Materiały źródłowe

• #1 Key Statistics for Endometrial Cancer | American Cancer Society | American Cancer Society

  https://www.cancer.org/cancer/types/endometrial-cancer/about/key-statistics.html

  In the United States, cancer of the endometrium (the lining of the uterus) is the most common cancer of the female reproductive organs. […] The American Cancer Society estimates for cancer of the uterus in the United States for 2025 are: About 69,120 new cases of cancer of the uterus will be diagnosed. About 13,860 women will die from cancers of the uterus. […] Endometrial cancer is the fourth most common cancer for women in the United States. Worldwide, an estimated 417,367 cases of endometrial cancer were diagnosed in 2020. […] About 69% of uterine cancers are diagnosed when the cancer is in an early stage. This is largely because abnormal vaginal bleeding is an early symptom, particularly when it occurs after menopause. […] Endometrial cancer affects mainly post-menopausal women. The average age of women diagnosed with endometrial cancer is 60. It’s uncommon in women under the age of 45.

• #2 Endometrial Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525981/

  Endometrial cancer is the most prevalent gynecologic malignancy in American women and a significant cause of morbidity and mortality. Over 66,000 new cases were expected in 2023; therefore, clinicians must be equipped with the necessary clinical knowledge to evaluate patients presenting with symptoms such as abnormal uterine bleeding, pelvic pain, or uterine enlargementcommon manifestations of this condition. […] Uterine corpus cancer is the most prevalent gynecologic malignancy in the United States. In 2023 alone, over 66,000 new cases were expected, and over 13,000 deaths were due to this cancer. […] Endometrial cancer is the most common cancer of the female genital tract and the fourth most common cancer overall in women in the United States, with approximately 61,880 newly diagnosed cases and 12,160 deaths reported annually.

• #3 Uterine Cancer — Cancer Stat Facts

  https://seer.cancer.gov/statfacts/html/corp.html

  Estimated New Cases in 2025 69,120 […] Estimated Deaths in 2025 13,860 […] Uterine cancer represents 3.4% of all new cancer cases in the U.S. […] In 2025, it is estimated that there will be 69,120 new cases of uterine cancer and an estimated 13,860 people will die of this disease. […] Most cases of endometrial cancer are diagnosed in women aged 45-74. The rate of new cases of uterine cancer was 28.3 per 100,000 women per year based on 2018-2022 cases, age-adjusted. […] Most deaths from endometrial cancer occur in women who are middle-aged or older. Uterine cancer is the thirteenth leading cause of cancer death in the United States. The death rate was 5.3 per 100,000 women per year based on 2019-2023, age-adjusted. […] Using statistical models for analysis, age-adjusted rates for new uterine cancer cases have been rising on average 0.7% each year over 2013-2022. Age-adjusted death rates have been rising on average 1.6% each year over 2014-2023.

• #4 Endometrial cancer statistics | World Cancer Research Fund

  https://www.wcrf.org/preventing-cancer/cancer-statistics/endometrial-cancer-statistics/page/141/

  Endometrial (sometimes known as womb or uterine) cancer is the 15th most common cancer among women worldwide. It is the 6th most common cancer in women. […] There were 420,368 new cases of endometrial cancer in 2022. […] China, the US and Russia had the highest number of endometrial cancer cases in 2022. […] China, the US and India had the highest number of deaths from endometrial cancer in 2022.

• #5 Key Statistics for Endometrial Cancer | American Cancer Society | American Cancer Society

  https://www.cancer.org/cancer/types/endometrial-cancer/about/key-statistics.html

  This cancer is more common in Black women than in White women. […] Incidence has increased by more than 1% per year since the mid-2000s; over the past decade (2012-2021), the rate increased by 0.6% per year in White women and 2% to 3% per year in women of all other racial and ethnic groups. […] Uterine cancer is one of the few cancers with increasing mortality; from 2013 to 2022 the death rate rose by 1.5% per year. […] In 2020, an estimated 97,370 people worldwide died from uterine cancer.

• #6 Endometrial Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525981/

  The average age for type 1 endometrial cancer diagnosis in the United States decreased from 64 to 61 years, which some experts have posited is secondary to increasing obesity rates. […] Some study results have estimated the incidence of endometrial cancer will double to 122,000 cases annually by the year 2030. […] The incidence of endometrial cancer is also increasing more significantly in Hispanic, Asian, Pacific Islander, and Black women than in non-Hispanic White women. […] Moreover, Black women have a higher incidence of advanced, high-grade cancers at the time of diagnosis, as well as poorer outcomes than non-Hispanic White women, which may be due to socioeconomic and healthcare access disparities.

• #7 Uterine cancer incidence statistics | Cancer Research UK

  https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/uterine-cancer/incidence

  For uterine cancer, like most cancer types, incidence increases with age. This largely reflects cell DNA damage accumulating over time. Damage can result from biological processes or from exposure to risk factors. A drop or plateau in incidence in the oldest age groups often indicates reduced diagnostic activity perhaps due to general ill health. […] The age distribution of uterine cancer cases probably reflects hormonal changes during and after the menopause. […] Uterine cancer European age-standardised (AS) incidence rates for females increased by 58% in the UK between 1993-1995 and 2017-2019. […] Over the last decade in the UK (between 2007-2009 and 2017-2019), uterine cancer AS incidence rates for females increased by 9%. […] Uterine cancer incidence rates have increased overall in most broad age groups in females in the UK since the early 1990s, but have remained stable in some. Rates in 0-24s have remained stable, in 25-49s have increased by 49%, in 50-59s have increased by 33%, in 60-69s have increased by 60%, in 70-79s have increased by 88% and in 80+s have increased by 48%.

