Symptomatology, delay, and stage of disease in endometrial cancer

This study evaluated the characteristics of symptoms associated with stage and other extent of disease factors at diagnosis among incident cases of the endometrium (N = 98) identified in the Iowa NCI-SEER population-based cancer registry. The purpose was to determine if there were symptoms or other related factors associated with late-stage cancer that distinguished them from earlier stages and for which earlier detection might be beneficial. Most endometrial cancers presented in early-state disease with irregular vaginal bleeding, menorrhea, and abdominal swelling. Most late stage cases also reported irregular vaginal bleeding or irregular menstrual cycle not associated with menopause, but were significantly more likely to notice pain (P less than .05) then earlier-stage cases. Less delay was associated with late, not early, stage of cancer (P less than .05). There was no association between histology, grade, medical history including menopausal status, and symptoms. There were similar symptoms in both early- and late-staged tumors, with no distinguishing factors explaining their appearance at different stages of disease. This result appears to limit earlier detection by patients diagnosed with progressive disease.