Wikipedia:Featured article candidates/Endometrial cancer/archive1

Endometrial cancer

Endometrial cancer (edit | talk | history | links | watch | logs)

• Featured article candidates/Endometrial cancer/archive1

Nominator(s): Keilana|^{Parlez ici} 23:40, 31 August 2014 (UTC)

This article is about the fourth most prevalent cancer in women, very highly viewed and quite important. The article has been improved substantially in the past weeks by a peer review, GA review, and an expert review from Cancer Research UK. Keilana|^{Parlez ici} 23:40, 31 August 2014 (UTC)

• Well, Kei, I guess I'll review this... but we all know I don't know anything about medicine (the ear bone's connected to the ... what now?)
• Globally, as of 2012, endometrial cancers occurred in 320,000 women and caused 76,000 deaths. - "As of" would be present tense, as it is something that holds true or we expect to hold true. I'd use "in 2012" as the numbers can change dramatically from year to year.

Done

• What's with all the hidden refs? When at the end of a paragraph, one would expect a footnote (i.e. Abnormal menstrual periods or extremely long, heavy, or frequent episodes of bleeding in women before menopause may also be a sign of endometrial cancer.)

• That was per the recommendation of Doc James. Keilana|^{Parlez ici} 00:19, 4 September 2014 (UTC)

• For those at the end of a paragraph (such as the one I quoted) I'd make the ref apparent. People generally assume that a ref doesn't cover paragraphs before the paragraph in which the ref is located. — Crisco 1492 (talk) 01:05, 4 September 2014 (UTC)

Done

• Symptoms, other than bleeding, do not occur commonly. - "Commonly do not occur" or "there are few in common" or... I feel this could probably be reworked

Done

• You really need to check for duplicate links. I've gotten two or three in the same paragraph. I'm not removing any more as there are too many.

Done

• by 3-4 times - by 300 to 400%, or another reworking. "By 3 to 4 times" just feels off

Done

• Ovarian cancer and endometrial cancer - why the extra "cancers"? Couple instances of this

Done

• There is a loose association because breast and ovarian cancers are often treated with tamoxifen. - the treatment causes the illness? That's what it reads like to me. What you intend (I think) is that the treatment of another kind of cancer (tamoxifen) can cause endometrial cancer, but that's not what the wording conveys to me. The connection only becomes clear in the following paragraph

Done

• Women with this disorder have a 5-10% lifetime risk of developing endometrial cancer. - as opposed to ...?

Done As opposed to a normal 2-3% risk, clarified.

• Specifically, ovarian granulosa cell tumors and thecomas are ovarian tumors associated with endometrial cancer. - repetition of "ovarian"

Done

• is not currently significant - when, exactly, is "currently"?

Done

• CDKN2A are both dablinks

Done

• 10-20% of endometrial cancers, - I'd refactor to avoid starting sentences with numerals

Done

• 20% of endometrioid - again

Done

• 8-30% of atypical - again

Done

• Why does the Mani source not have vol, issue, and page numbers?

It was an e-publication ahead of print - I don't think it's been printed yet.

• Hmm... wouldn't most e-publications still have such information? I know my own such publications have had the volume and issue easily accessible. — Crisco 1492 (talk) 16:05, 5 September 2014 (UTC)

@Crisco 1492: For some reason it doesn't. I'm confused too... Keilana|^{Parlez ici} 17:55, 6 September 2014 (UTC)

• "Article in press"... if it weren't for the publication saying it's alright to cite, I'd be wary... who's to say that there will be no major changes in the process? Anywho, it looks fine to me in this case. — Crisco 1492 (talk) 23:58, 6 September 2014 (UTC)

Generally article in press means all changes have already been made and the only further changes will be to page numbers etc as it hasn't been published in the print edition yet and assigned those minor details. Since that comment, it has now been assigned those details, Second Quantization (talk) 13:11, 26 September 2014 (UTC)

• The single-sentence or single paragraphs sections a bit further south look really rough. Any way to either expand and/or merge?

If you're referring to the section on other carcinomas, I've looked for information and since there are only about 100 known cases each of both squamous cell carcinoma of the endometrium and transitional cell carcinoma, it's hard to find anything meeting MEDRS. I've found a couple promising papers but they're quite dense. More to come on this later - I've been overloaded with molecular path and evo/devo papers this week and need a day to unscramble my poor brain.

