Henny Lukman Consultant Obstetrician amp Gynaecologist Cancer General Population Risk Syndrome Risk Mean age of onset 10 year survival England amp Wales Endometrium 3 4060 4855 ID: 930367
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Slide1
Endometrial & Ovarian Cancer in Lynch Syndrome
Henny Lukman
Consultant Obstetrician & Gynaecologist
Slide2Slide3Cancer
General Population Risk
Syndrome Risk
Mean age of onset10 year survival (England & Wales)Endometrium3%40-60%48-5578%Ovarian1.4%10-20%42-4635%
RCOG 2015
Slide4Screening ?
Endometrial Cancer
Ovarian cancer
Evidence for screeningNo (RCOG- part of research only)No difference in early stage pick upSymptomsAbnormal bleedingNone in early stages, often vagueUltrasoundTransvaginalTransvaginalOther tests
Hysteroscopy, biopsy
CA125
How often
?
?
Slide5Symptoms
Endometrial cancer: abnormal bleeding
Ovarian cancer : very vague in early stages
pain, bloating
Slide6Slide7Slide8Slide9Slide10Slide11Key hole surgery
Open surgery
Risk Reducing Surgery
Slide12Hormone Replacement Therapy
Recommended until the age of 50
Oestrogen only
Most publicised risk only apply to women over 50.
Slide13The evidence – NICE 2015
Per 1000 women
<60 y.o.Baseline
Current user
>5 years since stopping
Coronary heart disease
UK over 7.5 years: 26.3 per 1000
1
E only --6 fewer
E only --6 fewer
E+P ---5 more
E+P ---4 more
Stroke
UK over 7.5 years: 11.3 per 1000
E only --0
E only –1 more
E+P ---6 more
E+P ---4 more
Breast cancer
UK over 7.5 years: 22.48 per 1000
E only --4 fewer
E only --5 fewer
E+P ---5 more
E+P ---8 more
Fragility fractures
Baseline rate 69 per 1000
23 fewer
No data
Ovarian
1 more per 1000 after 5 years use
Little difference between E alone or E+P
No data
Dementia
No data
Slide14Slide15Risks that can be changed
-Endometrial cancer
Risk
RiskIncreased body weightCombined oral contraceptive pillLow of physical activitiesRegular exerciseRed meatEat more vegetable(HRT)Coffee, tea (especially green)Contraceptive
coil
Aspirin
(HRT)
Slide16Risks that can be changed
-Ovarian cancer
Risk
RiskSmokingBreastfeeding more than 6 months?have more pregnancies?OverweightCombined oral contraceptive pillEat more vegetable
Slide17Slide18