Several factors contribute to the increasing incidence of endometrial cancer in India. Obesity is a major factor due to the higher levels of estrogen produced by adipose tissue. Prolonged exposure to estrogen, such as in cases of polycystic ovarian disease (PCOD), hormone therapy for breast cancer, hormone replacement therapy, or certain ovarian tumors, also increases the risk. Women who have never been pregnant or have had fewer pregnancies are at higher risk, as are those with a family history of endometrial or colorectal cancer, particularly in cases of Lynch syndrome. Additionally, an early age at menarche, the first menstrual period, can increase the risk of developing endometrial cancer later in life. Other contributing factors include a sedentary lifestyle, diabetes, hypertension, and infertility.
Symptoms of endometrial cancer include bleeding after menopause, irregular and heavy bleeding around menopause, abnormal vaginal discharge, and sometimes lower abdominal pain. For diagnosis, doctors typically use trans-vaginal ultrasound, MRI, and endometrial biopsy.
Treatment strategies for endometrial cancer depend on the stage and grade of the cancer. Surgery is usually the primary treatment, involving the removal of the uterus, fallopian tubes, and ovaries. In early cases, fertility-sparing surgeries are possible. Cytoreductive surgery, which aims to remove all visible cancer cells from the abdominal cavity and pelvis, is considered for advanced cases with limited peritoneal spread. Radiation therapy is used as an adjunct to surgery in advanced cases, and chemotherapy is utilized when the cancer has spread beyond the uterus.
Addressing the rising incidence of endometrial cancer in India requires increased awareness, early detection, and comprehensive management strategies.
Public health initiatives should focus on educating women about the symptoms and risk factors, promoting healthy lifestyles, and ensuring access to quality healthcare services. These efforts can help mitigate the impact of endometrial cancer, improving the prognosis and quality of life for affected women.