Okay. I went diving in PubMed and mined the only two relevant MEDRS-ish sources for PSCCE. I did use an article that had both case reports and a review of the literature because my options were very limited. There aren't any reviews of the past 5 years covering transitional cell carcinoma of the endometrium (it's that rare) so I'm going to go slightly outside of that in order to get something on TCCE. Keilana|^{Parlez ici} 17:51, 6 September 2014 (UTC)

• Looks very good. There's also the few short paragraphs in #Research. — Crisco 1492 (talk) 00:02, 7 September 2014 (UTC)

Done

• More to follow. — Crisco 1492 (talk) 15:03, 2 September 2014 (UTC)

@Crisco 1492: Thank you so much for all your comments! I think I've satisfied most of your concerns from this section. I'll keep plugging away this weekend. Keilana|^{Parlez ici} 15:55, 5 September 2014 (UTC)

• being highly suspicious for endometrial cancer. - Was the patient suspicious, or... what's meant here?

Done - Clarified that the finding is what's suspicious.

• both an endometrial biopsy and a transvaginal ultrasound - so used in conjunction?

Yup. Not sure how to make this clearer beyond saying "used in conjunction".

• In the United States they are more common in white women, often with a history of endometrial hyperplasia. - the subject was "they" as in the carcinomas. I don't think carcinomas can have a history of endometrial hyperplasia

I mean, they evolve from hyperplasia... ;) Done

• have a good outcome - prognosis? I can't imagine a cancer left unchecked having a "good" outcome. Prognosis, at least, implies treatment.

Done

• The CTNNB1 (beta-catenin) mutation is most commonly mutated in the squamous subtype of endometrioid adenocarcinoma. - mutation - mutated; can we avoid the repetition

Yeah, we can. Done

• 30% of endometrial serous carcinomas - more numerals

Not sure what the issue is here?

• Sentences starting with numerals (or, at least, were when I reviewed)

Ah. Done.

• pelvic and para-aortal nodes - I don't think these are linked yet

Done

• in the lung - or in the lungs? — Crisco 1492 (talk) 02:45, 3 September 2014 (UTC)

Done

• is performed for tumors of histologic grade II or above. Lymphadenectomy is routinely performed for all stages of endometrial cancer in the United States, but in the United Kingdom, the lymph nodes are typically only removed with disease of stage II or greater. - redundant

I'm not sure how this is redundant, since histologic grade and disease stage are different. Am I missing something?

• What's that? Humans only use 10% of their brain? Stet. I must have misread this sentence, or not comprehended the difference. — Crisco 1492 (talk) 16:40, 10 September 2014 (UTC)

• 90% of women are treated with some form of surgery - another sentence beginning with numerals. Also, this would work much better closing the paragraph

Done

• In stage IV disease, where there are distant metastases, surgery can be used as part of palliative therapy. - could this be merged somewhere?

Done

• happen about 5-10% of the time - "happen in about 5-10% of cases" might be more professional.

Done

• dilation and curettage (D&C) - you've already linked this and given the abbreviation. You should just use D&C, or get rid of the abbreviation altogether and use the full name

Done

• This is called adjuvant therapy. - redundant to the two sentences before

Done

• Mutations in mismatch repair genes can lead to resistance against platins, meaning that chemotherapy with platins is ineffective in people with these mutations. - if this is related to Lymph disease or another condition which exacerbates the disease, we might want to be more explicit

Done

• shows tumor invading the cervix, - This feels rough to me, though if it's the proper terminology I'll push that concern aside

Invasion is the technical term, yeah. Not sure how to write that without compromising the scientific meaning.

• 25% of metastatic endometrioid - again

Done

• Also, endometrial stromal sarcomas can be treated with hormonal agents, including tamoxifen, 17-hydroxyprogesterone caproate, letrozole, megestrol acetate, and medroxyprogesterone - and how well do these work?

Jury's out. I could go into more extensive detail about various studies and such if you think that wouldn't be overkill.

