Key Facts
More than 1 in 20 female cancers in Europe are cancers of the endometrium.
Across Europe, endometrial cancer is the fifth most common cancer in women.
Uterine cancer occurs most commonly in postmenopausal women over 50 years old when diagnosed. 50% of patients are over 60 years old.
It is more common in women who have never been pregnant.
Most uterine cancers are diagnosed early on in the disease. This is because postmenopausal bleeding (a major indicator of uterine cancer) is a worrying symptom and most women seek medical help when it occurs.
Early diagnosis usually means the prognosis will be good.
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Key Figures
| Total number of new cancer cases in Europe (2006) |
3.2 million |
| Total number of cancer deaths in Europe (2006) |
1.7 million |
| Number of new uterine cancer cases (2006) |
149,300 |
|
84,900 (EEA) |
|
82,500 (EU25) |
| Number of uterine cancer deaths (2006) |
46,600 |
|
24,200 (EEA) |
|
23,600 (EU25) |
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Cancer Types
Endometrial adenocarcinoma is the most common type of endometrial cancer and accounts for more than 75% of cases.
Papillary serous carcinoma is rare.
Clear-cell adenocarcinoma is another rare form of uterine cancer.
Both the carcinosarcomas that develop in the endometrium and leiomyosarcomas are sarcomas – cancers that develop from the smooth muscle found in the wall of the uterus. Both are very rare.
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Causes of Uterine Cancer
Most uterine cancers occur in postmenopausal women. The most common age at presentation is between 50 - 70 years.
The following factors increase the risk of developing uterine cancer:
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Prevention of Uterine Cancer
Obese women should reduce their weight to a healthy level to protect against uterine cancer as well as many other conditions.
Women who are still menstruating and who take the contraceptive pill have a lower risk of developing cancer of the uterus.
Preventative removal of the uterus and ovaries is radical but may be considered for women with Lynch syndrome - Hereditary Non-Polyposis Colorectal Cancer (HNPCC) - which carries a 40 – 60% lifetime chance of developing uterine cancer.
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Common Symptoms
The most common symptom of uterine cancer in postmenopausal women is vaginal bleeding.
Other symptoms in all women are:
- bleeding between menstrual periods
- heavier menstrual periods
- an abnormal vaginal discharge
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Diagnostic Tests
The diagnostic tests for cancer of the uterus consist of an examination of biopsies of the wall of the uterus to identify malignant cells and the precise type of cancer. MRI scans of the pelvis and abdomen will help exclude spread outside the uterus.
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Treatment
Surgery
The first line treatment for uterine cancer. Usually the uterus, fallopian tubes and ovaries are all removed (a total abdominal hysterectomy and bilateral salpingo-oophorectomy).
Radiotherapy
Radiotherapy may be given either before or after surgery, or as an alternative to surgery.
Radiotherapy is used in conjunction with surgery and reduces the risk of the cancer recurring. Radiotherapy can be given in a number of ways.
Radiotherapy – Brachytherapy
Radioactive material is placed inside or in close proximity to the tumour for a period of time.
Radiotherapy – External Beam Radiation
A linear accelerator (LINAC) is the most common way to deliver external beam radiation treatment to patients. The linear accelerator delivers a uniform dose of high-energy X-ray to the region of the cancer. These X-rays can destroy the cancer cells while sparing the surrounding normal tissue.
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Key Trends
- Obesity is increasing and becoming a significant risk factor for uterine cancer as well as many other conditions
- Early presentation results in more effective treatment and better outcomes for the patient
- Radiotherapy after surgery reduces recurrence rates.
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Important Research Areas
- Improving the delivery of lower doses of radiotherapy to reduce side effects whilst providing the same level of protection against recurrence of the cancer.
- The assessment of Image Modulated RadioTherapy (IMRT) to reduce adverse effects to the bowel.
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Unresolved Questions
- The use of combined chemotherapy and radiotherapy as a treatment for more advanced disease. (This has been shown to work well in other areas - for example, the treatment of some forms of lung cancer).
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