The common misconception that Pap smear tests can help screen for all gynecological cancers has sometimes led to delayed diagnoses of endometrial cancer, which affects an average of 1,700 women in the nation per year, a gynecologist said yesterday.
“One such patient was a 59-year-old postmenopausal woman, surnamed Kao (高), who shrugged off her symptom of abnormal vaginal bleeding six months ago because all her annual smear tests had come back normal,” Cathay General Hospital gynecologist Chen Ssu-yu (陳思宇) told a press conference in Taipei yesterday afternoon.
Chen said Kao later sought medical attention at a local clinic, where she was diagnosed with atrophic vaginitis, a common cause of vaginal bleeding after menopause that results from an insufficiently lubricated vagina.
After medications failed to assuage her symptoms, Kao went to a large hospital in the city and to her great astonishment, a vaginal sonography and an endometrial biopsy diagnosed her with stage-one endometrial cancer, Chen said.
“Pap smears can only reach as far as the cervix and only rarely do they happen to collect cancer cells falling off the endometrium. One must not rely on smear test to detect endometrial or ovarian cancers,” Chen said.
Chen said that in Taiwan, nearly 1,700 people are diagnosed each year with endometrial cancer, which ranked sixth in gynecological cancer incidence.
Primary risk factors for the cancer include polycystic ovarian syndrome, infertility, childlessness, high blood pressure, diabetes, obesity, Western-style diet, early menarche and late menopause.
“Also at risk are breast-cancer patients who are on the anti-estrogen drug tamoxifen, which may reduce their chances of breast-cancer recurrence, but increase their risk of endometrial cancer,” Chen said.
Chen advises non-menopausal women to seek immediate medical care should they experience unusually prolonged menstrual periods, short intervals between periods or abnormal vaginal bleeding.
“As for postmenopausal women, they are urged to consult a gynecologist once they notice any vaginal bleeding,” Chen said.
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