Primary Risk Factors:
- Estrogen use without progesterone
- Tamoxifen use
- Later age of menopause
- Family history
With over 50,000 women diagnosed each year, uterine cancer, of which a majority are endometrial cancer, accounts for the fourth most common cause of cancer in women in the United States. Though there are currently no screening tests for endometrial cancer, a majority of patients present with abnormal bleeding, potentially allowing for early detection of the disease.
Furthermore, the identification of high risk factors and the association with endometrial cancer has been well established. These risk factors include a direct correlation with obesity as well as diabetes, tamoxifen use, and family history/genetic predisposition. Therefore, recognizing patients at particularly increased risk for endometrial cancer and counseling all women on symptoms and risk reduction may allow for improved outcomes.
However, assessment of patient awareness and their baseline knowledge in regards to endometrial cancer is unknown. Secondary to the increased availability of resources such as the Internet, patients readily have access to medical information and are often more informed than ever before. However, the quality, interpretation, and understanding of information remain unclear.
In a recent study, a majority of participants were unaware of known risk factors and incorrectly identified smoking as a risk factor. Though it is a risk factor in up to 10% of cases, family history/genetic predisposition was the most frequently identified risk factor.
Two common risk factors, obesity and diabetes, were less frequently reported even though some women in the study were being treated for diabetes.
Similarly to studies on ovarian cancer, participants inaccurately reported that Pap tests were one of the most important tools in the prevention/detection of endometrial cancer. Furthermore, only a minority of participants, less than one fifth of the study population correctly noted the protective effect of oral contraception. Though it is one of the most common symptoms, vaginal bleeding was identified as a symptom by approximately half of the patients in each group. Furthermore, over 40% of participants in one group stated they did not know any symptoms.
Increasing awareness of symptoms of this, the most common gynecologic cancer, may allow for earlier medical intervention and understanding risk factors may result in employing risk reduction strategies. The role of healthcare providers to counsel women on risk factors may result in the potential to offer risk-reducing behaviors (weight loss, diabetes management, etc) as well as risk assessment (genetic predisposition).
There are opportunities to improve education in women regarding endometrial cancer and healthcare providers should maximize their role, as it is preferred by a majority of women we surveyed, particularly in women at increased risk.
The Foundation hosts the Uterine Cancer Network for Endometrial and Uterine Cancer Survivors (UCaN) to assist women living with a uterine cancer, seek increased funding for research and engage in education programs geared toward at-risk women. The UCaN Steering Committee to learn more about its members who include clinicians, researchers and advocates.
Women living with endometrial or other uterine cancers are invited to join the UCaN listserve by sending an email to firstname.lastname@example.org.
Please consider supporting efforts by the Foundation for Women’s Cancer to expand its educational programs to more fully educate women about risk-reduction strategies and early detection of endometrial and other uterine cancers. Donate now.