• #8 Nationwide Surveillance in Uterine Cancer: Survival Analysis and the Importance of Birth Cohort: 30-Year Population-Based Registry in Taiwan | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0051372

  Uterine cancer was the most rapidly increasing malignancy and the second most common gynecologic malignancy in Taiwan. […] The age-adjusted incidence rate of endometrioid adenocarcinoma increased from 0.83 per 100,000 women per year between 1979 and 1983 to 7.50 per 100,000 women per year between 2004 and 2008. […] An increase over time in the number of patients with endometrioid adenocarcinomas was noted in this 30-year, nationwide, population-based study. Histologic type, age and treatment period were survival factors for uterine cancers. […] Uterine cancer is the most common gynecologic cancer in the United States, with 47,130 new cases projected in 2012. In Taiwan, it is the second most common gynecologic cancer, with 1,424 newly diagnosed cases of uterine cancer in 2009. […] The incidence of uterine cancer has remained stable in the past 20 years in the United States. However, the age-adjusted incidence of uterine cancer (all females of any age) dramatically increased from 1979 to 2007 in Taiwan (0.99 per 100,000 women per year in 1979 and 8.26 per 100,000 women per year in 2007), and uterine cancer was the most rapidly increasing malignancy in Taiwanese women.

• #9 Endometrial Carcinoma: Practice Essentials, Background, Etiology

  https://emedicine.medscape.com/article/254083-overview

  Endometrial cancer (also referred to as corpus uterine cancer or corpus cancer) is the most common female genital cancer in the developed world, with adenocarcinoma of the endometrium the most common type. In the United States, an estimated 2.8% of women will be diagnosed with this malignancy at some point in their lifetime. […] The most recent Surveillance, Epidemiology, and End Results (SEER) data are from 2011-2015 cases, which reveal a total age-adjusted incidence of 26 cases per 100,000 women. The incidence in White women is 26.6 cases per 100,000 compared to the incidence in Black women, which is 25.4 cases per 100,000. […] Mortality is higher in Black women (8.3 deaths per 100,000) than in White women (4.3 deaths per 100,000). Asian/Pacific Islander women have the lowest mortality (2.9% deaths per 100,000) among all races.

• #10 Black Women Less Likely to Survive Endometrial Cancer | The AACR

  https://www.aacr.org/patients-caregivers/progress-against-cancer/black-women-less-likely-to-survive-endometrial-cancer/

  Researchers have found a significant racial disparity in the survival rates of women facing endometrial cancer. A recent study found non-Hispanic black women were more likely to die from endometrial cancer than women in other racial or ethnic groups, no matter what stage or subtype of the disease they had. […] Endometrial cancer, a form of uterine cancer, is the most commonly diagnosed gynecological cancer in the United States, and the incidence is rising among all racial and ethnic groups. In 2015, an estimated 54,870 women across the country will be diagnosed with this form of cancer, according to the National Cancer Institutes Surveillance, Epidemiology, and End Results (SEER) Program. […] Researchers discovered that mortality rates for the aggressive endometrial cancer subtypes were more than 1.5 times higher among non-Hispanic black women compared with non-Hispanic white women.

• #11 Black Women Less Likely to Survive Endometrial Cancer | The AACR

  https://www.aacr.org/patients-caregivers/progress-against-cancer/black-women-less-likely-to-survive-endometrial-cancer/

  The analysis of overall five-year survival rates showed that non-Hispanic black women had poorer survival rates at every stage of diagnosis, regardless of endometrial cancer subtype, compared with non-Hispanic white women, while five-year survival rates were similar or higher among Asian and Hispanic women compared with non-Hispanic white women. […] Our data suggest that disparities persist even when these factors are controlled for, Dr. Cote said. […] Dr. Cote also pointed out that socioeconomic factors did not appear to influence womens chances of survival. It was somewhat surprising that the endometrial cancer survival disparity we identified was limited to non-Hispanic black women because many of the challenges previously linked to worse outcomes, including low socioeconomic status and high rates of obesity and diabetes, are also experienced by Hispanic women, but that population did not have poor outcomes, said Dr. Cote.

• #12 Endometrial Carcinoma: Practice Essentials, Background, Etiology

  https://emedicine.medscape.com/article/254083-overview

  Endometrial adenocarcinoma occurs during the reproductive and menopausal years. The median age of women with this malignancy is 62 years; most patients are aged 55-64 years. […] Approximately 63,230 new US cases of endometrial cancer are expected to have been diagnosed in 2018 (3.6% of all new US cancer cases); of these women, approximately 11,350 will die from this disease (1.9% of all cancer deaths). On the basis of 2013-2015 data, an estimated 2.9% of women will be diagnosed with endometrial cancer in their lifetime.

• #13 The Epidemiology of Endometrial Cancer | GLOWM

  https://www.glowm.com/section-view/heading/The%20Epidemiology%20of%20Endometrial%20Cancer/item/236

  The majority of women diagnosed with endometrial cancer are peri- or postmenopausal between the ages of 50 and 65. […] The average age at diagnosis is 61. […] However, the risk of developing endometrial cancer increases with advancing age. […] In the United States, white women are more likely to be diagnosed with endometrial cancer than African-American, Asian, or Hispanic women. […] The age-adjusted incidence rate for white women is 24.8 per 100,000 women, whereas it is 20.9, 18.2, and 15.9 for African-American, Asian, and Hispanic women, respectively. […] In general, African-American women are more likely to present with regional or distant metastasis, have high-risk tumor types, have less access to care, and have more medical comorbidities than other racial groups. […] In general, the incidence is highest in developed countries.

