Disclosures
Author

William T Creasman, MD  J Marion Sims Distinguished University Professor, Department of Obstetrics and Gynecology, Medical University of South Carolina College of Medicine

William T Creasman, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Gynecological and Obstetrical Society, American Medical Association, North Carolina Medical Society, Society of Gynecologist Oncologists, and South Carolina Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

John J Kavanagh Jr  MD, Chief, Professor, Department of Internal Medicine, Section of Gynecological and Medical Therapeutics, MD Anderson Cancer Center, University of Texas Medical School at Houston

John J Kavanagh Jr is a member of the following medical societies: American Association for Cancer Research, American Association for the Advancement of Science, American Association for the History of Medicine, American College of Physicians, American Federation for Medical Research, American Medical Association, Society of Gynecologist Oncologists, Southern Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

A David Barnes, MD, PhD, MPH, FACOG  Consulting Staff, Department of Obstetrics and Gynecology, Mammoth Hospital (Mammoth Lakes, California), Pioneer Valley Hospital (Salt Lake City, Utah), Warren General Hospital (Warren, Pennsylvania), and Mountain West Hospital (Tooele, Utah)

A David Barnes, MD, PhD, MPH, FACOG is a member of the following medical societies: American College of Forensic Examiners, American College of Obstetricians and Gynecologists, American Medical Association, Association of Military Surgeons of the US, and Utah Medical Association

Disclosure: Nothing to disclose.

Frederick B Gaupp, MD  Consulting Staff, Department of Family Practice, Hancock Medical Center

Frederick B Gaupp, MD is a member of the following medical societies: American Academy of Family Physicians

Disclosure: Nothing to disclose.

Chief Editor

Warner K Huh, MD  Professor, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Senior Scientist, Comprehensive Cancer Center, University of Alabama School of Medicine

Warner K Huh, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American College of Surgeons, American Society of Clinical Oncology, Massachusetts Medical Society, and Society of Gynecologist Oncologists

Disclosure: MERCK Consulting fee Consulting; GSK Consulting fee Consulting; ROCHE PHARMA/DIAGNOSTICS Consulting fee Consulting; HOLOGICS Consulting fee Consulting; HELIX BIOPHARMA Consulting fee Consulting; COVIDIEN Consulting fee Consulting; INTUITIVE SURGICAL Surgical Proctor

Additional Contributors

Medscape Reference thanks Tarek Bardawil, MD, Assistant Professor, Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, for assistance with the video contribution to this article.

References

  1. Surveillance, Epidemiology, and End Results (SEER) Program. SEER Database: Incidence - SEER 9 Regs Public-Use. National Cancer Institute, DCCPS, Surveillance Research Program. Available at http://seer.cancer.gov/.

  2. Bernstein L, Deapen D, Cerhan JR, et al. Tamoxifen therapy for breast cancer and endometrial cancer risk. J Natl Cancer Inst. Oct 6 1999;91(19):1654-62. [Medline].

  3. Creasman WT. Endometrial cancer: incidence, prognostic factors, diagnosis, and treatment. Semin Oncol. Feb 1997;24(1 Suppl 1):S1-140-S1-50. [Medline].

  4. [Best Evidence] Bjorge T, Stocks T, Lukanova A, Tretli S, Selmer R, Manjer J, et al. Metabolic syndrome and endometrial carcinoma. Am J Epidemiol. Apr 15 2010;171(8):892-902. [Medline].

  5. Creasman WT. Revised FIGO staging for carcinoma of the vulva, cervix and endometrium. Inter J Gynecol and Obstet. 2009;105:103-4.

  6. Sharma C, Deutsch I, Lewin SN, et al. Lymphadenectomy influences the utilization of adjuvant radiation treatment for endometrial cancer. Am J Obstet Gynecol. Dec 2011;205(6):562.e1-9. [Medline].

  7. Kilgore LC, Partridge EE, Alvarez RD. Adenocarcinoma of the endometrium: survival comparisons of patients with and without pelvic node sampling. Gynecol Oncol. Jan 1995;56(1):29-33. [Medline].

  8. Chan JK, Cheung MK, Huh WK, et al. Therapeutic role of lymph node resection in endometrioid corpus cancer: a study of 12,333 patients. Cancer. Oct 15 2006;107(8):1823-30. [Medline].

  9. American College of Obstetricians and Gynecologists. Estrogen replacement therapy and endometrial cancer. ACOG Committee Opinion: Committee on Gynecologic Practice Number 126--August 1993. Int J Gynaecol Obstet. Oct 1993;43(1):89. [Medline].

  10. Creasman WT, Kohler MF, Odicino F, et al. Prognosis of papillary serous, clear cell, and grade 3 stage I carcinoma of the endometrium. Gynecol Oncol. Dec 2004;95(3):593-6. [Medline].

  11. Creasman WT, Morrow CP, Bundy BN, et al. Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Oncology Group Study. Cancer. Oct 15 1987;60(8 Suppl):2035-41. [Medline].

  12. DiSaia PJ, Creasman WT. 7th ed. Clinical Gynecologic Oncology. St. Louis, Mo: Mosby; 2007.

  13. Ferenczy A, Gelfand M. The biologic significance of cytologic atypia in progestogen-treated endometrial hyperplasia. Am J Obstet Gynecol. Jan 1989;160(1):126-31. [Medline].

  14. Goff BA, Kato D, Schmidt RA, et al. Uterine papillary serous carcinoma: patterns of metastatic spread. Gynecol Oncol. Sep 1994;54(3):264-8. [Medline].

  15. Kadar N, Malfetano JH, Homesley HD. Determinants of survival of surgically staged patients with endometrial carcinoma histologically confined to the uterus: implications for therapy. Obstet Gynecol. Oct 1992;80(4):655-9. [Medline].

  16. Kurman RJ, Kaminski PF, Norris HJ. The behavior of endometrial hyperplasia. A long-term study of "untreated" hyperplasia in 170 patients. Cancer. Jul 15 1985;56(2):403-12. [Medline].

  17. Mariani A, Dowdy SC, Keeney GL, et al. High-risk endometrial cancer subgroups: candidates for target-based adjuvant therapy. Gynecol Oncol. Oct 2004;95(1):120-6. [Medline].

  18. Morrow CP, Bundy BN, Kurman RJ, et al. Relationship between surgical-pathological risk factors and outcome in clinical stage I and II carcinoma of the endometrium: a Gynecologic Oncology Group study. Gynecol Oncol. Jan 1991;40(1):55-65. [Medline].

  19. Silverberg SG, Major FJ, Blessing JA, Fetter B, Askin FB, Liao SY, et al. Carcinosarcoma (malignant mixed mesodermal tumor) of the uterus. A Gynecologic Oncology Group pathologic study of 203 cases. Int J Gynecol Pathol. 1990;9(1):1-19. [Medline].

 
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Diagnostic hysteroscopy for endometrial cancer. Video courtesy of Tarek Bardawil, MD.
 
 
 
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