Pennington Biomedical: Raising awareness of endometrial cancer

When physicians at Pennington Biomedical Research Center realized that endometrial cancer—the cancer most strongly associated with excess weight—was the fastest-growing cancer for young women in Louisiana, they knew time was of the essence.

“Most women are well-aware of cervical or ovarian cancer,” says Vance L. Albaugh, MD, PhD, a metabolic surgeon with Pennington Biomedical’s Metamor Institute. “Unfortunately, the cancer that’s much more common in women in Louisiana and increasingly prevalent is endometrial cancer … and many women are at increased risk without even realizing it.”

While recent changes in Pap smear guidelines recommending women in their 20s have the test every three years reflects a win in the battle against cervical cancer, it has unintentionally caused many women to see their gynecologist much less frequently – leaving decreased opportunity to address other important issues. In fact, nearly 20 percent of women at highest risk at Metamor Institute had not seen a gynecologist in years.

“Through our screening we’ve realized many women have abnormal menstrual cycles, but most don’t realize their cycle is ‘abnormal’ at all,” says Dr. Albaugh. “And since younger women don’t have as consistent contact with a gynecologist like women did decades ago, symptoms of abnormal cycling are going unnoticed and untreated.”

Dr. Albaugh and his team began screening all women being seen at Metamor Institute, the multidisciplinary obesity and metabolic disease clinic at Pennington Biomedical with Our Lady of the Lake and others, in early 2022 with funds from a grant from the Baton Rouge Health District. Two years later, they’ve discovered numerous women in their 20s and 30s at high risk for underlying issues, and many who have been diagnosed with cancer or other abnormalities.

“Catching any cancer as early as possible is important for achieving a cure,” says Dr. Albaugh. “For these women, early detection can help avoid a hysterectomy, hormonal therapy, or other invasive treatments—a big deal for all women, but especially those still wanting to bear children.”

Dr. Albaugh’s team is focused on raising awareness about the link between endometrial cancer and obesity. While Metamor doesn’t treat or diagnose endometrial cancer, the women identified as higher risk are being directed to their gynecologic providers to receive specific, personalized care to rule out an underlying problem that can be lifesaving.

“Twenty years ago, endometrial cancer was almost exclusively seen in post-menopausal women in their 50s or 60s,” says Dr. Albaugh. “Now, driven by the rise in obesity across the country, this has become a cancer of premenopausal women in their 20s and 30s. Many physicians today do not realize the strong connection between excess weight and endometrial cancer.”

The team at Metamor has established feasibility of the screening program for patients seeking obesity treatment, and now wants to expand it to hospitals across the state focusing on metabolic/bariatric surgery.

The screening program is not invasive, but is rather “a basic list of questions that any woman can answer,” according to Dr. Albaugh. If a young woman with obesity is limiting her activities due to her period, has abnormal or concerning bleeding, or even sporadic cycle lengths, those should prompt gynecologic follow-up.

“With Louisiana leading the country in obesity prevalence, we are interested in testing whether primary care practices should also include this screening—maybe even as a standard of care in the future,” says Dr. Albaugh. “Endometrial cancer is easily treatable when detected early, and we are dedicated to raising awareness not only in the public, but also the medical community.”

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