• #14 Genital Tract Cancers in Females: Endometrial Cancer – Province of British Columbia

  https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/endometrial-cancer

  There are 2 major recognized categories of endometrial cancer: type 1 and type 2. Type 1 tumours are much more common (~80% of all cases) and are of lower histological grade. They are associated with estrogen excess and have a more favourable prognosis. Type 2 tumours are much less common and are of higher grade. They are not estrogen-related, and their prognosis is poorer. […] Endometrial cancer* represents 3% of all new cancer cases. The median age for diagnosis of endometrial cancer is 62 years, with 74% of cases diagnosed after the age 55. Only 7% are diagnosed before the age of 44, and 26% before the age of 54.3 […] If other causes of AUB have been ruled out, and/or endometrial cancer is suspected, an endometrial biopsy and transvaginal ultrasound are the recommended initial diagnostic investigations.1

• #15 Concerning Trends in Endometrial Cancer – Endometrial Cancer Update

  https://www.medpagetoday.com/resource-centers/endometrial-cancer-update/concerning-trends-endometrial-cancer/5578

  While endometrial cancer incidence has risen overall in the past decade, it’s increasing at a faster rate among women younger than 50 compared to older women. […] The rising incidence of endometrial cancer among young racial/ethnic minority women is especially concerning and points to the need for culturally tailored and multilevel prevention efforts targeting modifiable risk factors such as obesity and diabetes. […] Clinicians should be aware of these rising incidence trends and prioritize educating young women about the risk factors and symptoms of endometrial cancer, while actively listening to and addressing their concerns to ensure equitable and timely diagnosis and care.

• #16 The Epidemiology of Endometrial and Ovarian Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3259524/

  Worldwide, higher rates of endometrial and ovarian cancer are observed in industrialized and Northern European populations and lower rates in third world countries. There is a positive correlation between endometrial cancer occurrence and ovarian cancer occurrence that is significant (Pearson correlation = 0.76, p<0.001). [...] This review has highlighted similarities in the epidemiology of endometrial and ovarian cancer that includes highly correlated incidence rates and similar risk factor profiles. Factors that decrease risk for both cancers include a late menarche, early age at first birth, giving birth and breastfeeding, and use of oral contraceptives. Short or irregular cycles and late menopause is associated with increased risk for both. Other risk factors that appear to operate in a similar direction include decreased risk associated with IUD use or a tubal ligation and increased risk associated with obesity, lack of exercise, and use of talc powders in genital hygiene.

• #17 The Epidemiology of Endometrial Cancer | GLOWM

  https://www.glowm.com/section-view/heading/The%20Epidemiology%20of%20Endometrial%20Cancer/item/236

  Interestingly, when one compares among various regions within racial groups, there are differences noted in incidence rates. […] Studies have shown that the rates of endometrial cancer in African-American and Asian women living in the United States are higher than in women living in Africa or Asia. […] Additionally, there are data to suggest that Chinese and Japanese immigrants to the United States have a higher risk of endometrial cancer than women who remain in China and Japan. […] This suggests that environmental factors play an important role in the development of endometrial cancer. […] Table 3 reviews common risk factors for endometrial cancer and their associated relative risk. […] It should be noted that the majority of these risk factors are related to excess estrogen, and are therefore applicable to type I tumors.

• #18 Endometrial carcinoma: Epidemiology, risk factors, and prevention – UpToDate

  https://www.uptodate.com/contents/endometrial-carcinoma-epidemiology-and-risk-factors

  Endometrial carcinoma: Epidemiology, risk factors, and prevention […] Uterine cancer is the second most common gynecologic cancer worldwide when both resource-abundant and resource-limited countries are considered (cervical cancer is more common in worldwide statistics). Over 90 percent of uterine cancers are endometrial, originating in the epithelium; most of the remainder are mesenchymal, originating in the myometrial muscle or, less commonly, the endometrial stroma. […] The major risk factor for endometrial carcinoma (EC) is the presence of a clinical scenario associated with an excess of endogenous or exogenous estrogen without adequate opposition by a progestin. Lynch syndrome (hereditary nonpolyposis colon cancer) is a genetic risk factor; the pathogenesis in these cases is a germline mutation in one of the DNA mismatch repair genes. […] This topic will discuss the epidemiology, risk factors, and prevention of EC.

• #19

  https://journals.lww.com/cancerjournal/fulltext/2023/19020/epidemiological_characteristics_of_endometrial.45.aspx

  The incidence of endometrial cancer is on the rise in recent years and it is estimated to increase by 50% worldwide by 2040. The incidence and mortality vary among countries. It is seen that the incidence is higher in high-income or developed countries than low- and middle-income countries. […] Early age of menarche and late age of menopause are two risk factors related to increased risk for uterine cancer. […] Majority (82.5%, n = 71) of the patients in our study were postmenopausal. […] The mean age of menopause in our study was 47, and 61 patients (86%) out of total 86 patients have menopause at the age of 50 years or less. […] About 25% (n = 22) of the patients had hypertension and 27% (n = 23) has diabetes as comorbidity. […] The data also revealed that 46% (n = 40) patients were overweight and 16% (n = 14) were obese which clearly agrees with different researches. […] Endometrium cancer is one of the most common malignancies affecting women worldwide and its incidence has shown a steady rise for two decades.

• #20 The Epidemiology of Endometrial Cancer | GLOWM

  https://www.glowm.com/section-view/heading/The%20Epidemiology%20of%20Endometrial%20Cancer/item/236

  The most common risk factor for type II cancers is age. […] Obesity, long recognized as an important risk factor for endometrial cancer, has been shown to increase exposure of the endometrium to endogenous estrogen in a number of ways. […] As a risk factor for endometrial cancer, obesity has been reported to account for 17-46% of all cases. […] The heaviest women are at the highest risk of developing endometrial cancer. […] A recent study found that overweight women had twice the risk of developing disease as normal-weight women, while obese women carried four to five times the risk. […] Nulliparous women have two to three times the risk of developing endometrial cancer compared with parous women. […] Moreover, a woman’s endometrial cancer risk decreases with each child she has.

