Endometrial cancer is the most common female genital tract cancer in the developed world.
But it is less common than cervical cancer in developing countries.
Risk factors for endometrial cancer include, unopposed estrogen action, especially with hormone replacement therapy with estrogen alone, granulosa cell tumor, and polycystic ovarian syndrome.
Obesity.
Medical conditions such as diabetes, and hypertension.
Positive family history of endometrial cancer.
Use of tamoxifen.
Anovulation.
Late menopause.
And high fat diet.
In addition, women with breast cancer, colon cancer, and ovarian cancer, are at a higher risk of getting endometrial cancer.
There are several different histological types of endometrial cancer.
Endometrial adenocarcinoma is the most common type, and accounts for about 70 to 80% of the cases of endometrial cancer.
Other types include Adenosquamous carcinoma.
Clear cell carcinoma.
Papillary serous carcinoma.
And carcinosarcoma.
Both clear cell and papillary serous carcinomas are more aggressive and have a relatively poor prognosis.
About 75% of women with endometrial cancer are post-menopausal.
Therefore, post-menopausal bleeding is the commonest symptom of endometrial cancer.
In peri menopausal or pre-menopausal women, heavy, frequent menstrual periods, and intermenstrual bleeding are present.
Diagnosis of endometrial cancer requires a few steps.
Individuals who are suspected to have endometrial cancer should undergo trans vaginal ultrasound scan to measure the endometrial thickness.
If the thickness is more than 5-millimeters, they should undergo an endometrial biopsy to confirm or exclude malignancy.
Pipelle biopsy is the gold standard for the diagnosis of endometrial cancer.
Staging of endometrial cancer is according to the Figo classification system.
According to this system, there are four main stages of endometrial cancer.
In stage 1 A, no or less than half of the myometrium is involved.
In stage 1 B, invasion is equal to half or more than half of the myometrium.
In stage 2, tumor invades the cervical stroma, but does not extend beyond the uterus.
In stage 3 A, tumor invades the serosa of the uterus, with or without adnexal involvement.
Stage 3 B is vaginal metastasis.
In stage 3 C, the tumor metastasizes to pelvic or para-aortic lymph nodes.
In stage 4, tumor invades the bladder and bowel mucosa.
Finally, the treatment of endometrial cancer depends on the stage of the disease.
For stage 1 disease, abdominal hysterectomy with by lateral tube and ovary removal and selective lymphadenectomy can be done.
For stage 2 disease, radical hysterectomy with pelvic and para-aortic lymphadenectomy can be done.
And for stage 3 and 4 cancer, cytoreductive surgery is indicated.
Some patients may also receive radiotherapy following surgery.

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