• Would be nice to have at least that much, maybe with one or two discussions of studies. — Crisco 1492 (talk) 03:29, 10 September 2014 (UTC)

K, I've expanded the bits on hormonal treatment of ESS, added some to Research about hormonal agents, and expanded the ESS section itself. Better? (It's super rare so hard to find MEDRS on it.) Keilana|^{Parlez ici} 00:04, 12 September 2014 (UTC)

• Looks better. — Crisco 1492 (talk) 01:39, 12 September 2014 (UTC)

• Research is ongoing in this area. - as of?

Same as the other ones, mid-2010s. Done

• You have a hidden note about the table being US figures... why isn't this noted in the article?

It should be. Done

• Older age indicates a worse prognosis. - "older age" is a bit rough, I think. "There is a negative relationship between patients' ages and survival rates." would be more professional, or something similar.

@Crisco 1492: I'm not sure if that's clear enough for the lay reader, perhaps something like "Survival rates are lower for older women"? Keilana|^{Parlez ici} 01:58, 12 September 2014 (UTC)

• Even better wording, I agree. — Crisco 1492 (talk) 02:28, 12 September 2014 (UTC)

• Higher-staged cancers are more likely to recur — those that have invaded the myometrium or cervix, or that have metastasized into the lymphatic system, are particularly likely to recur. - Could we avoid "likely to recur" being in the article twice? Perhaps " Higher-staged cancers are more likely to recur, as are those that have invaded the myometrium or cervix, or that have metastasized into the lymphatic system."

Done

• If a cancer treated with radiation occurs, - occurs -> recurs?

Uh, yeah. Done.

• Worldwide, approximately 320,000 women are diagnosed with endometrial cancer each year and 76,000 die, making it the sixth most common cancer in women. - date of statistics?

2014. Done

• Too much repetition of "developed countries" in #Epidemiology

Not sure how to reduce that without making stats unclear. Any ideas?

• Is "first-world" still politic, or are we supposed to avoid it? — Crisco 1492 (talk) 02:28, 12 September 2014 (UTC)

I personally prefer to avoid it. Keilana|^{Parlez ici} 04:05, 12 September 2014 (UTC)

• Then I don't have any ideas. "The West" is just as problematic, if not more so. — Crisco 1492 (talk) 04:16, 12 September 2014 (UTC)

• Northern Europe, Eastern Europe, and North America have the highest rates of endometrial cancer, comprising 48% of diagnoses in 2012, whereas Africa and West Asia have the lowest rates. Asia saw 41% of the world's endometrial cancer diagnoses in 2012. - That's three continents making up 48%, compared to one continent making up 41%. How do three individually have higher rates than Asia alone? Concerning...

Not quite sure what the worry is here, but it might be helped by "together comprising 48% of diagnoses ....". Obviously Asia has by far the largest pop. Wiki CRUK John (talk) 12:19, 4 September 2014 (UTC)

• Perhaps it's the mix of rates (relative to population) with absolute numbers (the percent of diagnoses) that is confusing me. Is there perhaps a more elegant way to phrase this? — Crisco 1492 (talk) 13:01, 4 September 2014 (UTC)

• So I agree, it's the mix of rates and absolute numbers and the confounding factor of West Asia vs all of Asia. I think it's clarified better now...? Keilana|^{Parlez ici} 01:58, 12 September 2014 (UTC)

• Much better. Thanks. — Crisco 1492 (talk) 02:28, 12 September 2014 (UTC)

• most frequently during perimenopause and menopause, between the ages of 50 and 65; overall, 75% of endometrial cancer occurs after menopause. - Feels contradictory: if 75% of cancer cases occur after menopause, then during menopause it wouldn't be "most frequent"

Perimenopause and menopause together are most frequent - perimenopause includes after menopause. Keilana|^{Parlez ici} 01:58, 12 September 2014 (UTC)

• Indeed, but perimenopause (according to the menopause article) also includes "before menopause"... which, to me, at least, means pretty much any woman from age 35 to 65 (or however menopausal age is defined) is most frequently affected. — Crisco 1492 (talk) 02:28, 12 September 2014 (UTC)

Yeah, unfortunately the source isn't more specific. Should I just remove the bit about perimenopause/menopause? Keilana|^{Parlez ici} 04:05, 12 September 2014 (UTC)

• I defer to Doc James or another person better versed in medicine than I. — Crisco 1492 (talk) 04:16, 12 September 2014 (UTC)

• 5% of cases occur in women younger than 40 and 10-15% occur in women under 50 years of age. - another numeral

Done

• is still underway. - as of?

