1. Endometrial & Ovarian Cancer in Lynch Syndrome
Henny Lukman
Consultant Obstetrician & Gynaecologist

3. General Population Risk Syndrome Risk Mean age of onset
Cancer
General Population Risk
Syndrome Risk
Mean age of onset
10 year survival (England & Wales)
Endometrium 3%
40-60%
48-55
78%
Ovarian
1.4%
10-20%
42-46
35%
RCOG 2015

4. Screening ? Endometrial Cancer Ovarian cancer Evidence for screening
No (RCOG- part of research only)
No difference in early stage pick up
Symptoms
Abnormal bleeding
None in early stages, often vague
Ultrasound
Transvaginal
Other tests
Hysteroscopy, biopsy
CA125
How often ?

5. Symptoms Endometrial cancer: abnormal bleeding
Ovarian cancer : very vague in early stages
pain, bloating

11. Risk Reducing Surgery
Key hole surgery
Open surgery

12. Hormone Replacement Therapy
Recommended until the age of 50
Oestrogen only
Most publicised risk only apply to women over 50.

13. >5 years since stopping Coronary heart disease
The evidence – NICE 2015
Per 1000 women <60 y.o.
Baseline
Current user
>5 years since stopping
Coronary heart disease
UK over 7.5 years: 26.3 per 1000 1
E only --6 fewer
E+P more
E+P more
Stroke
UK over 7.5 years: 11.3 per 1000
E only --0
E only –1 more
E+P more
Breast cancer
UK over 7.5 years: per 1000
E only --4 fewer
E only --5 fewer
E+P more
Fragility fractures
Baseline rate 69 per 1000
23 fewer
No data
Ovarian
1 more per 1000 after 5 years use
Little difference between E alone or E+P
Dementia

15. Risks that can be changed-Endometrial cancer
Increased body weight
Combined oral contraceptive pill
Low of physical activities
Regular exercise
Red meat
Eat more vegetable
(HRT)
Coffee, tea (especially green)
Contraceptive coil
Aspirin

16. Risks that can be changed-Ovarian cancer
Smoking
Breastfeeding more than 6 months
?have more pregnancies?
Overweight
Combined oral contraceptive pill
Eat more vegetable