Cabrera Silvia, de la Calle Irene, Baulies Sonia, Gil-Moreno Antonio, Colas Eva
Gynecologic Oncology Unit, Department of Gynecology and Obstetrics, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
Fundación Santiago Dexeus Font, Gynecology, Obstetrics and Reproductive Medicine Department, Dexeus Mujer, 08028 Barcelona, Spain.
J Clin Med. 2024 Sep 13;13(18):5445. doi: 10.3390/jcm13185445.
Endometrial cancer is the most common gynecological malignancy in high-income countries and the sixth most common cancer in women. Overall incidence has risen in the last few decades as a consequence of the increase in the prevalence of its risk factors, mainly obesity and the aging of the population, and although diagnoses have increased across all age groups, the incidence rates have doubled in women under the age of 40 years. The survival rates of endometrial cancer are highly dependent on its stage at diagnosis, bringing to the fore the importance of early diagnosis. The aim of a screening strategy in this type of tumor should be to detect the disease in the pre-invasive or early stage (before developing myometrial invasion), which would improve cure rates, reduce the morbidity associated with aggressive treatment and offer uterus-sparing management options for younger women. The ideal screening tool in this scenario would be a minimally invasive, inexpensive and easy-to-perform test or auto-test, which could be implemented in a routine gynecologic checkup of patients at-risk or in the general adult population. In this comprehensive review, we aim to define the populations at higher risk of developing endometrial cancer, to assess the performance of current diagnostic tools when used in a screening setting and to discuss the accuracy of new molecular screening strategies.
子宫内膜癌是高收入国家最常见的妇科恶性肿瘤，也是女性中第六大常见癌症。在过去几十年中，由于其危险因素（主要是肥胖和人口老龄化）的患病率增加，总体发病率有所上升。尽管所有年龄组的诊断率都有所提高，但40岁以下女性的发病率翻了一番。子宫内膜癌的生存率高度依赖于诊断时的分期，这凸显了早期诊断的重要性。这种类型肿瘤的筛查策略目标应该是在肿瘤浸润前或早期（在发生肌层浸润之前）检测到疾病，这将提高治愈率，降低与积极治疗相关的发病率，并为年轻女性提供保留子宫的治疗选择。在这种情况下，理想的筛查工具应该是一种微创、廉价且易于操作的检测或自动检测方法，可以在高危患者或普通成年人群的常规妇科检查中实施。在这篇综述中，我们旨在确定患子宫内膜癌风险较高的人群，评估当前诊断工具在筛查环境中使用时的性能，并讨论新分子筛查策略的准确性。