Probably, for most/all of these: "now, 5 years ago and in 10 years time". It's a very slow process, with research before and after anything affects clinical practice. It's probably best to start the section with some blanket statement including a vague date "in the middle 2010s" maybe. Wiki CRUK John (talk) 12:19, 4 September 2014 (UTC)

• "As of the mid-2010s" would work nicely too. Much better than a whole bunch of "as ofs", and it would satisfy WP:ASOF. — Crisco 1492 (talk) 13:08, 4 September 2014 (UTC)

Done

• Research is ongoing on the use of metformin, a diabetes medication, - again, as of?

Done

• in the first place, - feels non-formal. Perhaps "Long-term use of metformin has not been shown to have a preventative effect against developing cancer (?or, "the development of cancer"?), but may improve overall survival."

Done

• Temsirolimus, an mTOR inhibitor, is under investigation as a potential treatment. - again

per above, included in the "mid-2010s" umbrella. Done

• <-- hormonal stuff --> - I know this is hidden text, but... "stuff"?

uh. "hormonal research". Done.

• Hormone therapy that is effective in breast cancer - in treating, perhaps?

Yeah, done

• The last three paragraphs are much too short

Merged.

• Intensity modulated radiation therapy is currently under investigation for application in endometrial cancer, - as of? — Crisco 1492 (talk) 09:38, 3 September 2014 (UTC)

As above.

• I'm getting error messages from some of your cites: "Endometrial Cancer Treatment (PDQ®)" and "General Information About Endometrial Cancer"" have date errors, and Lee JM and Banerjee S, use deprecated parameters. — Crisco 1492 (talk) 09:40, 3 September 2014 (UTC)

I'm not getting error messages from either of those sources. Maybe someone came by and fixed it? Keilana|^{Parlez ici} 01:58, 12 September 2014 (UTC)

• No, they're still there (hence the inclusion in Category:Pages containing cite templates with deprecated parameters). There's a useful script there that you may want. Highlights the errors. — Crisco 1492 (talk) 02:28, 12 September 2014 (UTC)

Ooooh, I see what you mean. Fixed now. :) Keilana|^{Parlez ici} 04:05, 12 September 2014 (UTC)

• Once the prose changes settle down, I'd recommend checking the order of your footnotes. I've seen some like [23][15] etc. — Crisco 1492 (talk) 00:02, 7 September 2014 (UTC)

Done.

• Image review
  • File:Blausen 0348 EndometrialCancer.png - Free enough. Watermark could be cleaned up
  • File:Autosomal dominant - en.svg - Fine
  • File:Endometrial adenocarcinoma gross.jpg - So do we have a link to the file itself, rather than the agency website?
  • File:Endometrial stromal sarcoma gross.jpg - This too

Can't find either of them but the website is really difficult to navigate. I've removed them for now, until I can dig up the originals.Keilana|^{Parlez ici} 02:50, 12 September 2014 (UTC)

• • File:Endometrial adenocarcinoma (1).jpg - Fine
  • File:EndometrialStromalSarcoma.JPG - I'm not seeing evidence that the uploader is the copyright holder. Web resolution and quality / type of other nominations suggest (to me) that s/he may not be. Since the side-by-side presentation looks a little rough (and the image sizes are uneven) losing it is not too much of a blow.

K, removed. Keilana|^{Parlez ici} 02:50, 12 September 2014 (UTC)

• • File:Figure 28 02 06.JPG - Source page is licensed CC-BY, but I don't see the image there. Could we have a direct link?

Found it. Keilana|^{Parlez ici} 02:50, 12 September 2014 (UTC)

• • File:Endometrial fluid accumulation, postmenopausal.jpg - Fine
  • File:Diagram showing stage 1A and 1B cancer of the womb CRUK 196.svg and others (File:Diagram showing stage 2 cancer of the womb CRUK 206.svg, File:Diagram showing stage 3A to 3C cancer of the womb CRUK 224.svg, File:Diagram showing stage 4A and 4B cancer of the womb CRUK 234.svg, and File:Diagram showing keyhole hysterectomy CRUK 164.svg): do we have a link to a page discussing this collaboration? I don't doubt Fae, but I'd like to verify this.

