Endometrial cancer is a type of uterine cancer that develops in the inner lining of the uterus, known as the endometrium. It is the most common form of uterine cancer in the United States, and its incidence has been increasing over the past few decades. According to the American Cancer Society, about 66,570 new cases of endometrial cancer will be diagnosed in the United States in 2022, and about 12,940 women will die from the disease. While most cases of endometrial cancer are diagnosed in postmenopausal women, it can also affect younger women.
The Risk: One of the risk factors for endometrial cancer is Lynch syndrome, an inherited colon cancer syndrome that affects about 1 in 300 people. Lynch syndrome is caused by mutations in genes that help repair DNA, and it increases the risk of developing several types of cancer, including colon, ovarian, and uterine cancer. According to the National Cancer Institute, women with Lynch syndrome have a lifetime risk of 40% to 60% of developing endometrial cancer.
Currently, screening guidelines for endometrial cancer do not recommend evaluating individuals with Lynch syndrome for the disease. However, a new study from Harvard University has developed a model that can identify individuals at higher risk of developing endometrial cancer, including those with Lynch syndrome. The study was conducted by the Epidemiology of Endometrial Cancer Consortium, which includes 19 case-control studies with participants from different countries.
The model used a statistical tool called LASSO (Least Absolute Shrinkage and Selection Operator) to predict individuals at higher risk of endometrial cancer. LASSO is a machine learning technique that is used to select variables that are most important for predicting a specific outcome. In this case, the researchers used LASSO to select the most relevant risk factors for endometrial cancer, including age, body mass index (BMI), hormone therapy use, and Lynch syndrome status. The model then translated these risk factors into an absolute risk prediction to determine the likelihood of an individual developing endometrial cancer in the next decade.
Research Limitation: The study found that the model was effective at predicting endometrial cancer risk in postmenopausal white women aged 45 to 85 years. The researchers noted that further research is needed to determine the effectiveness of the model with different races and younger women. The study also highlighted the importance of evaluating individuals with Lynch syndrome for endometrial cancer, as the model identified this group as being at higher risk.
The Bottom Line: The development of this model has the potential to serve as a framework for developing a risk prediction tool for clinical public health practice. By identifying individuals at higher risk of endometrial cancer, healthcare providers can offer personalized screening and preventive strategies to reduce the incidence and mortality of the disease. The study also underscores the importance of genetic testing and counseling for individuals with Lynch syndrome, as early detection and intervention can lead to better outcomes.
In conclusion, endometrial cancer is a growing public health concern, and new research from Harvard University has developed a model that can identify individuals at higher risk of developing the disease. The model has the potential to serve as a framework for developing a risk prediction tool for clinical public health practice and underscores the importance of evaluating individuals with Lynch syndrome for endometrial cancer. Further research is needed to determine the model's effectiveness with different races and younger women. However, this study represents a promising step towards personalized screening and prevention strategies for endometrial cancer.