Endometrial cancer is the most common invasive gynaecological cancer in Australia and specifically refers to cancer that arises from the lining of the uterus (called the endometrium). It affects approximately 1 in 69 Australian women before the age of 75 years. In 2010, about 2100 women were expected to be diagnosed with endometrial cancer. This means that across Australia in 2010, on average, six females were diagnosed with endometrial cancer each day.
The incidence of endometrial cancer is increasing in Australia, due in part to an ageing population and an increasing prevalence of obesity (a known risk factor for the disease). Other risk factors for this cancer include history of endometrial hyperplasia, history of polycystic ovary syndrome, nulliparity, exposure to unopposed oestrogen, strong family history of endometrial or colon cancer (Lynch syndrome), and tamoxifen therapy.
Once the histological diagnosis of endometrial cancer is confirmed then the patient is offered treatment that in most cases is an operation to remove the uterus, fallopian tubes and ovaries. In some circumstances it may be appropriate to remove lymph nodes from the pelvic and aortic areas.
Cancer Australia’s National Gynaecological Cancers Service Delivery and Resource Framework (2011), developed in partnership with the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, recommends that ‘all women with a suspected (i.e. with symptoms indicative of a high risk of cancer) or actual gynaecological cancer have access to a comprehensive multidisciplinary team led by a gynaecological oncologist to provide high-quality management based on the best available evidence and tailored to women’s needs to achieve the best outcome for each woman.
The following guidelines to clinical practice relate to apparent early stage endometrial cancer at the time of diagnosis, that may have low or high risk features. Since adjuvant treatment is most commonly recommended when disease is found on final pathology to be more advanced than initially thought, a decision was made early on to include more advanced stage disease in the adjuvant treatment chapters so the controversial issues of adjuvant radiotherapy and chemotherapy could be addressed.
There is a lack of strong evidence for many of the treatment options available to women with this cancer and it is hoped that this publication will assist doctors and their patients in making informed choices about management options.
Dr Alison Brand
Chair, Endometrial Cancer Guidelines Working Party
Gynaecological Oncologist, Westmead Hospital
- Australian Institute of Health and Welfare (AIHW), Australasian Association of Cancer Registries (AACR). Cancer in Australia: an overview, 2010. Cancer series no. 60. Cat. no. CAN 56. Canberra: AIHW; 2010 Jan 1.
- Cancer Australia, Royal Australian and New Zealand College of Obstetricians and Gynaecologists. National Gynaecological Cancers Service delivery and Resource Framework. Cancer Australia. Canberra; 2011.