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« Back to Contents ENDOMETRIAL CANCER

LiFE re

Literature for ENYGO

Screening for uterine cancer/hereditary uterine cancer

Editor María de los Reyes Oliver Pérez of the hysteroscopy was 90 % (range 50-100 %). The specificity was
98-100 % for both techniques.
Descriptive summary
Hereditary uterine cancer [3-6]:
Screening for uterine cancer [1-2]:
The ESMO–ESGO–ESTRO consensus proposes in women with high
The consensus of the European Society for Medical Oncology (ESMO), risk for EC:
European Society for Radiotherapy & Oncology (ESTRO) and Euro-
pean Society of Gynaecological Oncology (ESGO) has been recently S urveillance of the endometrium by gynaecological examination,
published [1]. Regarding the screening of endometrial cancer (EC), the transvaginal ultrasound, and aspiration biopsy starting from the age
main recommendations are: of 35 years (annually until hysterectomy) should be offered.

T here is no evidence for EC screening in the general population. P rophylactic surgery (hysterectomy and bilateral salpingo-oophorec-
tomy) should be discussed at the age of 40 as an option for Lynch
U nopposed oestrogen treatment should not be started or should be Syndrome (LS) mutation carriers.
discontinued in women with a uterus in situ.
Hall et al. [3] published a review of the genetic testing and manage-
R outine surveillance in asymptomatic women with risk factors of ment of hereditary cancer predisposition. In a group of women who
EC (obesity, polycystic ovary syndrome, diabetes mellitus, infertil- have completed childbearing, prophylactic hysterectomy should be
ity, nulliparity, or late menopause) is not recommended. However, considered; screening should be reserved for the other cases. The
asymptomatic women with risk factors for EC who have endometrial authors also review the evidence on the use of oral contraceptive pills
thickening and other positive findings on ultrasound should be and high-dose aspirin to reduce the risk of EC in average-risk women.
managed on a case-by-case basis.
There are two publications discussing new genetic testing for hereditary
R outine screening for EC in asymptomatic tamoxifen users is not cancer predisposition and identification of (LS) in sporadic EC [4-5].
recommended.
Although the prevalence of occult EC at the time of risk-reducing sur-
F or women with adult granulosa cell tumour, endometrial sampling gery in women with LS remains unknown, Frey et al. [6] emphasises
is recommended. If this shows no evidence of (pre) malignancy, no the utility of endometrial sampling prior to risk-reducing hysterectomy
further screening for EC is required. to improve surgical planning in this population and to avoid a two-
stage procedure for staging.
In patients with epithelial ovarian cancer undergoing fertility-spar-
ing treatment, endometrial sampling is recommended.

Van Hanegem et al. [2] published a systematic review of the accuracy
of endometrial sampling for the diagnosis of EC. The sensitivity of
dilatation and curettage was 100 % (range 100-100 %). The sensitivity

Relevant articles retrieved Nov 2015 - Feb 2016

No Title Authors Journal Link to abstract

1 ESMO–ESGO–ESTRO consensus conference on endometrial cancer: Diagno- Colombo N et al. Int J Gynecol Cancer. http://www.ncbi.nlm.nih.gov/
sis, treatment and follow up. pubmed/26645990

2 Genetic testing for hereditary cancer predisposition: BRCA1/2, Lynch syndro- Hall MJ et al. Gynecol Oncol. http://www.ncbi.nlm.nih.gov/
me, and beyond. pubmed/26812021

3 The accuracy of endometrial sampling in women with postmenopausal Van Hanegem N et al. Eur J Obstet Gynecol Reprod http://www.ncbi.nlm.nih.gov/
bleeding: a systematic review and meta-analysis. Biol. pubmed/26748390

4 Targeted next-generation sequencing of 22 mismatch repair genes identifies Talseth-Palmer BA et al. Cancer Med. http://www.ncbi.nlm.nih.gov/
Lynch syndrome families. pubmed/26811195

5 Clinicopathologic comparison of Lynch syndrome–associated and “Lynch-li- Mills AM et al. Am J Surg Pathol. http://www.ncbi.nlm.nih.gov/
ke” endometrial carcinomas identified on universal screening using mismatch pubmed/26523542
repair protein Immunohistochemistry.
http://www.ncbi.nlm.nih.gov/
6 Utility of endometrial sampling prior to risk-reducing hysterectomy in a Frey MK et al. Ecancermedicalscience. pubmed/26823682
patient with Lynch syndrome.

International Journal of Gynecological Cancer, Volume 26, Supplement #1 Page 25