What is Endometrial (Uterine) Cancer?
Endometrial cancer, also known as uterine cancer, begins in the lining of the uterus (the endometrium). It is the most common type of uterine cancer and primarily affects postmenopausal women. The primary types include:
- Endometrioid Adenocarcinoma: This is the most common type of endometrial cancer, accounting for approximately 75-80% of cases. It typically resembles the normal endometrial glands and can vary in grade from well-differentiated to poorly differentiated.
- Serous Carcinoma: This type is more aggressive and less common, representing about 10% of cases. Serous carcinoma tends to occur in older women and is characterized by a high-grade histology and a poor prognosis.
- Clear Cell Carcinoma: Another rare and aggressive form of endometrial cancer, clear cell carcinoma accounts for about 4% of cases. It is named for its clear, glycogen-rich cells and is typically associated with a worse prognosis.
- Mixed Carcinoma: This type contains a combination of two or more histological types of endometrial cancer, such as endometrioid and serous components. The behavior and prognosis depend on the proportion and nature of each component.
- Undifferentiated Carcinoma: This is a very rare and highly aggressive type of endometrial cancer in which the cells do not resemble normal tissue cells, leading to a very poor prognosis.
- Carcinosarcoma (Malignant Mixed Müllerian Tumor): This type has both carcinomatous (epithelial) and sarcomatous (mesenchymal) components. It is rare and aggressive, often associated with a poor prognosis.
- Squamous Cell Carcinoma: This type is rare and usually associated with long-standing endometrial hyperplasia or pre-existing endometrial adenocarcinoma.
- Transitional Cell Carcinoma: This is an extremely rare type of endometrial cancer that resembles transitional cell carcinoma of the urinary tract.
Each type of endometrial cancer has distinct pathological features and can vary significantly in terms of prognosis and treatment strategies. Diagnosis typically involves histopathological examination of tissue obtained through biopsy or surgical resection.
Risk Factors
- Hormonal Imbalance: High levels of estrogen without adequate levels of progesterone can increase the risk.
- Age: Most common in women over 50.
- Obesity: Fat tissue produces estrogen, which can increase the risk.
- Reproductive History: Women who have never been pregnant have a higher risk.
- Menstrual History: Early menarche (before age 12) and late menopause (after age 55) can increase risk.
- Genetics: A family history of endometrial cancer or genetic syndromes like Lynch syndrome.
- Medical Conditions: Diabetes, polycystic ovary syndrome (PCOS), and endometrial hyperplasia.
Understanding these risk factors can help guide preventive measures and early detection efforts. By prioritizing regular check-ups and prompt medical attention, the GW Cancer Center Gynecological Oncology team can significantly improve the prognosis and survival of endometrial (uterine) cancer.