• #21 Pregnancy duration and endometrial cancer risk: nationwide cohort study | The BMJ

  https://www.bmj.com/content/366/bmj.l4693

  Endometrial cancer is the most common gynaecological cancer in developed countries, with an increasing incidence in North America and Europe. A womans risk of endometrial cancer has been strongly associated with number of full term pregnancies, with a noticeable protection associated with the first full term pregnancy and additional protection associated with subsequent full term pregnancies. […] The risk of endometrial cancer is reduced regardless of whether a pregnancy ends shortly after conception or at 40 weeks of gestation. This reduction in risk could be explained by a biological process occurring within the first weeks of pregnancy, as pregnancies ending in induced abortions were associated with similar reductions in risk as pregnancies ending in childbirth. […] Our study shows that the protective association between pregnancy and endometrial cancer is equivalent for pregnancies resulting in induced abortion and birth, and thus suggests that the association is attributable to a womans underlying fecundity or a biological process occurring early in gestation. The findings from our study and others support an early gestational process, as each additional pregnancy was associated with a reduction in risk of endometrial cancer, and because adjustment for infertility did not explain the effect of parity on risk. Future research is of great importance as it could lead to insights into early gestational factors that potentially could facilitate the prevention of endometrial cancer.

• #22 Uterine Cancer Facts and Causes – Color Health

  https://www.color.com/learn/cancer/uterine-cancer-facts-and-causes

  Uterine cancer makes up 3% of all new cancer cases diagnosed in women in the US each year. […] Approximately 1 in 36 women will develop uterine cancer in their lifetime. […] Certain medications, treatments, and medical conditions can increase risk. […] Certain medical conditions such as diabetes, polycystic ovarian syndrome (PCOS), uterine hyperplasia and non-cancerous ovarian tumors called granulosa cell tumors increase the risk of uterine cancer. […] Obesity has been linked to increasing uterine cancer risk because fat tissue can change certain hormones called androgens into estrogen. This increase in estrogen levels increases uterine cancer risk. Uterine cancer is twice as common in overweight women, and more than three times as common in obese women. […] Using oral contraceptives (birth control pills), using an intrauterine device (IUD) for birth control, having a lower body mass index (BMI), giving birth, and having a hysterectomy (surgical removal of the uterus) also reduce the risk of developing uterine cancer.

• #23 Association of endometrial cancer risk with hypertension- an updated meta-analysis of observational studies | Scientific Reports

  https://www.nature.com/articles/s41598-024-76896-8

  Endometrial cancer is one of the most common gynaecological cancers in the developed countries. […] Overall meta-analysis demonstrates significant association between hypertension and endometrial cancer risk (RR=1.37, 95% CI: 1.271.47, p0.001). […] Findings of this comprehensive review and meta-analysis indicate that hypertension is associated with higher overall risk of endometrial cancer. […] Endometrial cancer ranks as the sixth most frequently diagnosed cancer in women and the 15th most prevalent cancer overall. […] In 2020, there were over 417,000 newly reported cases, resulting in 97,000 fatalities attributed to this form of cancer. […] The likelihood of a woman developing endometrial cancer during her lifetime stands at approximately 3%, with the average age of diagnosis being 61 years.

• #24 Association of endometrial cancer risk with hypertension- an updated meta-analysis of observational studies | Scientific Reports

  https://www.nature.com/articles/s41598-024-76896-8

  Several studies have shown that the risk of endometrial cancer increases with: older age, early menstruation, late menopause, obesity, family history of endometrial cancer, exposure to radiation, infertility, and prolonged use of estrogen in hormone therapy. […] Our findings suggest that hypertension is significantly associated with an increased risk of this cancer. […] Our meta-analysis showed that hypertension increases the risk of endometrial cancer by 1.37 times (95% CI 1.271.47, p0,001), which aligns with the results of the only other meta-analysis on this topic, conducted by Aune et al. […] It is worth noting that all RR values we obtained were lower than in the previous meta-analysis, and the RR values from case-control studies in both meta-analyses were consistently higher than those from cohort studies.

• #25

  http://www.bccancer.bc.ca/health-professionals/clinical-resources/cancer-management-manual/gynecology/endometrium

  Unlike histopathological evaluation, the molecular subtyping of EC offers an objective and reproducible classification system that has been shown to have strong prognostic value and therapeutic implications. In Dec 2020, the World Health Organization (WHO) recommended the integration of molecular parameters in to standard pathology reporting where available and molecular classification is also now incorporated in many Societal guidelines (NCCN, ESGO/ESTRO/ESP). […] An excess of unopposed estrogen is a major risk factor for developing EC. Excess estrogen can be attributed to obesity (conversion of androstenedione to estrone in adipose tissue), anovulatory conditions (polycystic ovarian syndrome, which results in a deficiency of progesterone), and exogenous estrogen (estrogen hormone replacement therapy, or tamoxifen, a selective estrogen receptor modulator, which acts as an estrogen agonist in the uterus).

• #26

  https://bpac.org.nz/2023/endometrial-cancer.aspx

  Pacific peoples have the highest incidence of endometrial cancer amongst any ethnic group and this is increasing more rapidly than in Mori and European populations. […] Most endometrial cancers are aetiologically linked to excessive exposure to endogenous or exogenous oestrogen unopposed by progesterone, with the most significant risk factors being increasing age (55 years) and obesity. […] Many cases of endometrial cancer cannot be prevented, however, there is evidence that even slight changes to certain predisposing factors, e.g. obesity, can significantly reduce the risk of endometrial cancer. […] Lynch syndrome accounts for approximately 3% of endometrial cancers and 9% of all cases diagnosed in people aged 50 years. […] There are no screening programmes for the early detection of endometrial cancer in the general population or for high-risk groups. […] Approximately 95% of people diagnosed with endometrial cancer are symptomatic.

