Historically, endometrial cancer occurred post-menopause, but new University of Otago (Wellington) research shows the age landscape is changing, and cases have increased exponentially over the past decade in New Zealand.
It has prompted research co-author and University of Otago surgery and anaesthesia researcher Dr Claire Henry to call for better management of the disease.
"The incidence is now increasing before people reach menopause.
"There are many and complex reasons for this increase."
The cancer grew in the lining of the uterus and symptoms included heavy or abnormal menstrual bleeding, including post-menopausal bleeding, she said.
A hysterectomy was the standard treatment for the disease.
Researchers interviewed 15 healthcare professionals from three Te Whatu Ora Health New Zealand regions with experience in caring for individuals with endometrial cancer.
The study highlighted two main themes — concerns for the future and the impact on fertility and treatment options.
Concerns were mainly focused on a lack of awareness about the disease, the increasing incidence as well as workforce shortfalls.
All participants said they were seeing an increasing number of people with high weight presenting each year with endometrial cancer.
"There is a huge amount of alarm among the oncology community about the rates — they are just rocketing up," one participant said.
"Other cancer rates are staying the same or going down, but this is the outlier, and really linked to obesity.
"It's terrible, as this is affecting younger and younger women."
As well as the increased incidence of the disease in younger individuals in successive generations, there was also concern regarding health equity.
Another participant said they were seeing more younger women in the under-45 age group and 47%-48% of them were Pacific Islanders.
More awareness and advocacy was needed in that space, Dr Henry said.
Researchers believed there were inequities in access and outcomes which could occur over the care continuum.
Building on the findings from this and other studies, Dr Henry said it was critical to develop equity-focused initiatives to improve outcomes for individuals with, or at risk of, endometrial cancer.