See Wikipedia:WikiProject_CRUK. There is an OTRS ticket wending its way here, which will be added to all these via the template, I hope in a few days. As WiR, I can confirm the release has been approved by CRUK, who supplied Fae with the svg files. Wiki CRUK John (talk) 12:12, 3 September 2014 (UTC)

• Great. Thanks, that's more than enough. — Crisco 1492 (talk) 14:09, 3 September 2014 (UTC)

• • File:Adenocarcinoma of the Endometrium.jpg - Fine
  • File:Endometrioid adenocarcinoma of the uterus FIGO grade III.jpg - Fine
  • File:Metastatic endometrial carcinoma (3944215367).jpg - Fine
  • Not too crazy about the gallery, to be honest. The images are too small to really see anything, — Crisco 1492 (talk) 15:16, 2 September 2014 (UTC)

Isn't that what MediaViewer is for? ;) In all seriousness, I'm not sure there's a better option. Keilana|^{Parlez ici} 02:50, 12 September 2014 (UTC)

• Cutting down to just the diagrams would be nice. Or we could do something fancy like this. — Crisco 1492 (talk) 03:00, 12 September 2014 (UTC)

I'm gonna steal your fancy gallery thingy and stick the gross path somewhere else. Keilana|^{Parlez ici} 04:05, 12 September 2014 (UTC)

• Excellent. *tents fingers* — Crisco 1492 (talk) 04:16, 12 September 2014 (UTC)

• Support on prose and images. Assuming this is comprehensive and accurate. I mean, damn it, I'm a literary critic, not a doctor. — Crisco 1492 (talk) 11:04, 16 September 2014 (UTC)

Thank you very much for the review and your support! The article is much better for it. :) Keilana|^{Parlez ici} 14:21, 16 September 2014 (UTC)

Source review - spotchecks not done, building on what Crisco's already said

• Why so many citations in the lead?
  • Uh, Doc James? Something something MEDMOS? Everything in the lead is discussed and cited elsewhere. Keilana|^{Parlez ici} 02:50, 12 September 2014 (UTC)
    • Do you mean Wikipedia_talk:Manual_of_Style/Medicine-related_articles#References_in_the_lead? As far as I can tell that hasn't actually been added to MEDMOS, it's just a proposal. Nikkimaria (talk) 03:01, 12 September 2014 (UTC)
      • Ooh, didn't realize that was just a proposal. I have no strong feelings either way. Keilana|^{Parlez ici} 04:05, 12 September 2014 (UTC)
        • Proposal passed and it has now been added.Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:09, 29 September 2014 (UTC)
• "Abnormal menstrual periods or extremely long, heavy, or frequent episodes of bleeding in women before menopause may also be a sign of endometrial cancer." - source?
  • Sourced.
• Fixed number of columns in {{reflist}} is deprecated in favour of column width
  • Think it's better now.
• National Cancer Institute is a publisher, not a publication - generally you're being inconsistent in how you treat it, compare for example FNs 1, 2, 6 and 9
  • Done
• MM/DD/YYYY is not an allowed date format
  • Seppi is awesome and took care of this.
• Be consistent in how you format author lists - sometimes you've got "lastname, initial;", other times "lastname initial,"

Done

• Where you have page ranges for chapters, it would be helpful to include them

A lot of these are e-books and don't have page ranges. Is that okay?

Yes, just good to have when you have them. Nikkimaria (talk) 03:01, 12 September 2014 (UTC)

• Sometimes you're abbreviating journal titles, other times not - be consistent

Done

• FN19 has doubled quote marks

Seppi got this one too.

• FN43: suggest splitting out publisher from title. Nikkimaria (talk) 20:15, 6 September 2014 (UTC)

I think the citation number has changed, could you point me to this again?

