[Early detection of endometrial carcinoma]

Carcinoma of the endometrium has not only seen a relative increase compared to carcinoma of the cervix in the last few decades but also an absolute increase. The only method to improve the cyto-morphological detection of endometrial carcinoma is to obtain the cytological material from the site of the disease which is the uterine cavity. For this purpose a large number of devices were developed within the past 10 years. These permit an approximately 90% detection rate by endometrial cytology. It may be difficult to introduce instruments into the uterine cavity of older women with a narrow cervical canal. Even well experienced cytologists have to relearn the evaluation of cyto-smears from the uterine cavity. The recognition of highly differentiated carcinomas and atypical hyperplasias of the endometrium is especially difficult. Screening examinations of women over age 45 by endometrial cytology from the uterine cavity area apparently capable of detecting a fairly large number of asymptomatic endometrial carcinomas. How far the intra-uterine cytology is capable of detecting pre-cancerous conditions of the endometrium such as atypical glandular hyperplasia is still not known.