Grant: Operating Grant: CCS/CIHR Action Grants

Need for project Endometrial cancer (EC) has increased by 2-3% per year since 2005, due in part to a global increase in obesity. Hysterectomy for EC patients is often curative but is associated with increased complications for those with obesity. The diagnosis of EC in these individuals can also be delayed due to obesity-associated bias. By identifying individuals at high risk for developing EC, we could direct them to interventions (lifestyle, hormonal) shown to be effective in preventing cancer. Goal of project The goal of this pilot is to evaluate feasibility and acceptability of a study protocol that identifies individuals at high risk for developing EC in the general population and tailors a prevention approach. We will investigate how well we can recruit participants, if we can retain them in the study, and whether they will follow the suggested prevention strategies. We will ask participant opinions on the study methods used. Results will inform the design of a larger efficacy study. Project description Postmenopausal female participants will be recruited across BC for screening using epidemiological risk models. Those at high-risk for EC will undergo a Progesterone Challenge Test (PCT), a 10-day course of medroxyprogesterone acetate. Withdrawal bleeding following PCT may indicate pre-cancerous abnormality and will trigger an endometrial biopsy. Abnormal biopsy findings will stratify participants into interventions including lifestyle changes and/or hormonal therapy. Future impact Obesity, one of the most common risk factors for EC, is often linked to socioeconomic status and visible minorities. Using objective tools in all postmenopausal females can reduce disparities in incidence and survival of EC and other obesityassociated comorbidities. This program identifies populations at high-risk for developing EC, currently underserved by the health system. The pathology-directed lifestyle and/or hormonal therapy could decrease incidence of EC, the fourth most common women’s cancer in Canada. Feasibility and acceptability of this study will enable us to investigate efficacy of the proposed interventions in a larger study.