Screening for gynecologic malignancies It is well known that early detection and early treatment of cancer are far better than those found at a later stage. Screening for cervical cancer has now received widespread attention. Then are there any good screening methods to detect the other two major gynecological cancers, endometrial cancer and ovarian cancer, at an early stage? Endometrial cancer is the most common gynecologic malignancy in western countries and some economically developed cities in China. The vast majority of endometrial cancers are estrogen-related and can be seen in women of all ages, but the majority occur in perimenopausal and postmenopausal women. The most prominent manifestation of endometrial cancer is irregular vaginal bleeding, which can be large or small in volume. Especially, vaginal bleeding that occurs again after menopause should be alerted to endometrial cancer. Early stage endometrial cancer can be treated very well and may even be completely cured after surgery, but the mortality rate of advanced endometrial cancer is also very high. The cause of endometrial cancer is currently unknown (so it is not possible to screen tumors by testing for HPV like cervical cancer), only that endometrial cancer is associated with high blood pressure, obesity, diabetes, long-term use of estrogen drugs, and family history of breast/endometrial cancer. Therefore, screening for endometrial cancer during routine physical examinations is not recommended worldwide. For example, the European Society of Medical Oncology/European Society of Radiation Oncology/European Society of Gynecologic Oncology (ESMO-ESGO-ESTRO, these three bodies are the best in the world, lol) concluded that there is no evidence to support screening for endometrial cancer in the general population. Routine endometrial testing and screening for endometrial cancer is not recommended for asymptomatic women with obesity, polycystic ovary syndrome, diabetes, infertility, nulliparity, or late menopause. Some breast cancer patients take a drug called tamoxifen (triamcinolone) by mouth, which may cause lesions in the endometrium. However, routine screening for endometrial cancer is not recommended for people taking the drug without symptoms. For more details, see: Attention, attention, attention: The above is for the general population like you and me. For special groups of people who need regular monitoring of the endometrium: including postmenopausal patients with symptoms (irregular vaginal bleeding, fluid discharge), obese, polycystic ovary syndrome, infertile, estrogen-secreting tumors such as those using estrogen or tamoxifen, such as patients with granulosa cell tumor patient syndrome, from the age of 35 They should be screened annually for endometrial cancer by gynecological examination, ultrasound and endometrial biopsy starting from age 35. Ergo, what is Lynch syndrome: it is a genetic mutation disease, and patients are prone to develop tumors such as intestinal cancer and endometrial cancer at a young age. Therefore, it is not necessary to do endometrial cancer screening for people who are usually healthy. In fact, eating less high-fat food, controlling blood pressure and blood sugar, not taking all kinds of supplements (especially those containing estrogen) indiscriminately, and seeing doctors early for children with bad menstruation are the measures to really reduce the occurrence of endometrial cancer. In the next issue, we will talk about whether there is any screening method for ovarian cancer, which is a phobia.