Uterine cancer is two different diseases, with very different outlooks
Womb cancer covers two distinct illnesses. About nine in ten US cases start in the uterine lining and are often curable when caught early; a rarer kind grows from the muscle and supporting tissue and is harder to treat. American diagnoses rose from 35,040 in 1999 to an estimated 61,880 in 2019.
Endometrial cancer arises from gland cells in the endometrium, the lining of the uterus. Its commonest form, a well-differentiated endometrioid adenocarcinoma, responds readily to treatment, while serous and clear-cell types behave more aggressively. Uterine sarcomas come from the muscular wall or connective tissue; leiomyosarcoma, for instance, starts in the muscle layer and should not be confused with fibroids, which are benign. A rare hybrid, the carcinosarcoma, shows features of both families.
Exact causes are unknown, but hormones seem to matter. Cancer cells of this type carry estrogen receptors, and the hormone is thought to spur their growth. Recognised risk factors for the endometrial form include obesity, metabolic syndrome, type 2 diabetes, estrogen pills taken without progesterone, past tamoxifen use, late menopause and inherited conditions such as Lynch and Cowden syndromes. Sarcoma risk is linked to earlier pelvic radiation and a childhood eye cancer called retinoblastoma. Combined contraceptive pills are associated with lower risk.
Abnormal bleeding is the usual warning sign, including bleeding between periods or after menopause, sometimes with pelvic pain or pressure. Doctors typically confirm endometrial cancer with a biopsy of the lining, supported by pelvic examination and ultrasound. Routine screening is advised only for women with those hereditary syndromes. Surgery, usually removal of the uterus, is the main treatment, alongside radiation, chemotherapy, hormone therapy and targeted drugs. Researchers have also reported an infrared light test on blood samples that detected the cancer with 87% accuracy.
In the United States about 81% of patients survive at least five years, 95% when the disease is still localised but 19.6% once it has spread far. Median age at diagnosis is 63. Worldwide about 3.8 million women were affected in 2015, rates are highest in North America and northern Europe, and deaths rose from 45,000 in 1990 to 58,000 in 2010.
Source: Uterine cancer
