Ebeling K, Nischan P
Zentralbl Gynakol. 1987;109(7):409-19.
During the last two decades, in the GDR the incidence rate of endometrial carcinoma increased from 17.3 to 23.7/100,000 women. Because the increase was strictly limited to women older than 55 years, a real increase of endometrial cancer risk of younger women seems to be unlikely. As consequences of the relatively high rate of cases detected at stage I (68%) and of improved therapeutic results (overall relative 5-YSR 77%), the mortality rate remained nearly stable and amounted to 9.5/100,000 women in 1983 (4% of overall cancer mortality in females). --Obesity, hypertension, nulliparity and long-term intake of estrogens are the most important risk factors for endometrial cancer providing support for the unopposed estrogen hypothesis of the etiology of endometrial cancer. --In a few investigations, screening asymptomatic women resulted in earlier detection of occult endometrial carcinomas, but up to now there have been considerable lack of informations about cost-benefit-risk relations. Mass screening for endometrial cancer therefore can not be recommended. Women at high risk are suggested to have regular gynaecological examinations and if acceptable endometrial biopsies by suction curettage.
在过去二十年中,民主德国子宫内膜癌的发病率从每十万名女性17.3例增至23.7例。由于发病率的上升严格局限于55岁以上的女性,年轻女性子宫内膜癌风险的实际增加似乎不太可能。由于I期病例检出率相对较高(68%)以及治疗效果有所改善(总体5年生存率相对为77%),死亡率基本保持稳定,1983年为每十万名女性9.5例(占女性癌症总死亡率的4%)。肥胖、高血压、未生育以及长期服用雌激素是子宫内膜癌最重要的风险因素,为子宫内膜癌病因的无对抗雌激素假说提供了支持。在一些调查中,对无症状女性进行筛查可更早发现隐匿性子宫内膜癌,但到目前为止,关于成本效益风险关系的信息严重不足。因此,不建议对子宫内膜癌进行大规模筛查。建议高危女性定期进行妇科检查,如可接受,通过吸刮术进行子宫内膜活检。