I appear to have fixed the MM/DD/YYYY and FN19 issues you noted while performing the MOS-related edits in my review. Seppi333 (Insert 2¢ | Maintained) 21:14, 9 September 2014 (UTC)

@Nikkimaria: Thanks much for the review! I think I've taken care of or responded to everything. Thanks also Seppi for your fixes. :) Keilana|^{Parlez ici} 02:50, 12 September 2014 (UTC)

43 is now 47; a couple of other replies above. Nikkimaria (talk) 03:01, 12 September 2014 (UTC)

Thanks, took care of 47. Keilana|^{Parlez ici} 04:05, 12 September 2014 (UTC)

Review by Seppi333

I went ahead and fixed all the issues with MOS:CAPTION, MOS:IMAGELOCATION, MOS:NDASH, MOS:MDASH, MOS:DATEFORMAT, MOS:NBSP, MOS:NUMERAL, MOS:%, and MOS:FRAC that I could find - diff of those changes.

Thank you!! :) Keilana|^{Parlez ici} 03:35, 12 September 2014 (UTC)

• I'll review the prose later this week, though I did notice that the capitalization of the word "type" isn't consistent in the article. In some cases, "Type I" and "Type II" is used and elsewhere it's written as "type I" and "type II".

Done

• Also, I noticed none of the images had WP:ALT text. Ideally, a featured article should have this for every image. I already added alt text to the images that I moved into templates, but the remaining images are missing it. Seppi333 (Insert 2¢ | Maintained) 21:14, 9 September 2014 (UTC)

Done

History and culture

Currently this article lacks any section about the cultural impact of this condition. For such a common disease it seems that it hardly exists in popular discussion. I do not expect much, but I would like either a history or society and culture section here, even if that is just a single sentence where someone says "No sources discuss the history of recognizing this condition.(citation needed)"

Here are the oldest sources I could find on PubMed. I cannot read them. Maybe one of them says something about the early history of treatment or recognition of the disease.

• DIDDLE, AW (1949 Jan). "Endometrial carcinoma". Western journal of surgery, obstetrics, and gynecology. 57 (1): 20–2. PMID 18107274. {{cite journal}}: Check date values in: |date= (help)
• ARNESON, AN (1950 Aug). "The use of radium in the treatment of endometrial cancer". The Journal of the Kansas Medical Society. 51 (8 Suppl.): 37A–38A. PMID 14774594. {{cite journal}}: Check date values in: |date= (help)
• SPEERT, H (1949 Mar). "Carcinoma of the endometrium in young women". Surgery, gynecology & obstetrics. 88 (3): 332–6. PMID 18111780. {{cite journal}}: Check date values in: |date= (help)

Blue Rasberry (talk) 17:59, 19 September 2014 (UTC)

I imagine there was very little "popular discussion" until recent decades (or even now), because of the "delicate" location, and it would probably be lumped with other female repro system cancers. Like the pancreas, the endometrium is not one of the bits of internal anatomy that most people know about, or can name (a smaller group than one might think, it seems). I agree some medical history would be good. Wiki CRUK John (talk) 10:28, 22 September 2014 (UTC)

Indeed, just today in The Guardian: "Womb cancer: the most common diagnosis you’ve never heard of". Wiki CRUK John (talk) 12:31, 22 September 2014 (UTC)

@Bluerasberry:/@Wiki CRUK John: I'm taking an immunology exam this week (eek!) so it may take me a couple days but I'll read through these articles and see if I can come up with anything beyond "nobody talks about this". Watch this space! :) Keilana|^{Parlez ici} 04:23, 23 September 2014 (UTC)

@Bluerasberry:/@Wiki CRUK John: Okay. Immunology exam survived. It turns out that I don't have access to these articles either. I've looked at the Guardian article and incorporated a brief history and culture section. I think John is right - there's not much discussion because it's in the uterus and it's in a relatively obscure bit of anatomy. I can't find anything more to add to a history and culture section - I hope it's adequate. Keilana|^{Parlez ici} 15:53, 29 September 2014 (UTC)

Keilana We checked for sources and Wikipedia is a summary of what we have found. I am happy with the outcome and think that the culture section presents what identified reliable sources have to say. Thanks. Blue Rasberry (talk) 16:10, 29 September 2014 (UTC)

Comments by Cas Liber

• I'll copyedit anything straightforward and drop some notes as I go....

