Endometrial Cancer Diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2] Ogechukwu Hannah Nnabude, MD

Diagnosis

A thorough history and physical examination, including all systems, habits, medications, allergies, present acute and chronic illnesses and previous illnesses, significant injuries and surgeries, and a meticulous family medical-surgical history with multigeneration family cancer history, engaging cancer genetics counseling are crucial in narrowing down a diagnosis. Abnormal uterine bleeding is the most common symptom of endometrial cancer. [1] Occasionally, cervicovaginal cytology or abnormal vaginal discharge may lead to the diagnosis of endometrial cancer. Pap smears taken within 6 months prior to the diagnosis of endometrial cancers were reported to be abnormal 38% of the time, consistent with adenocarcinoma 21% of the time, and in 13% of cases showed atypical glandular cells. [2] The definitive diagnosis of endometrial cancer is accomplished by the use of histology. However, the personal and family history of the patient together with a complete physical examination are instrumental. Intrauterine pregnancy should be considered in women of reproductive age with abnormal uterine bleeding or amenorrhea unless postmenopausal status has been confirmed. If suspicious symptoms, signs, and/or family history are present, basic laboratory evaluation, cervical-vaginal Pap smear, and transvaginal TVU scanning generally are considered. Patients with an abnormal Pap smear should undergo further investigation regardless of age . [3]

  1. Pessoa JN, Freitas AC, Guimaraes RA, Lima J, Dos Reis HL, Filho AC (2014). "Endometrial Assessment: When is it Necessary?". J Clin Med Res. 6 (1): 21–5. doi:10.4021/jocmr1684w. PMC 3881985. PMID 24400027.
  2. Lai CR, Hsu CY, Hang JF, Li AF (2015) The Diagnostic Value of Routine Papanicolaou Smears for Detecting Endometrial Cancers: An Update. Acta Cytol 59 (4):315-8. DOI:10.1159/000438975 PMID: 26315394
  3. Tzur T, Kessous R, Weintraub AY (2017). "Current strategies in the diagnosis of endometrial cancer". Arch Gynecol Obstet. 296 (1): 5–14. doi:10.1007/s00404-017-4391-z. PMID 28508342.