Uterine cancer
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Synopsis
Uterine cancer is the most common gynecologic cancer in the United States. Lifetime risk is 1 in 40. It was the fourth most common cancer diagnosis in 2018 according to the US Centers for Disease Control and Prevention (CDC), with approximately 63 000 new cases. Worldwide, it was the sixth most common cancer. Average age at diagnosis is 60 years.
Risk factors include exogenous estrogen exposure (ie, unopposed estrogen from hormone replacement therapy, obesity), nulliparity, tamoxifen use, family history of uterine cancer, history of polycystic ovary syndrome (PCOS), history of diabetes, European decent, infertility, early menarche, late menopause, and history of Lynch syndrome.
It is thought that varying degrees of protection are afforded from a history of breastfeeding, menopausal hormone use (estrogen plus progesterone), progesterone intrauterine device (IUD) use, parity, tobacco use, and moderate activity levels.
Patients will usually present with abnormal uterine bleeding, most commonly postmenopausal bleeding. Although the bleeding can be associated with pain / cramping, usually it is painless, and postmenopausal bleeding can be as light as spotting with wiping after voiding. Patients may also have bloating, fatigue, early satiety, pelvic pain, and/or bowel changes if the disease has progressed to an advanced stage.
Related topic: endometrial carcinoma
Codes
ICD10CM:C55 – Malignant neoplasm of uterus, part unspecified
SNOMEDCT:
371973000 – Malignant neoplasm of uterus
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Leiomyomas
- Endometrial hyperplasia
- Vaginal atrophy
- Anovulatory bleeding
- Endometrial polyps
- Hemorrhoids
- Urinary tract infection
- Kidney stones
- Cervical cancer
- Trauma
- Fissures
- Secondary to pessary use / erosion
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:02/05/2020
Last Updated:02/06/2020
Last Updated:02/06/2020