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Gynecological cancers

Learn about seven types of gynecological cancer, assess your risks and find out about important screening measures.

By Heather Camlot

According to the Canadian Cancer Society, 3,600 cases of endometrial, or uterine, cancer were detected in Canada in 2002. While the most prevalent, it's not the biggest killer of the gynecological cancers. The one that claims the most lives is ovarian cancer, a condition for which there is no screening test available. "If you have a family history [of gynecological cancer], get checked," says Dr. Al Covens, gynecologic oncologist at Sunnybrook Regional Cancer Centre in Toronto.

The following is a guide to the seven types of gynecological cancer:
Endometrial or uterine, ovarian, cervical, vaginal, vulvar, gestational trophoblastic disease and choriocarcinoma, and fallopian tube.

Endometrial or uterine
Description: The most common gynecologic cancer, it begins in the cellular lining of the uterus.
Risk factors: Risk increases after menopause and for those who never give birth. Obesity, high blood pressure, menstrual problems, exposure to high levels of estrogen, diabetes or tamoxifen therapy are also risk factors.
Screening: Fortunately, says Covens, the symptom of abnormal bleeding occurs very early on, unlike with Ovarian cancer, which can grow considerably before any symptoms appear. If warning signs are detected early, when the cancerous cells have not spread passed the uterus, survival rate is high after undergoing a hysterectomy. An endometrial biopsy may be conducted as well as an ultrasound.

Ovarian
Description: The biggest killer of the gynecologic cancers. The cancerous cells commonly begin on the surface of the ovary.
Risk factors: The majority of women with ovarian cancer have no risk factors, but the indicators may include being over 40, family history, breast cancer, early menstruation, late menopause, high-fat diets, and the use of fertility drugs.
Screening: No screening exam exists, but the Ovarian Cancer Alliance Canada suggests an annual bimanual rectovaginal exam, to identify ovarian abnormalities. Testing may also include a CA 125 blood test and a transvaginal or pelvic ultrasound scan.

Cervical
Description: About 85 per cent of cases develop in the cellular lining of the cervix, but can enter the cervix and spread. The human papilloma virus (HPV), transmitted during sexual intercourse, could be the cause of this cancer.
Risk factors: Any woman who has been sexually active is at risk, says Covens. Risk increases the younger a woman is when she first has sexual intercourse and with the more partners she's had.
Screening: According to Health Canada, up to 90 per cent of cases of cervical cancer could be prevented by getting a Pap Smear -- which can detect the cancer early in its development and be successfully treated. Covens suggests yearly screenings.

1. Types 1 - 3
2. Types 4 - 7, plus online resources
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