Uterine cancer

Uterine cancer, also known as womb cancer, are two types of cancer that develops from the tissues of the uterus.[3] Endometrial cancer forms from the lining of the uterus and uterine sarcoma forms from the muscles or support tissue of the uterus.[1][2] Symptoms of endometrial cancer include unusual vaginal bleeding or pain in the pelvis.[1] Symptoms of uterine sarcoma include unusual vaginal bleeding or a mass in the vagina.[2]

Uterine cancer
Other namesWomb cancer
SpecialtyGynecology, oncology
SymptomsEndometrial cancer: vaginal bleeding, pelvic pain[1]
Uterine sarcoma: vaginal bleeding, mass in the vagina[2]
TypesEndometrial cancer, uterine sarcoma[3]
Risk factorsEndometrial cancer: obesity, metabolic syndrome, type 2 diabetes, family history of the condition[1]
Uterine sarcoma: radiation therapy to the pelvis[2]
TreatmentSurgery, radiation therapy, chemotherapy, hormone therapy, targeted therapy[1][2]
Prognosis81% 5 year survival (US)[4]
Frequency3.8 million (2015)[5]
Deaths90,000 (2015)[6]

Risk factors for endometrial cancer include obesity, metabolic syndrome, type 2 diabetes, and a family history of the condition.[1] Risk factors for uterine sarcoma include prior radiation therapy to the pelvis.[2] Diagnosis of endometrial cancer is typically based on an endometrial biopsy.[1] A diagnosis of uterine sarcoma may be suspected based on symptoms, a pelvic exam, and medical imaging.[2]

Endometrial cancer can often be cured while uterine sarcoma typically is harder to treat.[3] Treatment may include a combination of surgery, radiation therapy, chemotherapy, hormone therapy, and targeted therapy.[1][2] Just over 80% of people survive more than 5 years following diagnosis.[4]

In 2015 about 3.8 million people were affected globally and it resulted in 90,000 deaths.[5][6] Endometrial cancer is relatively common while uterine sarcoma is rare.[3] In the United States they represent 3.6% of new cancer cases.[4] They most commonly occur in women between the ages of 55 and 74.[4]

Causes

It is not known with certainty what the causes for uterine cancer may be, though hormone imbalance is speculated as a risk factor. Estrogen receptors, known to be present on the surfaces of the cells of this type of cancer, are thought to interact with the hormone causing increased cell growth, which can then result in cancer. The exact mechanism of how this occurs is not understood.[7]

Types

The terms uterine cancer and womb cancer may refer to any of several different types of cancer which occur in the uterus, namely:

  • Endometrial carcinomas originate from cells in the glands of the endometrium (uterine lining). These include the common and readily treatable well-differentiated endometrioid adenocarcinoma, as well as the more aggressive uterine papillary serous carcinoma and uterine clear-cell carcinoma.
  • Endometrial stromal sarcomas originate from the connective tissues of the endometrium, and are far less common than endometrial carcinomas.
  • Malignant mixed Müllerian tumors are rare endometrial tumors which show both glandular (carcinomatous) and stromal (sarcomatous) differentiation – carcinosarcoma behaves similar to a high grade carcinoma, and it is felt to be of epithelial origin rather than true sarcoma.

Epidemiology
Age-standardized death from cancer of the uterine body per 100,000 inhabitants in 2004.[8]
  no data
  less than 0.5
  0.5–1
  1–1.5
  1.5–2
  2–2.5
  2.5–3
  3–3.5
  3.5–4
  4–4.5
  4.5–5
  5–8
  more than 8

Uterine cancer effects approximately 3.1% of women during their lifetime.[4] Uterine cancer resulted in 45,000 deaths worldwide in 1990, with this number increasing to 58,000 deaths in 2010.[9] North America and Northern Europe have the highest rates of uterine cancer. Asia, Southern Europe, Australia and South America have moderate rates, with the lowest rates in Africa and Eastern Asia.[10] About 81% of women with uterine cancer surviving for five years. This rate is higher with more localized cancer at 95% survival rate for five years and lower for a distant spread of the cancer, at a 16.8% survival rate for five years.[4]

