About Gynecologic Disease
In the United States, approximately 80,000 women were diagnosed with gynecologic cancer during 2003, and almost 27,000 women are expected to die of their disease. According to the Agency for Healthcare Research and Quality in the Department of Health and Human Services, annual health care expenditures for gynecologic tumors are staggering. The inpatient treatment of breast cancer is 1.6 billion dollars annually while the management of gynecologic cancer costs over 2.1 billion dollars. Over seven billion health care dollars are annually spent in the inpatient treatment of gynecologic tumors. This cost exceeds the combined inpatient treatment costs of breast cancer, colon cancer, and lung cancer in female patients.
| Annual In-Patient Expenditures for Tumors Affecting Women (2004 dollars) | |||
| Cancer | Annual Expenditures | Benign Tumor | Annual Expenditures |
| Cervix | $492,014,426 | Ovarian cysts | $797,546,079 |
| Ovary | $836,265,946 | Uterine fibroids | $3,416,450,980 |
| Uterus | $772,298,520 | Endometriosis | $1,105,690,114 |
| Subtotal | $2,100,578,892 | Subtotal | $5,319,687,173 |
| Total expenditures for Gynecologic Tumors: $7,420,266,065 | |||
| Breast | $1,652,058,359 | ||
| Colon | $2,171,369,518 | ||
| Lung | $2,181,627,381 | ||
Uterine tumors
Endometrial cancer (which affects the lining of the uterus) is the most common gynecologic cancer in the United States, affecting almost 40,000 women a year. According to data from the National Cancer Institute, endometrial cancer is the only malignancy for which survival has actually decreased over the past 30 years. Benign tumors of the uterus (fibroids) also negatively impact on women's health. Fibroids are the most common female solid pelvic tumor, occurring in up to 70% of women and resulting in over 360,000 hysterectomies in the United States annually.
Over the past 5 years, 16,280 female military
health care beneficiaries receiving treatment for fibroids have been
hospitalized for almost 45,000 bed days in military treatment facilities.
Currently, research is needed to refine hormonal chemopreventives and develop
novel molecular therapies aimed at decreasing the frequency of endometrial
cancer and uterine fibroids, both of which may be largely preventable in female
military health care beneficiaries.
Cervical disease
Elevated rates of cervical cancer in the military recently prompted the implementation of more sensitive methods of cervical cancer screening. The use of liquid-based cytology and human papillomavirus testing will significantly improve early detection of treatable precancerous conditions and prevent the development of cervical cancer among military healthcare beneficiaries.
Approximately 7,300 active duty females were medically evaluated
for precancerous cervical lesions in 1998 and this number is expected to rise in
association with the more accurate system of screening currently in place.
Although many of the significant issues related to the elevated rate of cervical
cancer have been addressed, the failure to diagnose and adequately follow the
active duty female soldier throughout prolonged deployments remains an ongoing
challenge. The investigation of self-collection cervical screening technology
and preventive molecular/vaccine therapies that could potentially be used prior
to or during deployments, is necessary to maintaining the gynecologic health of
our deployable female soldiers.
Ovarian cancer
Ovarian cancer is the fifth leading cause of cancer related death in women. Unfortunately, nearly two-thirds of women diagnosed with ovarian cancer are diagnosed with advanced stage disease. During the past five years, over 900 patients have been hospitalized with ovarian cancer and another 1,700 patients have received inpatient treatment for benign ovarian tumors, resulting in the consumption of over 14,000 bed days of care in military treatment facilities. Future research should not only be directed at treatment of advanced ovarian tumors but also early detection. H. Con Res. 385, which passed the House on July 22, and S. Con. Res. 138, now pending in the Senate, express the need for further research to refine contemporary screening technologies for early detection of ovarian cancer.
Endometriosis
Endometriosis is one of the most common gynecological diseases, affecting more than 5.5 million women in North America alone. The two most common symptoms of endometriosis are pain and infertility. Endometriosis occurs when tissue like that which lines the inside of uterus grows outside the uterus, usually on the surfaces of organs in the pelvic and abdominal areas, in places that it is not supposed to grow.