There is insufficient evidence to establish whether a decrease in mortality from endometrial cancer occurs with screening by endometrial sampling or transvaginal ultrasound. Although the diagnosis of endometrial cancer is an occasional outcome following an abnormal Pap test of cytological material from the uterine cervix, this method has been evaluated and found to be insensitive for endometrial screening. 1 Age- adjusted endometrial cancer incidence in the United States declined steadily between 1978 and 1988, and has remained fairly constant since 1988.
Several factors affect the interpretation of statistics for non-cervical endometrial cancer.
Over time, the proportion of cases in the NOS category attributable to a cervical origin has decreased. In addition, rates of endometrial cancer are not adjusted for the substantial portion of the female population that has undergone hysterectomy. These examples illustrate how observed trends in the reported incidence of and mortality from endometrial cancer could have been affected by temporal changes in factors related to the diagnosis of endometrial cancer. In the United States, it is estimated that approximately 6,400 women will die of endometrial cancer in 1999. A transient increase in incidence occurring from 1973 to 1978 was associated with estrogen replacement therapy, but there was no associated increase in mortality.