The South African Society of Obstetricians and Gynaecologists (SASOG) and the South African Society of Gynaecologic Oncology (SASGO) are proud to join the international community in recognising June 2023 as Global Uterine Cancer Month. This month-long initiative aims to raise awareness about uterine cancer, also known as cancer of the womb or endometrial cancer, and highlights the urgent need for increased research, early detection, and equitable access to healthcare.
Uterine cancer is the fourth most common women's cancer in South Africa, accounting for approximately 6% of all cancers in women. It primarily affects women between the ages of 55 and 70, although it can occur before menopause or around the time menopause begins. Although endometrial cancer was traditionally considered a “good prognosis” cancer, survival is dependent on early diagnosis, early and good treatment, and also on the molecular type of cancer. It is increasingly recognised that Black ethnic groups have substantially higher mortality rates. Differences in access to care plays an important role, but there are also racial differences in tumour type with Black women having more histological and molecular high risk types which have a more aggressive behaviour and therefore poor outcomes.
One of the most common symptoms of uterine cancer is postmenopausal bleeding, including spotting or brownish discharge, which should never be considered a normal part of menopause. While abnormal bleeding does not always indicate cancer, it is essential to seek urgent medical attention as early diagnosis saves lives in this disease. In later stages of the disease, spontaneous weight loss , pain, feeling a lump or mass in the pelvis, bloating, feeling full quickly, and changes in bowel or bladder habits may occur.
Various factors contribute to the rising risk of developing uterine cancer, including obesity (being more than 20 kg overweight), hypertension, a high-fat diet, lack of exercise, and Type 2 diabetes. Women with a history of polycystic ovarian syndrome (PCOS), irregular periods, an increased number of menstrual cycles, and late menopause are also at risk. Additionally, a family history of uterine cancer or colorectal cancer associated with Lynch Syndrome increases the susceptibility. Women without these risk factors should not ignore warning signs, as the disease is not exclusive to those with risk factors.
Despite the global impact of uterine cancer, research into new treatments remains significantly underfunded compared to other reproductive cancers. This lack of funding impedes progress in developing more effective therapies and finding potential cures. We urgently call for increased investment in research to address this disparity and improve outcomes for patients.
Furthermore, we acknowledge the disparities in access to healthcare that have far-reaching consequences for those lacking adequate access to healthcare. The disparities in the incidence and survival of uterine cancer and access to care have become critical issues in women's health globally. We advocate for equal access to healthcare services, including increased awareness among health care workers, early detection measures, diagnostic tools, and comprehensive treatment options.
Early-stage disease is associated with excellent outcomes. While there are no uterine cancer screening tests needed for average, healthy women, the apparent symptoms of uterine cancer - particularly abnormal uterine bleeding or postmenopausal bleeding - provide an opportunity for early diagnosis and timely intervention, emphasising the importance of access to healthcare.
The South African Society of Obstetricians and Gynaecologists and the South African Society of Gynaecologic Oncology urge all women to prioritise their health by being aware of the signs and symptoms associated with uterine cancer and to consult their health professional if they are experiencing these symptoms. We encourage women to maintain regular visits with healthcare professionals for appropriate evaluation and care and to reach out to other women who may be less fortunate or less informed.
During Global Uterine Cancer Month, let us unite in our efforts to increase awareness, promote early detection, advocate for equal access to healthcare, and support research for improved treatment options. Together, we can make a difference in the lives of women affected by uterine cancer.