Gynaecological malignancies, including endometrial carcinoma (EC), cervical carcinoma (CC), and ovarian carcinoma, remain one of the important health burdens in females worldwide. These tumours represent one of the most common causes of cancer-related mortality in females, especially in developed countries. Because of this scenario-the constantly increasing number of cases, more than 400,000 ECs, 600,000 CCs, and 300,000 OCs every year-early diagnosis and prevention are necessary not only to improve survival rates but also to lessen the burden on public healthcare systems.
The strategies of prevention vary according to the type of cancer; cervical stands first because of its vaccination and screening programs, hence making it the most preventable of all cancers. Vaccination against human papilloma virus given to young adolescents before they become exposed to the virus leads to an 85% reduction in incidence of cervical cancer. This primary prevention modality is further augmented when combined with regular cervical cytology and HPV testing, hence keeping morbidity and mortality from cervical cancer as low as possible.
Similarly, there are a number of challenges to be encountered in the case of endometrial cancer because of the lack of effective screening methods. Symptoms usually include abnormal bleeding, after which patients undergo investigations such as a transvaginal ultrasound and biopsy. The major risk factor identified for EC is Obesity. This risk decreases with weight reduction methods. It was found that women experiencing a weight decline in midlife have a 25% decrease in the risk of developing endometrial carcinoma. Nevertheless, further studies are needed to develop biomarkers to assist in the early detection of endometrial cancer.
In contrast, ovarian malignancy has been less well-served by screening strategies, none of which has major trials demonstrating a clear-cut mortality reduction, although biomarkers such as CA-125 and HE4 give a very promising lead to enhance diagnostic precision. Ovarian cancer susceptibility is well established and this calls for especially genetic counseling and risk assessment among those whose family histories are affected by the condition.
Where neither vaccination nor early detection is universally applied, weight management allows for optimism toward further reductions in the incidence and burden of these cancers. More awareness, continuous research, and individualized risk assessment are the keys to further improvement in outcomes related to these cancers among women around the world.
Journal article: Ferrari F, et al., 2024. Approaches to prevention of gynecological malignancies. BMC Women’s Health.
Summary by Faith Oluwamakinde
