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[Epidemiology and early detection of endometrial cancer]
Abstract:
During the last two decades, in the GDR the incidence rate of endometrial carcinoma increased from 17.3 to 23.7/100,000 women. Because the increase was strictly limited to women older than 55 years, a real increase of endometrial cancer risk of younger women seems to be unlikely. As consequences of the relatively high rate of cases detected at stage I (68%) and of improved therapeutic results (overall relative 5-YSR 77%), the mortality rate remained nearly stable and amounted to 9.5/100,000 women in 1983 (4% of overall cancer mortality in females). --Obesity, hypertension, nulliparity and long-term intake of estrogens are the most important risk factors for endometrial cancer providing support for the unopposed estrogen hypothesis of the etiology of endometrial cancer. --In a few investigations, screening asymptomatic women resulted in earlier detection of occult endometrial carcinomas, but up to now there have been considerable lack of informations about cost-benefit-risk relations. Mass screening for endometrial cancer therefore can not be recommended. Women at high risk are suggested to have regular gynaecological examinations and if acceptable endometrial biopsies by suction curettage.