This monograph has been comprehensively written by two pathologists (a father and daughter team) and specifically addresses the prevention and early diagnosis of endometrial cancer. The authors have considerable experience in endometrial cytology and wrote the book in response to the increased incidence of endometrial cancer in recent years.
We are made aware that the increase in endometrial cancer in developed nations is thought to be due to a combination of factors including obesity, diabetes, hormonal imbalance and an ageing population. Unlike the successful screening programs for cervical cancer, there is not an effective population screening program for endometrial cancer. Most women with endometrial cancer will present with symptoms of post-menopausal bleeding. An endometrial sample is necessary to obtain tissue for diagnosis.
The terminology in the book is American, as is seen in many textbooks on gynaecological cancer. In the first chapter the book discusses the current status of the prevention and early diagnosis of endometrial cancer. It covers epidemiology, pathogenesis, the effects of hormonal therapy on the endometrium, and the prevention of endometrial cancer by reducing the risk factors such as obesity, diabetes and hypertension in the general population.
The next few chapters highlight the value of endometrial cytology and the techniques of endometrial cytology and histopathology. There are diagrams of the multiple devices that have been available over the years for collecting endometrial cytology and the effectiveness of each. The recommendations of the authors for endometrial cytology are not in accordance with the National Health and Medical Research Council guidelines.
Traditionally, the most common technique for assessing the endometrium has been a dilatation of the cervix and curettage which is performed using a general anaesthetic. In recent years, there have been developments in simple and inexpensive methods of obtaining endometrial tissue for histological examination. We could learn something in Australia with a greater appreciation of outpatient techniques of endometrial sampling.
Other chapters cover topics such as new techniques for the diagnosis of endometrial pathology, cytology of the normal endometrium – cycling and postmenopausal, benign endometrial lesions and the cytopathology of endometrial hyperplasias.
The book is well referenced and contains many histology slides which are clear and add some colour to an otherwise dry textbook. It does not discuss clinical issues nor the management of women with endometrial cancer. The authors hope their monograph is useful to cytopathologists, pathologists, cytotechnologists and students of these fields. I don’t think the book has a wide appeal outside the above areas. Its best use would be as a reference book in a library or on the shelf in a pathology department. At $US132 for a 91 page book, the cost may well dictate whether it will be widely used in Australia.