RESUMEN
The review of references and data on endometrial and cervical cancer incidence in five continents (1970, 1976, 1982, 1987) are presented. The increase in cervical cancer rates in the developing countries of Asia, Africa and Latin America has been recorded. The hormonedependent tumours (endometrial, breast cancer) prevail in the economically developed countries of Europe and North America. They have shown a tendency to increase since the end of the 70's. The possible causes of peculiarities in oncogynecological incidence have been discussed.
Asunto(s)
Neoplasias Endometriales/epidemiología , Neoplasias del Cuello Uterino/epidemiología , África/epidemiología , Asia/epidemiología , Neoplasias de la Mama/epidemiología , Países en Desarrollo , Europa (Continente)/epidemiología , Femenino , Humanos , Incidencia , América Latina/epidemiología , Neoplasias Hormono-Dependientes/epidemiología , América del Norte/epidemiología , Neoplasias Ováricas/epidemiología , Factores Socioeconómicos , Neoplasias Uterinas/epidemiologíaRESUMEN
Development and (or) growth of myoma uteri in pre- and post-menopause is accompanied by hyperestrogenia which is shown by histological investigation of the endometrium and the ovaries. A comparative clinical and morphological study of 853 patients with myoma uteri, 996 patients with glandular, atypical hyperplasia and endometrial carcinoma was carried out. Benign tumors of the ovaries were revealed in 9.5% of patients with myoma, 12.7% of patients with atypical endometrial hyperplasia and 19.8% of patients with endometrial cancer. A significant increase of the occurrence of endometrial cancer in postmenopausal patients with myoma, in comparison with patients in the reproductive period was determined, 13.4% and 1.1% respectively, P = 0.01. In postmenopause "growth" of the tumor was more often and significantly simulated by malignant disease of the uterus and adnexa. In postmenopausal patients with myoma and uterine bleeding, endometrial carcinoma was 5.5 times more often revealed in comparison with the analogous group of patients in the reproductive period. The "relative risk" of the development of endometrial cancer, sarcoma uteri and ovarian tumors was calculated. The "relative risk" was shown to increase in the postmenopausal period. In the processes of observation of patients with myoma in postmenopause, cytological investigation of endometrial aspirates, ultrasound and mammographic screening should be carried out.
Asunto(s)
Hiperplasia Endometrial/etiología , Leiomioma/patología , Menopausia , Neoplasias Ováricas/etiología , Neoplasias Uterinas/patología , Adulto , Factores de Edad , Anciano , Hiperplasia Endometrial/patología , Femenino , Humanos , Persona de Mediana Edad , Factores de RiesgoAsunto(s)
Adenocarcinoma/complicaciones , Leiomioma/complicaciones , Neoplasias Primarias Múltiples , Neoplasias Ováricas/complicaciones , Sarcoma/complicaciones , Neoplasias Uterinas/complicaciones , Adulto , Factores de Edad , Femenino , Humanos , Leiomioma/patología , Menopausia , Persona de Mediana Edad , Factores de Riesgo , Neoplasias Uterinas/patologíaRESUMEN
The results of a two-stage hormonal treatment of 62 cases of atypical hyperplasia of the endometrium were analysed. Within the first 6 months, patients received 24.0-28.0 g of hydroxyprogesterone capronate each. Six courses of steroid contraceptives such as non-ovlon and bisecurin were given during the second stage when regression of endometrial precancer had already been registered. The results proved hormonal therapy to be highly effective in managing atypical hyperplasia of the endometrium. Complete response was observed in 67.7% of patients. Coexistent uterine myoma affected the efficacy of treatment adversely: only 4 out of 14 patients with atypical hyperplasia of the endometrium with concomitant myoma were good responders. Hormonal treatment was ineffective mainly in cases of myoma of sizes exceeding 8 weeks of gestation and in pre- and postmenopausal patients. This makes the case for surgery.