tailieunhanh - Cancer of the Uterine Corpus

Endometrial adenocarcinoma is the most common gynecological malignancy in industrialized coun- tries. However, incidences vary among regions. In industrialized countries the incidence maybe four to six times higher than in low-resourced countries. A number of reasons may explain this discrepancy. | 29 Cancer of the Uterine Corpus Robbert Soeters INTRODUCTION Malignancies affecting the uterine corpus are endometrial adenocarcinoma and uterine sarcomas. ENDOMETRIAL ADENOCARCINOMA Endometrial adenocarcinoma is the most common gynecological malignancy in industrialized countries. However incidences vary among regions. In industrialized countries the incidence maybe four to six times higher than in low-resourced countries. A number of reasons may explain this discrepancy. In industrialized countries there has been a sharp increase of the life expectancy and a subsequent risk of exposure to causative factors of endometrial cancer. Secondly it has been shown that obesity is reaching epidemic levels in industrialized areas. Obesity due to increasing levels of estrogens from peripheral conversion of androgens is closely associated with the occurrence of endometrial cancer. For patients with serous clear cell and other non-endometrioid cancers there is no clear association with obesity and other hormonal conditions but the association with increased life expectancy seems on the other hand to be stronger. The patients with non-endometrioid cancer seem to be older compared to those patients with endometrioid cancers. In South Africa with a mixed economy the number of patients with endometrial cancer also has increased over the past 10 years Figure 1 . The mortality of endometrial cancer is higher in low-resourced countries compared to industrialized regions. It may well be that a lack or at least sub-standard treatment options in low-resource regions are the cause for this discrepancy. Furthermore it may be that the population in those areas with co-morbid conditions such as HIV AIDS Figure 1 Number of new patients with uterine cancer at Groote Schuur Hospital Cape Town tuberculosis and malnutrition is in a worse state compared to that of high-resource areas. Although exact figures are not known it may well be that patients in low-resource areas present more often with .