• #27

  https://journals.lww.com/cancerjournal/fulltext/2023/19020/epidemiological_characteristics_of_endometrial.45.aspx

  A retrospective study which analyzed the data of female patients attending a tertiary care center in National Capital Territory for the treatment of endometrial cancer. […] The incidence of endometrium cancer is showing a steady rise in the recent past. Early age of menarche, late age of menopause, nulliparity, obesity, and diabetes mellitus are well-documented risk factors for uterine cancer. Better outcome and control of disease is possible by understanding of endometrial cancer etiology, risk factors, and its preventive measures. Thus, a robust screening program is warranted to detect the disease in early stage and for increased survival. […] Endometrial cancer is the second most common and fourth leading cause of death due to gynecological malignancy worldwide as recorded in 2020. […] The exact etiology of endometrial cancer is unknown, but prolonged exposure to estrogen is considered the main causative factor. Hence, women having early menarche and delayed menopause are at high risk for developing endometrial cancer. The other risk factors include nulliparity, obesity, comorbidities such as hypertension, diabetes, estrogen only hormone replacement therapy (HRT) and genetic factors such as lynch syndrome and cowden syndrome. It arises mainly in postmenopausal women. The peak incidence is in the 55-65 years age group.

• #28 Latest Data Indicate New Care Standard in Advanced/Recurrent

  https://www.esmo.org/newsroom/press-and-media-hub/esmo-media-releases/latest-data-indicate-new-care-standard-in-advanced-recurrent-endometrial-cancer-results-from-the-ruby-trial

  Adding immunotherapy to standard chemotherapy for first-line treatment of advanced or first recurrence of endometrial cancer significantly improves progression-free survival (PFS) compared to chemotherapy alone, with a promising early indication of improved overall survival (OS). […] Endometrial cancer is the sixth most common cancer in women worldwide, with over 400,000 new cases per year, and both incidence and mortality are increasing. […] Following identification of four molecular sub-groups of endometrial cancer, European and US guidelines now recommend testing for tumour DNA repair status for risk classification and potentially to help guide treatment and improve outcomes. […] We urgently need better treatment strategies, and the results of this trial have shown a new standard of care for women with advanced or relapsed endometrial cancer.

• #29 The Epidemiology of Endometrial Cancer | GLOWM

  https://www.glowm.com/section-view/heading/The%20Epidemiology%20of%20Endometrial%20Cancer/item/236

  Combined oral contraceptive pills (OCPs) are known to be protective against endometrial cancer with the amount of risk reduction being proportional to the length of OCP use. […] It has been suggested that 5 years of oral contraceptive use will halve the risk of developing endometrial cancer. […] This protective effect is greatest in nulliparous women. […] Endometrial cancer is a very common malignancy affecting hundreds of thousands of women worldwide with the number of cases increasing annually. Understanding the epidemiology of this disease may not only aid with treatment, but also further the development of prevention strategies.

• #30 The Epidemiology of Endometrial Cancer | GLOWM

  https://www.glowm.com/section-view/heading/The%20Epidemiology%20of%20Endometrial%20Cancer/item/236

  An increased incidence of diabetes mellitus among patients with endometrial cancer has been described for many years. […] However, given the strong association between obesity and type 2 diabetes, and that many patients with endometrial cancer are obese, the proposed relationship between diabetes and endometrial cancer was often attributed to confounding. […] Multiple authors have since established type 2 diabetes to be an independent risk factor for developing endometrial cancer. […] Recently, there has been increasing interest in insulin resistance and endometrial cancer, with multiple studies suggesting a relationship between the two. […] The inverse relationship between cigarette smoking and endometrial cancer risk has been known since the late 1970s. […] Multiple authors have reported the relative risk of endometrial cancer to be 0.5 in smokers.

• #31 Endometrial Carcinoma Guidelines: Guidelines Summary, Prevention, Diagnosis

  https://emedicine.medscape.com/article/254083-guidelines

  Currently, no major organization recommends screening for cancer of the uterus for asymptomatic women. According to the National Cancer Institute (NCI) PDQ cancer information summary for endometrial cancer screening, no evidence suggests that transvaginal sonography reduces mortality from endometrial cancer, and there is inadequate evidence that endometrial sampling (biopsy) reduces mortality. The early clinical presentation and high early detection rate (85%) make it unlikely that screening will have a successful impact on earlier detection and increased survival rate. […] The American Cancer Society (ACS) recommends that at the time of menopause, all women should be made aware of the risks and symptoms of endometrial cancer and strongly encouraged to report any unexpected bleeding or spotting to their physician.

• #32 Endometrial Carcinoma Guidelines: Guidelines Summary, Prevention, Diagnosis

  https://emedicine.medscape.com/article/254083-guidelines

  Additionally, the NCIs PDQ cancer information summary and ACS agree that for women at increased risk for endometrial cancer due to a history of receiving either estrogen therapy or tamoxifen therapy, there is no indication that routine screening would improve early detection or survival rates. As with women at average risk, these women generally present with symptoms at an early stage when the prognosis is good. […] The Spanish Society of Medical Oncology (SEOM) and the Spanish Group for Investigation in Ovarian Cancer (GEICO) do not recommend routine screening for endometrial cancer in women who are at average or high risk for endometrial cancer and do not have abnormal uterine bleeding; this recommendation includes patients who are taking tamoxifen. Metrorrhagia should always be investigated in postmenopausal women or those with risk factors, using transvaginal ultrasound with a cutoff level of 3 mm.

• #33 Endometrial Carcinoma Guidelines: Guidelines Summary, Prevention, Diagnosis

  https://emedicine.medscape.com/article/254083-guidelines

  The NCCN guidelines include the following recommendations for surveillance and risk reduction in women with Lynch syndrome: Hysterectomy and bilateral salpingo-oophorectomy should be offered to women who have completed child bearing and carry MLH1, MSH2, or MSH6 mutations; Annual endometrial sampling for carriers of MLH1 or MSH2; Annual colonoscopy (to decrease risk of colorectal cancer); Routine transvaginal ultrasound and serum CA-125 testing are not recommended. […] In women with Lynch syndrome, the SEOM and the GEICO recommend screening for endometrial cancer with annual endometrial sampling, transvaginal ultrasound (TVUS), and CA125 measurement, beginning at age 30-35, or 5-10 years prior to the earliest age of first diagnosis of Lynch-associated cancer of any kind. […] According to the Spanish Society of Medical Oncology (SEOM) and the Spanish Group for Investigation in Ovarian Cancer (GEICO), surveillance consists mainly of monitoring symptoms and physical examination that includes a speculum and pelvic examination every 3-6 months for 2 years, and every 6-12 months thereafter. Patients with low-risk endometrial cancer can be followed less frequently: 6-12 months for first 2 years, then yearly thereafter. Follow-up imaging may be useful in selected high-risk patients.

