Endometrial cancer: modern concepts of screening

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Abstract

Currently endometrial cancer remains a pressing issue for public health worldwide. Every year there is a steady increase in morbidity rates, which is associated with an increase in the prevalence of risk factors for the disease among which “non-steroid triad” is prevalent: obesity, diabetes, metabolic syndrome. Other significant risk factors for endometrial cancer include the long-term use of tamoxifen and the presence of Lynch syndrome, which makes it possible to carry out selective screening of the disease in these groups of patients. Endometrial cancer is a symptomatic disease, the main clinical manifestation of which is the bleeding from the genital tract on the background of postmenopause. In this case, with timely diagnostic measures, the disease is diagnosed in more than 80% of cases in the early stages of the tumor process, in which the results of treatment are satisfactory. However, despite years of research, questions remain about the relevance and feasibility of population and selective screening for uterine cancer, the ultimate goal of which is to reduce mortality from this disease in a population. Endometrial biopsy and ultrasound of the pelvic organs are considered as the main screening methods, however, the effectiveness of these methods as a population screening is limited. Unreasonable tests lead to overdiagnosis of the disease, invasive interventions increase the risk of the development of predictable complications. This review of the literature contains current information on factors that increase and decrease the risk of endometrial cancer and the results of scientific research on endometrial cancer screening. This information will allow the doctor to choose a rational tactic for managing each particular patient with various risk factors for endometrial cancer and to avoid unnecessary invasive interventions.

About the authors

A E Protasova

Saint Petersburg State University; North-Western State Medical University n.a. I.I. Mechnikov; Almazov National Medical Research Centre; LLC “AVA-PETER”

Email: glushakovruslan@gmal.com
Saint-Petersburg, Russia; Saint-Petersburg, Russia; Saint-Petersburg, Russia; Saint-Petersburg, Russia

M S Sobivchak

Saint Petersburg State University; Road Clinical Hospital JSC “Russian Railways”

Email: glushakovruslan@gmal.com
Saint-Petersburg, Russia; Saint-Petersburg, Russia

N N Bayramova

Saint Petersburg State University; LLC “AVA-PETER”

Email: glushakovruslan@gmal.com
Saint-Petersburg, Russia; Saint-Petersburg, Russia

R I Glushakov

Military Medical Academy n.a. S.M. Kirov

Author for correspondence.
Email: glushakovruslan@gmal.com
Saint-Petersburg, Russia

N I Tapil’skaya

The Research Institute of Obstetrics, Gynecology and Reproductology n.a. D.O. Ott

Email: glushakovruslan@gmal.com
Saint-Petersburg, Russia

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© 2019 Protasova A.E., Sobivchak M.S., Bayramova N.N., Glushakov R.I., Tapil’skaya N.I.

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