A strategy for the control of endometrial cancer

Epidemiologic studies can provide us with etiological clues and help us recognize high risk factors. The definition of high risk factors, especially in the perimenopausal years can lead to prophylactic measures that may aid in the control of endometrial cancer. Recognition of the high risk patient in the perimenopausal years by aspiration curettage of ambulatory women may offer a significant strategy of surveillance. The advent of modern steroid metabolic technology promises to help us clarify the problems of hormone sensitivity of this tumor so that we may properly translate these data into therapeutic action. Virulence scales can help the choice of treatment for invasive carcinoma so that patients with tumors of low virulence do not suffer from an excess of complications nor those with tumors of high virulence an excess of failure to control. In this manner we can define the role of radiotherapy and surgery, elect combined treatment when indicated and select radical surgery as indicated. There is evidence to suggest that the developmental concept of this tumor may lead to its control in a manner similar to that occurring with cervix cancer.