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This chapter discusses the diagnosis, evaluation, staging and prognosis and treatment of postmenopausal bleeding and endometrial cancer. The primary symptom of endometrial cancer (ECa) is postmenopausal bleeding (PMB). A physical examination of PMB should look for vaginal and cervical abnormalities, polyps, masses, uterine size and symmetry, or ovarian masses. ECa (cancer of the body or corpus of the uterus) is the fourth most common malignancy in women in the USA, and seventh most common cause of cancer deaths in women. Prognostic factors are related to age, race, endocrine status, histological cell type, tumor grade, depth of myometrial invasion, extension beyond the uterus, adnexal metastases, and extrauterine and peritoneal spread. PMB has a variety of causes, one of which is endometrial cancer. Endometrial cancer is usually discovered at an early stage, is curable, and is usually a disease of postmenopausal women.
Cardiovascular disease (CVD) is the major cause of death in women in the USA and in the UK. The actual value of the risk factors is used to predict coronary heart disease (CHD) risk more accurately. Primary prevention should focus on the major risk factors of passive and active smoking, systolic and diastolic hypertension, elevated serum total and low-density lipoprotein (LDL) cholesterol, low high-density lipoprotein (HDL) cholesterol, diabetes, physical inactivity, and obesity. The pillars of secondary prevention are antiplatelet therapy, beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), statins, cardiac rehabilitation, a Mediterranean diet, and folic acid. Future heart attacks are prevented by the prevention of atherosclerosis or plaque formation in the coronary arteries and by the stabilization and regression of existing plaque through lifestyle modification and medication. Women must take personal preventive action to prevent CHD death and disability by working to prevent plaque formation, and promote stabilization of existing atherosclerotic disease.