Other possible symptoms include: pain with urination, pain with sexual intercourse or pelvic pain - it's alotta pain in one sentence...why not "Other possible symptoms include: pain with urination or sexual intercourse, or pelvic pain"

Done

It most commonly occurs in the decades after menopause - looks weird without a number before "decades"....

I'm not sure what number I could put there, suggestions? Keilana|^{Parlez ici} 16:01, 29 September 2014 (UTC)

Hmmm, if it can't b quantified, do we lose any meaning by "It most commonly occurs in the decades after menopause"?

Endometrial cancer is associated with obesity, excessive estrogen exposure, high blood pressure and diabetes.[1] Approximately 40% of cases are related to obesity.[4] - I'd flip these, which allows some elimination of repetition - "Approximately 40% of cases are related to obesity.[4] Endometrial cancer is also associated with excessive estrogen exposure, high blood pressure and diabetes.[1] "

Done

Immigration studies show that there is some environmental component to endometrial cancer. - looks interesting - any other comments from the article that can be gleaned on the basis for this would be good to add at this point.

Unfortunately, it's a gyne textbook and doesn't say much beyond that. Will add more if I come across anything. Keilana|^{Parlez ici} 16:01, 29 September 2014 (UTC)

Endometrial cancer nearly always develops before colon cancer, on average, 11 years before - would be better further up its para.

Done

Endometrial cancer forms when normal cell growth in the endometrium encounters errors. - "encounters" strikes me as an odd word here..."errors arise in cell growth..."? Actually, try reading the para without the sentence as I think we can lose it and not lose meaning

Hrm, I was trying to avoid saying "goes wrong". How's "Endometrial cancer forms when there are errors in normal endometrial cell growth"? Keilana|^{Parlez ici} 16:01, 29 September 2014 (UTC)

Better, though I still think we could actually lose the sentence altogether. Cas Liber (talk · contribs) 21:32, 29 September 2014 (UTC)

Lymphadenectomy is routinely performed for all stages of endometrial cancer in the United States, but in the United Kingdom, the lymph nodes are typically only removed with disease of stage II or greater - this contrasts oddly with the sentence immediately before it. In fact, I'd put The topic of lymphadenectomy and what survival benefit it offers in stage I disease is still being debated. as the first sentence in the bit discussing who does what and probably lose the above sentence.

This came up earlier - it's histologic grade vs stage. I don't want to avoid the stage difference between US and UK. To clarify - in both countries, any cancer above stage II OR grade II gets lymphadenectomy. The only difference is that in the US, stage I (not grade I) cancers also can have lymphadenectomy. I'm not sure how to make the wording clearer. Keilana|^{Parlez ici} 16:07, 29 September 2014 (UTC)

sigh - this happens sometimes. Will take another look. Cas Liber (talk · contribs) 21:32, 29 September 2014 (UTC)

Laparotomy, an open-abdomen procedure, is the traditional surgical protocol; - strange way to use "protocol" - I'd say "Laparotomy (open surgery) is the traditional surgical procedure;" or somesuch.

Done

There are several experimental therapies for endometrial cancer under research as of the 2010s, including immunologic, hormonal, and chemotherapeutic. - I think you can lose the "as of the 2010s" -as implied and hence redundant

Done

can stop or reverse the progress of endometrial cancer in young women. - you'd want to qualify with an age limit or range other than "young".....

Not sure what "young" means beyond "pre-menopausal". The source isn't clear, unfortunately. Keilana|^{Parlez ici} 16:07, 29 September 2014 (UTC)

Ok Cas Liber (talk · contribs) 21:32, 29 September 2014 (UTC)

Just looking at the overall coverage and balance...looks good though I haven't investigated sources as yet. My cousin is a OBGYN so will ask her to have a look. Cas Liber (talk · contribs) 20:43, 21 September 2014 (UTC)

@Casliber: Thank you so much for your review! Keilana|^{Parlez ici} 16:07, 29 September 2014 (UTC)

Review by Jfdwolff

Firstly, well done on the hard work so far. Truly admirable and likely to have a real impact; the writing style is clear and accessible. I will keep my comments brief.

