Endometrial cancer risk factors and biomarkers for natural history and early detection: The Mayo Study
Endometrial cancer is the most common gynecological cancer in the U.S., with approximately 62,000 new cases and 12,000 deaths estimated for 2019. Unlike most cancers, incidence and mortality rates have been increasing worldwide; these trends are projected to continue over the next decade. Obesity is by far the strongest risk factor for endometrial cancer. Other major risk factors include early age at menarche, older age at menopause, and nulliparity. Most endometrial cancers are diagnosed at a localized stage and are often curable with surgery. However, studies evaluating early detection strategies for endometrial cancer are lacking, and at present, there is no recommendation for population-based screening.
Postmenopausal bleeding occurs in approximately 90% of endometrial cancer cases, including early stages amenable to cure, and thus presents a diagnostic and/or therapeutic window of opportunity for early detection and treatment. However, the practice of referring all women with postmenopausal bleeding for diagnostic work-up carries a considerable burden and cost. Alternative, non-invasive sampling approaches such as vaginal tampons that measure molecular markers for endometrial cancer have shown promise but need to be evaluated in clinically-relevant target populations.
To address this important gap, researchers at the NCI and Mayo Clinic have designed a large, prospective clinical cohort study of women who present for diagnostic evaluation for endometrial cancer. The study includes the collection of a novel biospecimen, the vaginal pool, using a vaginal tampon, as well as collection of material from the uterine lining using a Tao brush. Important clinical and epidemiologic risk factor information will be integrated with biomarker measures to improve endometrial cancer risk assessment and early detection strategies.
For more information, contact Megan Clarke.