Benefits, harms, and costs
- 1A complete focused history should be taken and a physical examination carried out in patients with suspected endometrial cancer. Attention should be paid to predisposing factors for excess estrogen stimulation of the endometrium such as long history of anovulation, obesity, menstrual irregularity, or long-term use of unopposed estrogen or tamoxifen. Patients with a strong family history of endometrial, ovarian, and colorectal cancers might have inherited Lynch syndrome (hereditary non-polyposis colorectal cancer syndrome) that increases their lifetime risk of developing endometrial cancer. Genetic counselling and testing can be used to individualize risk-management interventions including screening strategies and treatment options (III-B).
- 2Endometrial cancer should be ruled out in perimenopausal and postmenopausal patients with abnormal vaginal bleeding (II-1A).
- 3Depending on access, histologic endometrial evaluation and transvaginal ultrasound are the preferred initial diagnostic investigations for patients with suspected endometrial cancer (II-1B).
- 4Histologic evaluation of the endometrium should be done in all patients in whom endometrial cancer is suspected (II-1A).
- 5Hysteroscopic examination should be considered in patients with persistent uterine bleeding with benign endometrial sampling or insufficient endometrial sampling after ultrasound (II-2B).
- 6Formal review of the histopathology should be considered in patients with high grade tumours or rare histologic types such as serous, clear cell, or mucinous types (III-B).
- 7Additional tumour markers, CT scan, and MRI scan should not be used routinely (III-D).
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This document reflects emerging clinical and scientific advances on the date issued, and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Local institutions can dictate amendments to these opinions. They should be well-documented if modified at the local level. None of these contents may be reproduced in any form without prior written permission of the publisher.
Women have the right and responsibility to make informed decisions about their care in partnership with their health care providers. In order to facilitate informed choice women should be provided with information and support that is evidence based, culturally appropriate and tailored to their needs. The values, beliefs and individual needs of each woman and her family should be sought and the final decision about the care and treatment options chosen by the woman should be respected.