• General: a number of primary sources is referenced, and I was hoping they could be replaced with secondary sources (e.g. Mariño-Enríquez et al 2008, Nicolaije et al 2013)

I think these are okay because I only reference the portions that are the "review of the literature". If that's not okay, I can work on replacing them. Keilana|^{Parlez ici} 16:14, 29 September 2014 (UTC)

• The introduction has numerous references; I think they can be a bit offputting for the casual reader and I would recommend removing them.

• You're the second reviewer to say that - I've hidden most of them (for the sake of translation efforts, I don't want to remove them entirely.) Keilana|^{Parlez ici} 16:14, 29 September 2014 (UTC)

• We had a discussion about putting refs in the lead here [1]. For multiple reasons they are a good idea to keep to some extend. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:47, 30 September 2014 (UTC)
• Not a deal breaker. JFW | T@lk 20:19, 6 October 2014 (UTC)

• Signs and symptoms: in the second paragraph, the exact meaning of "these symptoms" is not quite clear. Does it refer to pyometra or to abdominal pain and cramping, and does it specifically indicate endometrial cancer or other cancers as well?

• It's since been changed, possibly by me? Better now? Keilana|^{Parlez ici} 04:17, 7 October 2014 (UTC)

• Risk factors: many readers may not understand what an "immigration study" is, and a short explanation of its relevance would be beneficial.

• Hopefully gave a fairly decent explanation.

• Risk factors#Genetics: I am unsure what is meant by "loose association" - is there an apparent link between BRCA1/2 and endometrial cancer that can be attributed to the use of tamoxifen? Clarification may be needed.

• Yeah, that's basically what's going on, there's a loose statistical association but the general consensus is that it's due to tamoxifen. Keilana|^{Parlez ici} 04:17, 7 October 2014 (UTC)

• Risk factors#Protective factors: is there any particular explanation why multiparity reduces the risk? Currently the context alludes to the possibility that it might be progestin-related.

• I haven't seen any authors make that direct connection, but it's implied in several texts. Is it okay as it stands? Keilana|^{Parlez ici} 04:26, 7 October 2014 (UTC)

• Pathophysiology: the text refers to "Type 1" and "Type 2" cancers, but they are only defined further down in the article (in Diagnosis#classification)

• Er, should I move pathophysiology? Because I don't want to get into the nitty gritty of classification in the middle of discussing pathophys. Keilana|^{Parlez ici} 04:26, 7 October 2014 (UTC)

• Management#Surgery: the exact purpose of mastectomy in type 2 tumors is unclear ("prophylaxis" is vague)

• So the source just says "For type II lesions, mastectomy is usually added." My assumption is that it's got something to do with estrogen receptors but I'm digging for a more comprehensive explanation. Keilana|^{Parlez ici} 16:12, 8 October 2014 (UTC)

• Management#Add-on therapy#Radiotherapy: some short explanations of concepts like EBRT and brachytherapy would be valuable
• Management#Targeted therapy: if this is not in widespread use it might be better to move this to "Research"
• References: generally good sourcing. Some of the journals are linked to a redlink - is there a reason for this or might it be possible to remove them?

• I think someone went through and linked them, I don't have strong feelings one way or another. Keilana|^{Parlez ici} 04:26, 7 October 2014 (UTC)

I am leaning strongly towards support, so please let me know when the above has been addressed! Good luck. JFW | T@lk 22:47, 23 September 2014 (UTC)

Some suggestions from an ip collaborator

First of all, I too would like to congratulate Keilana on her exemplary work here.

In the lead:

• Endometrial cancer is when cancer arises from the endometrium... Personally, I'm uncomfortable with this structure on stylistic grounds. Suggest either Endometrial cancer is cancer that arises from the endometrium... or Endometrial cancer occurs when cancer arises from the endometrium...
• It is due to the abnormal growth of cells that... The expression "due to" seems to imply that it is caused by abnormal growth (which at a cellular level is admittedly true). Suggest It stems from the abnormal growth of cells that...
• Suggest While Whereas taking estrogen alone increases...
• Suggest Between two and five percent of cancers cases are related to genes inherited from a the person's parents.

tbc 109.153.156.71 (talk) 16:51, 9 October 2014 (UTC)