b45cfb43001ff99b507cc88cfdbf7f8b 309012.pdf e8b5d82665e8a364a9f6ac3d6dd236975df7c3c3 309012.pdf 882cb917f9cccdbdcc7c68ffcb6d8b4d08a257cd0254fd86d7dc2195643d6817 309012.pdf Title: Screening Strategies to Improve Early Diagnosis in Endometrial Cancer Subject: 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. Keywords: endometrial cancer; diagnosis; screening; high-risk population Author: Silvia Cabrera, Irene de la Calle, Sonia Baulies, Antonio Gil-Moreno and Eva Colas Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Fri Sep 13 12:46:43 2024 CEST ModDate: Fri Sep 13 12:49:59 2024 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 531548 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- CMFVHJ+VnURWPalladioL Type 1 Custom yes yes yes 10 0 QPKLQW+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 IUKCKU+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 QHEBMZ+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 43 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 46 0 PDTLUH+CMSY10 Type 1 Builtin yes yes yes 63 0 QDCWHF+EURM10 Type 1 Builtin yes yes yes 74 0 JDFKHP+PalatinoLinotype,Bold CID TrueType Identity-H yes yes yes 82 0 JDFKIA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 88 0 JDFKIB+PalatinoLinotype CID TrueType Identity-H yes yes yes 91 0 JDFKIC+PalatinoLinotype TrueType WinAnsi yes yes no 97 0 JDFKIE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 100 0 JDFKND+PalatinoLinotype TrueType MacRoman yes yes no 103 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-03-19 02:42:00 CET RepresentationInformation: 309012.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-03-18 13:52:21 CET Size: 531548 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 373 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Target Population for Screening Strategies Destination: section.2 Children: Item: Title: Genetic Risk Destination: subsection.2.1 Item: Title: Obesity Destination: subsection.2.2 Item: Title: Metabolic Syndromes Destination: subsection.2.3 Item: Title: Tamoxifen and Hormonal Therapies Destination: subsection.2.4 Item: Title: Women with Abnormal Uterine Bleeding (AUB) Destination: subsection.2.5 Item: Title: Performance of Diagnostic Tools When Assessed in a Screening Setting Destination: section.3 Children: Item: Title: Transvaginal Ultrasonography Destination: subsection.3.1 Item: Title: Cervico-Vaginal Cytology Destination: subsection.3.2 Item: Title: Uro-Vaginal Cytology Destination: subsection.3.3 Item: Title: Endometrial Sampling Destination: subsection.3.4 Item: Title: New Biomarkers for Endometrial Cancer Screening Destination: section.4 Children: Item: Title: Blood Destination: subsection.4.1 Item: Title: Urine Destination: subsection.4.2 Item: Title: Uterine Fluid Destination: subsection.4.3 Item: Title: Cervico-Vaginal Fluid Destination: subsection.4.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: Screening Strategies to Improve Early Diagnosis in Endometrial Cancer Author: Silvia Cabrera, Irene de la Calle, Sonia Baulies, Antonio Gil-Moreno and Eva Colas Subject: 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. 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