• #34 Diagnosis and Management of Endometrial Cancer | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0315/p468.html

  The ACS recommends that all women older than 65 years be informed of the risks and symptoms of endometrial cancer and advised to seek evaluation if symptoms occur. There is no evidence to support the screening of asymptomatic women, with the exception of those who have or are at increased risk of Lynch syndrome. […] Management of risk factors such as obesity, diabetes, and hypertension could play a role in the prevention of endometrial cancer. For women on hormone therapy, the addition of progesterone has been shown to decrease the risk of endometrial cancer. […] Survival is based on the stage and histology of the diagnosis. Most patients with stage I and II endometrial cancer will have a favorable prognosis, whereas patients with stage III or IV endometrial cancer will have a worse likelihood of survival. Posttreatment surveillance is recommended for detection of recurrent disease. The Society of Gynecologic Oncology recommends follow-up symptom surveillance and pelvic examinations every three to six months for two years posttreatment, then every six months for three years, and annually thereafter.

• #35 Reassessment of intensive surveillance practices adopted for endometrial cancer survivors | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-022-01937-1

  In this study, we aimed to re-examine intensive surveillance protocols by retrospectively analyzing data, including surveillance methods to detect recurrence, recurrence sites, and survival periods after recurrence, to consider surveillance benefits for patients and cost-effective practices. […] The majority of patients with recurrent endometrial cancer have a poor prognosis, although some specific cases demonstrate long-term survival after recurrence. Post-treatment surveillance is expected to detect recurrent tumors at a very early stage, and these tumors can be completely cured with multidisciplinary therapy. […] In the present study, the time to first recurrence and local recurrence were significant predictive factors for better prognosis after recurrence. However, although 75% of recurrences were diagnosed as asymptomatic, the intensive surveillance protocol did not substantially improve post-recurrence outcomes.

• #36 Reassessment of intensive surveillance practices adopted for endometrial cancer survivors | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-022-01937-1

  Thus, our results are consistent with the recommendations of the 2021 version of the National Comprehensive Cancer Network guidelines, which do not recommend CA125 for routine surveillance, suggesting that CA125 measurements should only be used in specific patients with advanced disease, serous carcinoma, or pre-elevated CA125 levels before treatment. […] In this study, 33 of 45 patients with distant metastasis were diagnosed as asymptomatic, and only 4 patients did not have subsequent recurrence after salvage therapy. […] Although our study indicated that patients with local recurrence with a long time to recurrence had a better prognosis, our intensive surveillance protocol did not benefit patients with asymptomatic recurrence to a large extent. However, we believe that surveillance provides psychological support and effective control of symptoms caused by recurrence in survivors. Further development of treatment modalities and therapeutic approaches for recurrent endometrial cancer are required to establish effective strategies.

• #37 Increased incidence and improved survival in endometrial cancer in Sweden 1960–2014: a population-based registry survey | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-023-10746-0

  The most important prognostic factor in endometrial cancer is stage. Stage also determines recommended treatment. […] The aim of this study was to investigate long term trends of incidence and net survival (NS) for endometrial cancer in Sweden, and in later time periods with regards to stage and morphology. […] The number of endometrial cancer cases doubled during the studied time period and the crude incidence increased from 16.2/100 000 women in 1960 to 28.6/100 000 in 2014. […] In 2010-2014 80% of the patients were diagnosed in stage I or II. […] There was a trend of improved survival over the entire study period regarding both 1-, 5- and 10-year net survival (NS) rates for women above 55 years of age. […] The net survival improved gradually from the 1960s to 2014 with a 5 year NS increasing from 69% to 86%. The most prominent improvement in NS was found in the elderly women above 75 years of age.

• #38 Endometrial Cancer Overview | American Association for Cancer Research

  https://www.aacr.org/patients-caregivers/cancer/endometrial-cancer/

  Endometrial cancer (also known as uterine cancer) is a disease in which malignant cells form in the tissues of the endometrium the lining of the uterus. […] Some 67,880 women in the United States are expected to be diagnosed with endometrial cancer and nearly 13,250 will die of the disease in 2024, according to estimates by the National Cancer Institutes Surveillance, Epidemiology, and End Results (SEER) Program. The five-year survival rate is 80.8 percent. […] Obesity, high blood pressure, and diabetes may increase the risk of endometrial cancer. Endometrial cancer may develop in breast cancer patients who have been treated with tamoxifen. A patient taking this drug should have a pelvic exam every year and report any vaginal bleeding (other than menstrual bleeding) as soon as possible. Also women taking estrogen alone have an increased risk of endometrial cancer.

• #39 Krebs – Cancer of the uterus

  https://www.krebsdaten.de/Krebs/EN/Content/Cancer_sites/Uterus_cancer/uterus_cancer_node.html

  With about 10,860 new cases every year, malignant tumours of the uterine body (endometrial cancer) are the fifth most common cancer in women and the most common of the female genital organs. […] The incidence rate of uterine cancer is slightly decreasing, while the age-standardised mortality rate has remained fairly constant in recent years. […] The relative 5-year survival rate in Germany is about 78 percent. […] About 80 percent of endometrial carcinomas are hormone dependent. […] Oestrogen monotherapy during menopause also increases risk, which can be counteracted by combination with gestagens. […] Women with diabetes mellitus type 2 are more likely to develop uterine cancer. […] For the rarer forms of uterine cancer that are not affected by oestrogen, higher age and radiation of the uterus can increase risk.

