Gynecologic cancers

Overview

• Each year >110,000 people in the US are diagnosed with a gynecologic cancer and >32,000 die of their disease.
• Endometrial cancer is the most common gynecologic malignancy, but ovarian cancer has the poorest survival, though uterine (corpus) cancer now causes the most US gynecologic cancer deaths (ACS 2025: ~13,860 uterine vs ~12,730 ovary).
• Endometrial incidence has risen ~1% per year, with mortality increasing ~1.9% per year from 2008 to 2018, driven by more aggressive type 2 cancers.
• Cervical, endometrial, ovarian, uterine sarcoma, and vaginal cancer have their own notes; vulvar cancer is summarized in the table below.

General principles

• HPV-related: cervical, vulvar, and vaginal (16/18). Endometrial cancer is not HPV-related.
• Hereditary: Lynch: colorectal and endometrial are the principal cancers; among gyn cancers endometrial is #1, with lower, gene-dependent ovarian risk (colorectal risk far exceeds ovarian); BRCA1/2 (ovarian + breast).
• Multidisciplinary care: gynecologic oncology surgery + chemo + RT.
• Lymph node assessment is critical (sentinel LN biopsy emerging across many gyn cancers).

Framework: linking the major sites