Uterine Cancer rising among black women

In last weekend’s NY Times, there was a front-page article entitled, “Uterine cancer rapidly rising, especially among Black women.” Although the rates in Black women have risen the most, the rates of uterine cancer in all women have gone up steadily to the point where it is soon expected to replace colon cancer as the third most common cancer in women and is rapidly approaching the death rate seen with ovarian cancer, which many of you have come to realize is the most feared malignancy in women. The Times article correctly states that, “overall, survival rates are high when uterine cancer is detected early, but few women are aware that a change in menstrual bleeding before or after menopause is one of the main warning signs.”

Many of you know that I have been extremely interested in the modern approach to evaluating women with any degree of abnormality to their bleeding. Years ago, the most common diagnostic procedure was D&C (dilitation and curettage) or a “scraping.” Beginning in the 1990’s a biopsy of the uterine lining became popular, although as early as 1995, I began to point out the shortcomings of blind endometrial biopsy sampling if the process involving the uterus did not involve the entire cavity. It was not until 2012 that the American College of Obstetricians and Gynecologists (ACOG) went on record as stating that a blind endometrial sample is only definitive when it is positive. Increasingly, many gynecologists are now aware of the shortcomings of uterine biopsy, although, unfortunately, there are still many who perform this procedure only. A more modern approach to the evaluation of abnormal uterine bleeding involves the use of transvaginal ultrasound and, in some cases, sonohysterography (the instillation of a small amount of sterile saline with a tiny catheter into the uterus during an ultrasound examination) to further highlight the endometrial lining and distinguish if there is truly tissue present (polyps, precancers, cancers) versus those people whose bleeding may be “hormone imbalance” or from atrophy of menopause.

It is disturbing to learn that the rates of uterine cancer in women are, in fact, rising. It is gratifying, however, to see the NY Times cover this as a front-page article. Increasing awareness among women about the importance of reporting any abnormal uterine bleeding, especially after age 40, because prompt evaluation is paramount. 

If you or anyone you know will benefit from this information, feel free to share it. You can also find more information and an interesting video about abnormal uterine bleeding, and its diagnosis and treatment on our website