Division of Cancer Sciences, University of Manchester, School of Medical Sciences, Faculty of Biology, Medicine and Health, 5th Floor Research, St Mary's Hospital, Oxford Road, Manchester, M13 9WL, UK.
Department of Obstetrics and Gynaecology, Tameside General Hospital, Fountain St, Ashton-under-Lyne, OL6 9RW, UK.
Best Pract Res Clin Obstet Gynaecol. 2020 May;65:66-78. doi: 10.1016/j.bpobgyn.2019.12.005. Epub 2019 Dec 20.
Endometrial cancer (EC) is the most common gynaecological malignancy, and its incidence is rising alongside the growing prevalence of obesity. Effective risk-reducing interventions hijacking the key mechanisms driving endometrial carcinogenesis may affect EC diagnoses if aimed at those at greatest risk. An understanding of the key risk factors and their role in tumourigenesis is critical in developing such prevention strategies. In this review, we summarise the major risk factors for EC and the evidence for available risk-reducing interventions in high-risk women. We suggest potential prevention strategies and make a case for the need for risk prediction models that identify specific groups of women at a particularly high risk of EC for whom risk-reducing interventions are likely to have a significant impact.
子宫内膜癌(EC)是最常见的妇科恶性肿瘤,其发病率随着肥胖症的日益流行而上升。如果针对高危人群实施干预措施来阻断导致子宫内膜癌变的关键机制,可能会影响 EC 的诊断。了解关键的危险因素及其在肿瘤发生中的作用对于制定此类预防策略至关重要。在这篇综述中,我们总结了 EC 的主要危险因素,以及高危女性中可用的降低风险干预措施的证据。我们提出了潜在的预防策略,并认为需要建立风险预测模型,以确定特定的高危女性群体,对其实施降低风险的干预措施可能会产生重大影响。