• #40 Histopathological patterns of endometrial carcinoma in a tertiary hospital in North-West Nigeria – ecancer

  https://ecancer.org/en/journal/article/1651-histopathological-patterns-of-endometrial-carcinoma-in-a-tertiary-hospital-in-north-west-nigeria

  The prognostic factors for endometrial carcinoma include age, race, tumour grade, tumour stage, oestrogen receptor status and histologic type. […] There is growing concern about the increasing incidence of endometrial carcinoma especially in developing countries which may not be unrelated to lifestyle changes by Africans to the Western world, increased availability of diagnostic facilities, increased exposure to associated risk factors especially in the younger age groups with obesity, physical inactivity and in part increasing long life span in women, as well as increasing population of perimenopausal/menopausal women with low parity. […] This study was undertaken to characterise the prevalent rate, and age distribution and to analyse the histomorphologic variants of endometrial carcinoma in Aminu Kano Teaching Hospital, Kano, Nigeria.

• #41 Mixed Endometrial Epithelial Carcinoma: Epidemiology, Treatment and Survival Rates—A 10-Year Retrospective Cohort Study from a Single Institution

  https://www.mdpi.com/2077-0383/12/19/6373

  There are limited data available specifically on the recurrence rates for mixed epithelial endometrial carcinoma (MEEC), as it is a rare and relatively understudied subtype of endometrial cancer. […] The univariate Cox regression analysis indicated that the risk of recurrence and the risk of death from disease are both correlated with an advanced stage of disease. […] The 5-year disease-free survival rate (DFS) in our study was 50.4%, and the 5-year overall survival (OS) rate was 52.4%. […] The management of mixed epithelial endometrial carcinoma (MEEC) presents several challenges for clinicians and researchers that need to be addressed to improve oncologic outcomes for patients. Accurate and early diagnosis plays a fundamental role in determining the appropriate treatment plan.

• #42 Study shows incidence rates of aggressive subtypes of uterine cancer rising

  https://bioengineer.org/study-shows-incidence-rates-of-aggressive-subtypes-of-uterine-cancer-rising/

  By contrast, incidence rates of aggressive, nonendometrioid subtypes have been increasing dramatically over time in all racial/ethnic groups (overall increase of 2.9% per year from 2000 to 2015). […] The researchers also found that the 5-year relative survival rate was lower among all women with nonendometrioid subtypes than among women with endometrioid subtypes and that black women had the lowest survival rates, within each stage at diagnosis or histologic subtype. […] All of these trendsthe rates of uterine cancer among black women exceeding those of white women, the higher incidence rates of nonendometrioid subtypes among black women, and the lower survival rates of black women for all uterine cancerare very concerning, Dr. Clarke said. […] One key message from this study is that these aggressive, nonendometrioid cancers are increasing for all women, Dr. Clarke said.

• #43

  http://www.bccancer.bc.ca/health-professionals/clinical-resources/cancer-management-manual/gynecology/endometrium

  Endometrial cancer (EC) is the most common gynecologic malignancy in Canada, and the incidence and mortality continue to rise globally. Historically, Bokhman described two types of EC based on distinct epidemiological factors and clinical behaviour. Type I EC corresponded to the estrogen dependent low-grade endometrioid adenocarcinomas that typically had a favourable prognosis. Type II EC corresponded to the estrogen independent non-endometrioid carcinomas which typically showed more aggressive disease with a poor prognosis. […] To address these problems, in 2013 The Cancer Genome Atlas (TCGA) Project applied in depth genomic, proteomic, and transcriptomic methodologies to a cohort of ECs identifying four molecular subtypes with distinct prognoses; POLE ultramutated, microsatellite instability (MSI) hypermutated, copy-number low and copy-number high.

• #44 Uterine Cancer Incidence and Mortality — United States, 1999–2016 | MMWR

  https://www.cdc.gov/mmwr/volumes/67/wr/mm6748a1.htm

  Promoting awareness among women and health care providers of the need for timely evaluation of abnormal vaginal bleeding can increase the chance that uterine cancer is detected early and treated appropriately. […] This report also found that uterine cancer death rates were higher in 2016 than in 1999 and that black women were approximately twice as likely to die from uterine cancer as were women in other racial/ethnic groups. […] An important early symptom of uterine cancer is abnormal vaginal bleeding, including bleeding between periods or after sex or any unexpected bleeding after menopause. […] Uterine cancer outcomes could be improved by increasing awareness among women that abnormal vaginal bleeding should be evaluated promptly by a health care provider. […] Multifactorial efforts at individual, community, clinical, and systems levels to help women achieve and maintain a healthy weight and obtain sufficient physical activity might reduce the risk for developing uterine cancer.

• #45 Uterine Cancer Before Age 50: Incidence is Up, Survival is Stable – Endometrial Cancer Update

  https://www.medpagetoday.com/resource-centers/endometrial-cancer-update/uterine-cancer-before-age-50-incidence-up-survival-stable/5299

  The average annual percent change in incidence between 2000 and 2019 was 0.91% (95% CI, 0.59-1.22) for non-Hispanic White women, 2.07% (95% CI, 1.54-2.49) for non-Hispanic Asian/Pacific Islander women, 2.69% (95% CI, 2.19-3.25) for non-Hispanic Black women, and 2.79% (95% CI, 2.35-3.37) for Hispanic women. […] Endometrioid subtypes were the most common, with an incidence rate of 9.6 cases per 100,000 women during 2010-2019. […] The 5-year relative survival rates for 2000-2009 (88.9%; 95% CI, 88.4-89.3) and for 2010-2019 (88.6%; 95% CI, 88.1-89.0) were similar. […] Non-Hispanic Black women had the lowest survival rates among all racial and ethnic groups. […] These increasing trends of uterine cancers in women aged 20-49 years indicate the need for increased awareness about modifiable risk factors (e.g., obesity) as well as the need to be aware of potential signs and symptoms for uterine cancer in this age group. […] There is a need for improved risk assessment and early detection strategies for uterine cancer, especially in women <50 years. [...] Obesity is considered one of the strongest risk factors for uterine cancers with endometrioid histology.

