title: Clinical and pathological characterization of endometrial cancer in young women: identification of a cohort without classical risk factors.
abstract: OBJECTIVE
  Endometrial cancer (EC) is the most common gynecologic malignancy with known risk factors including excess estrogen and hereditary syndromes. The objective of this study was to determine the proportion of young women with EC that could be attributed to these factors and if, as we suspected, there is a third population of young women in which neither factor is identifiable. We were interested in comparing clinicopathologic characteristics and outcomes across subgroups in order to better inform treatment recommendations.
  
  
  METHODS
  We performed a retrospective chart review of women age 15-49 diagnosed with EC or complex atypical hyperplasia. Demographic, clinicopathologic, treatment, fertility, and outcome parameters were analyzed.
  
  
  RESULTS
  Of 719 women identified, 327 were fully evaluable. 57.5% fit the "High Estrogen" risk criteria. 8.25% met criteria for suspected Lynch syndrome. 34.25% classified as "Neither" had no classical risk factors identified. There were no statistical differences in age, gravidity, tumor grade, treatment selection and response to hormonal therapy. Age of menarche, stage, histology, and synchronous ovarian cancer differed significantly. Prevalence of synchronous ovarian cancer was 21.0% of "Neither", 23.1% of "Lynch", and 6.6% of "High Estrogen". For women who attempted pregnancy, 2/27 of "High Estrogen", 0/3 of "Lynch", and 2/16 of "Neither" achieved a live birth.
  
  
  CONCLUSIONS
  This study confirmed that a third population of young women with EC exist that lack classical risk factors and have distinct clinicopathologic parameters. No difference in success of conservative treatment or live births was noted in the small cohort in whom this treatment approach was attempted.
authors: Faculty of Medicine, University of British Columbia, Vancouver, Canada.
authors: Angela
authors: A
authors: Burleigh
authors: Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.
authors: Aline
authors: A
authors: Talhouk
authors: Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.
authors: C Blake
authors: CB
authors: Gilks
authors: Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University of British Columbia, Vancouver, Canada. Electronic address: Jessica.Mcalpine@vch.ca.
authors: Jessica N
authors: JN
authors: McAlpine
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001955:British Columbia / Q000453:epidemiology; D015331:Cohort Studies; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology; D016889:Endometrial Neoplasms / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology*; D004967:Estrogens / Q000378:metabolism; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D004967:Estrogens
keywords: Endometrial cancer; Lynch syndrome; Obesity; Outcomes; Young women