Since infection with human papillomavirus (HPV) is the most important risk factor for cervical cancer and precancers, it is important to avoid genital HPV infection. This may mean delaying sex, limiting the number of sex partners, and avoiding a sex partner who has had several other partners. Condoms are important to prevent the spread of sexually transmitted diseases, but they can't give full protection against HPV since there may be skin-to-skin contact of exposed areas which can transmit the virus...
Updated statistics with estimated new cases and deaths for 2014 (cited American Cancer Society as reference 1).
Revised text to state that irregular vaginal bleeding is an early sign, the foremost symptom, and the reason why the majority of patients with the highly curable endometrial tumor are diagnosed with stage I disease.
Added text to state that cardiovascular disease is the most common cause of death in patients diagnosed with endometrial cancer because of the early stage of the cancer at diagnosis and the metabolic risk factors (cited Ward et al. as reference 2).
Cellular Classification of Endometrial Cancer
Added text to state that endometrial cancers are classified in one of two categories; namely, type 1 may arise from complex atypical hyperplasia and is pathogenetically linked to unopposed estrogenic stimulation; type 2 develops from atrophic endometrium and is not linked to hormonally driven pathogenesis.
Added text to state that characteristic activating oncogenic mutations or amplification and inactivating mutations or deletion of tumor suppressors are seen more in association with one type of mutation versus the other type, but some overlap exists. Also added that with the Cancer Genome Atlas and a full genetic display of hundreds of endometrial cancers, four subtypes have been identified that will refine classification and provide prognostic and therapeutic implications (cited Kandoth et al. as reference 1).
Stage Information for Endometrial Cancer
Added text to state that even if it no longer influences staging, retrospective data based on the Surveillance, Epidemiology, and End Results Program suggest that positive peritoneal cytology is an independent risk factor in patients with early-stage endometrial cancer (cited Garg et al. as reference 3).
Stage I Endometrial Cancer
Added text to state that uterine serous histologies have higher rates of recurrence than do other stage I endometrioid carcinomas; the outcomes in institutional case series that utilize a policy of adjuvant carboplatin plus paclitaxel, occasionally including radiation therapy, for this histologic subtype, have been published and form the basis of management guidelines (cited Kiess et al., Boruta et al., Huh et al., Fader et al., Kelly et al., Havrilesky et al., and Dietrich et al., as references 1, 2, 3, 4, 5, 6, and 7, respectively). Also added that the Gynecologic Oncology Group (GOG-0249 [NCT00807768]) trial is comparing this chemotherapy regimen to pelvic radiation.