• #46 Screening Strategies to Improve Early Diagnosis in Endometrial Cancer

  https://www.mdpi.com/2077-0383/13/18/5445

  Around 85% of EC cases will appear in women older than 55 years old, being age the main risk factor for EC. […] Nevertheless, the screening of the entire menopausal population would require a massive amount of funding; therefore, there is a need to identify subgroups of women at high-risk of suffering from EC in order for it to be cost-effective. […] A screening strategy in EC should be to detect the disease in the pre-invasive stage (atypical hyperplasia or intraepithelial atypical neoplasia) or initial stage (intramucosal stage). An early stage at diagnosis is expected to improve cure rates, reduce the morbidity related to aggressive treatment and offer uterus-sparing management options for younger women wishing to preserve their fertility. […] The ideal screening tool in this scenario would be a minimally invasive, inexpensive and easy-to-perform test that could be implemented in a routine gynecologic checkup of patients at-risk.

• #47 New model identifies those at high risk for endometrial cancer — Harvard Gazette

  https://news.harvard.edu/gazette/story/2023/02/new-model-identifies-those-at-high-risk-for-endometrial-cancer/

  A model to identify those at high risk for endometrial cancer has been developed by a Harvard-led team of investigators. […] Despite endometrial cancer being the most common gynecological malignancy in the U.S., current guidelines do not recommend screening high-risk individuals, such as those with Lynch syndrome. […] Given the rising incidence and mortality rate of endometrial cancer, population screening to identify high-risk women is an attractive public health strategy, said first author Joy Shi of the Department of Epidemiology at Harvard School of Public Health. […] We found that epidemiologic risk factors alone could accurately distinguish between women at high and low risk for endometrial cancer. […] We found that epidemiologic risk factors alone, which could be quickly, cheaply, and easily collected in clinical or public health settings, could accurately distinguish between women at high and low risk for endometrial cancer, Shi said.

• #48 New model identifies those at high risk for endometrial cancer — Harvard Gazette

  https://news.harvard.edu/gazette/story/2023/02/new-model-identifies-those-at-high-risk-for-endometrial-cancer/

  When the risk model was applied to a more recent and representative U.S. population of white women, the model identified 2.5 percent of women with more than 20 percent cumulative risk of endometrial cancer between ages 40-85. […] These findings suggest that clinical guidance about endometrial cancer screening could be updated. […] Models will need to continually be recalibrated in new geographic, temporal, or population settings to account for rarer subtypes of endometrial cancer and make predictions in more diverse populations.

• #49 Screening Strategies to Improve Early Diagnosis in Endometrial Cancer

  https://www.mdpi.com/2077-0383/13/18/5445

  Considering clinical risk factors, we identify some target high-risk groups that could widely benefit from EC screening strategies, listed as follows: (a) women with a known genetic syndrome, (b) women with class 2 or 3 obesity (BMI ≥ 35 kg/m²), (c) women of any age with abnormal uterine bleeding (AUB) and (d) pre-menopausal women with PCO and/or type 2 diabetes. […] None of the current diagnostic tests perform accurately when used in a screening setting; therefore, the discovery of new biomarkers seems to be the future for EC screening.

• #50

  http://www.bccancer.bc.ca/health-professionals/clinical-resources/cancer-management-manual/gynecology/endometrium

  With respect to prevention, weight loss in obese women and improving glycemic control in diabetic women may have the most potential for reducing risk in these specific populations. The use of combination oral contraceptives has been shown to decrease risk by 50% if used for 5 or more years. […] Screening for endometrial cancer (endometrial biopsy, transvaginal ultrasound, CA125) has never proven to be effective in asymptomatic women. […] All cases of post-menopausal, intermenstrual bleeding or menorrhagia require investigation, which includes a pelvic examination and endometrial tissue sampling. […] MMR and p53 IHC are available in any pathology laboratory and is now considered standard of care for all ECs in BC. POLE testing has been approved in BC since May 2022. […] In the upfront treatment setting, combination chemotherapy with carboplatin and a taxane is the current standard of care. Treatment is usually for 6 cycles. […] For patients with MMRd endometrial cancer that has progressed after first-line chemotherapy, treatment with immune checkpoint inhibitors has been demonstrated to have a high response rate and long durations of treatment benefit.

• #51 Latest Data Indicate New Care Standard in Advanced/Recurrent

  https://www.esmo.org/newsroom/press-and-media-hub/esmo-media-releases/latest-data-indicate-new-care-standard-in-advanced-recurrent-endometrial-cancer-results-from-the-ruby-trial

  These results mean that many more women can be cured of endometrial cancer than was previously possible, but there will still be patients who progress after immunotherapy. […] Further trials are investigating other immunotherapy combinations for advanced endometrial cancer, including triple therapy with chemotherapy, immunotherapy and a PARP inhibitor, and a comparison of immunotherapy with chemotherapy in patients with hot tumours. […] D+CP showed statistically significant and clinically meaningful PFS benefits in the dMMR/MSI-H and overall populations vs CP alone.

• #52 Uterine Cancer Incidence and Mortality — United States, 1999–2016 | MMWR

  https://www.cdc.gov/mmwr/volumes/67/wr/mm6748a1.htm

  Uterine cancer is one of the few cancers with increasing incidence and mortality. […] During 1999-2015 and 1999-2016, uterine cancer incidence and mortality rates increased 0.7% and 1.1% per year, respectively, with black women disproportionately affected. […] Health care providers and community programs can help women achieve and maintain a healthy weight and get enough physical activity, which can reduce the risk for endometrial cancer, the most common uterine cancer. […] Public health efforts to help women achieve and maintain a healthy weight and obtain sufficient physical activity can reduce the risk for developing cancer of the endometrium (the lining of the uterus), the most common uterine cancer. […] Abnormal vaginal bleeding, including bleeding between periods or after sex or any unexpected bleeding after menopause, is an important symptom of uterine cancer.

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