Endometrial cancer risk factors
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Endometrial cancer usually occurs in women after menopause, and affects more white women than black women. Black women diagnosed with endometrial cancer are more likely to have more advanced disease at diagnosis, and are more likely to die from endometrial cancer than white women.
Risk Factors
Some of the risk factors for endometrial cancer are:
- Estrogen Exposure
Estrogen exposure through estrogen-only hormone replacement therapy. A combination estrogen-progestin replacement therapy in post menopausal women, however, has not been shown to increase the risk of endometrial cancer. Beginning to have menstrual periods at an early age also increases the number of years the body is exposed to estrogen and increases a woman's risk of endometrial cancer. Similarly, women who reach menopause at an older age are exposed to estrogen for a longer time and have an increased risk of endometrial cancer. Never being pregnant is also a risk factor for endometrial cancer. Because estrogen levels are lower during pregnancy, women who have never been pregnant are exposed to estrogen for a longer time than women who have been pregnant. This increases the risk of endometrial cancer.
- Tamoxifen
Tamoxifen is one of a group of drugs called selective estrogen receptor modulators, or SERMs. Tamoxifen is used to prevent breast cancer in women who are at high risk for the disease, but it increases the risk of endometrial cancer. This risk is greater in postmenopausal women. Another drug in the SERM group, raloxifene, is used to prevent bone weakness in postmenopausal women and has not been shown to increase the risk of endometrial cancer.
- Inherited risk
Hereditary nonpolyposis colon cancer (HNPCC) syndrome is an inherited disorder caused by changes in certain genes. Women who have HNPCC syndrome have a much higher risk of developing endometrial cancer than women who do not have HNPCC syndrome. The inherited genetic condition Cowden syndrome can also cause endometrial cancer. Women with this disorder have a 5–10% lifetime risk of developing endometrial cancer,compared to the 2–3% risk for unaffected women
- Polycystic ovary syndrome
Women who have polycystic ovary syndrome (a disorder of the hormones made by the ovaries) have an increased risk of endometrial cancer.
- Body fat
Obesity increases the risk of endometrial cancer. This may be because obesity is related to other risk factors such as estrogen levels, polycystic ovary syndrome, lack of physical activity, and a diet that is high in saturated fats.
- High blood pressure is also a risk factor.
- Prior pelvic radiation therapy: Radiation can increase the risk of endometrial cancer by damaging the DNA of cells.
- Diabetes: Epidemiological data shows that endometrial cancer may be as much as four times more common in women with diabetes.
- Ovarian tumors: The granulosa-theca cell tumor, one type of ovarian tumor, can produce estrogen and increase the risk of endometrial cancer.