United Kingdom

Uterine cancer is the fourth most common cancer in women in the UK (around 8,500 women were diagnosed with the disease in 2011), and it is the tenth most common cause of cancer death in women (around 2,000 people died in 2012).[11]

United States

In the United States, uterine cancer is the most commonly diagnosed invasive cancer of the female reproductive system.[12] The number of women diagnosed with uterine cancer has been steadily increasing, with 35,040 women diagnosed in 1999 and 56,808 diagnosed in 2016. The age-adjusted rate of new cases in 1999 was 23.9 per 100,000 and has increased to 27.3 per 100,000 in 2016.[13] The incidence of uterine cancer increased even more in 2019, with an approximated 61,880 new cases.[14]

The rates of incidence and death for uterine cancer differ depending on race. The incidence is highest for white women, with 28.1 new cases per 100,000 persons. Black women had a similar incidence with 27.4 new cases per 100,000 persons. Other ethnic groups had lower incidences, Hispanic women had 24.1 new cases per 100,000 persons, Asian/Pacific Islander women had 20.8 new cases per 100,000 persons, and American Indian/Alaska Native women had 19.7 new cases per 100,000 persons. For the death rates of uterine cancer, black women had the highest rates, 8.5 deaths per 100,000 persons. The death rates for the other ethnic groups were dramatically lower. White women had 4.4 deaths per 100,000 persons, Hispanic women had 3.9 deaths per 100,000 persons, American Indian/Alaska Native women had 3.5 deaths per 100,000 persons, and Asian/Pacific Islander women had 3.1 deaths per 100,000 persons.<ref name=SEER2019>

Uterine cancer has a high prevalence in the United States, with approximately 772,247 women with the disease in 2016.[14]

References
  1. "Endometrial Cancer Treatment". National Cancer Institute. 26 April 2018. Retrieved 3 February 2019.
  2. "Uterine Sarcoma Treatment". National Cancer Institute. 3 October 2018. Retrieved 3 February 2019.
  3. "Uterine Cancer". National Cancer Institute. 1 January 1980. Retrieved 3 February 2019.
  4. "Uterine Cancer - Cancer Stat Facts". SEER. Retrieved 3 February 2019.
  5. GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. (8 October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  6. GBD 2015 Mortality and Causes of Death, Collaborators. (8 October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/S0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  7. Causes, Risk Factors, and Prevention TOPICS - Do we know what causes endometrial cancer? - cancer.org - American Cancer Society - Retrieved 5 January 2015.
  8. "WHO Disease and injury country estimates". World Health Organization. 2009. Retrieved Nov 11, 2009.
  9. Lozano, R (Dec 15, 2012). "Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010". The Lancet. 380 (9859): 2095–128. doi:10.1016/S0140-6736(12)61728-0. hdl:10536/DRO/DU:30050819. PMID 23245604.
  10. Felix, Ashley S.; Brinton, Louise A. (May 8, 2019). "Cancer Progress and Priorities: Uterine Cancer". Cancer Epidemiology, Biomarkers & Prevention : A Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. 27 (9): 985–994. doi:10.1158/1055-9965.EPI-18-0264. ISSN 1055-9965. PMC 6504985. PMID 30181320.
  11. "Uterine cancer statistics". Cancer Research UK. Retrieved 28 October 2014.
  12. Felix, Ashley S.; Brinton, Louise A. (May 8, 2019). "Cancer Progress and Priorities: Uterine Cancer". Cancer Epidemiology, Biomarkers & Prevention : A Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. 27 (9): 985–994. doi:10.1158/1055-9965.EPI-18-0264. ISSN 1055-9965. PMC 6504985. PMID 30181320.
  13. "USCS Data Visualizations". gis.cdc.gov. Retrieved 2019-11-12.
  14. "Cancer of the Endometrium - Cancer Stat Facts". SEER. Retrieved 2019-11-12.
Classification
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