Australia-first study to find causes of endometrial cancer

A poorly-understood and increasingly common cancer, endometrial cancer, is the subject of an Australia-first study undertaken by The Queensland Institute of Medical Research (QIMR).

Endometrial cancer is Australia’s most common invasive gynaecological cancer, ranking 6th for incidence and 9th for mortality, but numbers are increasing as the population ages. Several histological subtypes are recognised and survival is poor for some of these. Although it is clear that the cause of other gynaecologic cancers varies by subtype, few studies have distinguished between different subtypes of endometrial cancer.

“Furthermore, very little is known about genetic factors in endometrial cancer risk, except that an increased risk among relatives suggests a strong inherited component exists,” said Dr Amanda Spurdle, from the Cancer Genetics Group at QIMR. “A thorough examination of the genetic basis of disease within families has not been carried out, and the contribution from other lower-risk genes is unclear from studies to date.”

The QIMR study will establish an integrated, multidisciplinary approach to the study of endometrial cancer by collecting epidemiological and clinical data and biological samples from a large population-based group of women newly diagnosed with endometrial cancer, a comparable group of cancer-free women, and selected relatives of cases reporting a family history of cancer.

The specific aims are to clarify existing and identify new risk factors, and their interaction with genetic factors; to examine the genetic basis of endometrial cancer within multiple-case families; and to establish and maintain a comprehensive epidemiological, molecular and clinical database for ongoing studies.

“To increase understanding of the causes of endometrial cancer it is essential to conduct a study large enough to evaluate risk factors separately for different subtypes, and to identify environmental and genetic risk factors for the more aggressive subtypes,” said Dr Spurdle.

The QIMR nation-wide population-based study will involve Qld, NSW, Vic, SA, and WA. Participants will be identified through an existing network of clinicians and through the state cancer registries. Women will be approached with permission from their treating physician, while attending for treatment in the capital cities, or via letter if identified through cancer registries. Cases with a strong family history of endometrial and other cancers will be screened for mutations in the HNPCC and PTEN genes.

The study will provide a better understanding of causal pathways leading to different types of endometrial cancer, and identify potentially modifiable risk factors to assist development of prevention strategies.