Endometrial cancer

Endometrial cancer is cancer of uterine lining. Incidence is rising in urban women in India. Patient commonly present with abnormal vaginal bleeding like heavy menstrual bleeding or postmenopausal bleeding and less commonly with abnormal vaginal discharge. These patients are usually obese, hypertensive and/or diabetic but it can also develop in women with no co morbidities with some high risk factors. Women with history of Polycystic ovarian disease (PCOD), postmenopausal patients on long term estrogen therapy, patients of carcinoma breast on hormonal therapy are at risk of endometrial cancer. Endometrial cancer can occur in women with family history of ovarian/ breast/ endometrial or colon cancer, as it is also inherited by genes in 5-10% of patients.

For early detection of endometrial cancer women should not neglect the abnormal vaginal bleeding in perimenopausal and postmenopausal age group. Do not start any blind hormone therapy without D&C and biopsy report in case of abnormal bleeding in this age group. Annual ultrasonography after age of 40 years in patients with family history of endometrial, colon, and breast or ovarian cancer is helpful in screening, so that patient can be diagnosed and treated in early stage. Transabdominal /transvaginal ultrasound is modality of choice to identify endometrial thickness. Endometrial thickness is >3mm in symptomatic postmenopausal lady is suspicious of endometrial cancer and should undergo hysteroscopy and D&C to rule out carcinoma endometrium.