Endometrial cancer risk factors: Difference between revisions
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{{Endometrial cancer}} | {{Endometrial cancer}} | ||
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==Overview== | ==Overview== | ||
Common risk factors in the development of endometrial cancer are [[estrogen]] exposure, [[tamoxifen]] use, obesity, [[diabetes]], [[high blood pressure]] and genetic disorders. | |||
==Risk Factors== | ==Risk Factors== | ||
Some of the risk factors for endometrial cancer are: | Some of the risk factors for endometrial cancer are: | ||
:1. '''Estrogen exposure''' | |||
:* Women who have received higher doses or longer periods of [[estrogen]] therapy have higher risks of endometrial cancer.<ref>{{cite book | last = Vern L. Katz | first = Gretchen M. Lentz | title = Comprehensive gynecology | publisher = Elsevier/ Mosby | location = Philadelphia, PA, USA | year = 2012 | isbn =978-0-323-06986-1}}</ref> | |||
:2. '''Early menarche''' | |||
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. | :* Women who 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.<ref name="pmid1442985">{{cite journal| author=Brinton LA, Berman ML, Mortel R, Twiggs LB, Barrett RJ, Wilbanks GD et al.| title=Reproductive, menstrual, and medical risk factors for endometrial cancer: results from a case-control study. | journal=Am J Obstet Gynecol | year= 1992 | volume= 167 | issue= 5 | pages= 1317-25 | pmid=1442985 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1442985 }} </ref> | ||
:3.'''Late menopause''' | |||
* | :* Women who reach [[menopause]] at an older age are exposed to estrogen for a longer time and have an increased risk of endometrial cancer.<ref name="pmid1442985">{{cite journal| author=Brinton LA, Berman ML, Mortel R, Twiggs LB, Barrett RJ, Wilbanks GD et al.| title=Reproductive, menstrual, and medical risk factors for endometrial cancer: results from a case-control study. | journal=Am J Obstet Gynecol | year= 1992 | volume= 167 | issue= 5 | pages= 1317-25 | pmid=1442985 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1442985 }} </ref> | ||
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. | :4. '''Nulliparity''' | ||
:* 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.<ref name="pmid22895938">{{cite journal| author=Vale CL, Tierney J, Bull SJ, Symonds PR| title=Chemotherapy for advanced, recurrent or metastatic endometrial carcinoma. | journal=Cochrane Database Syst Rev | year= 2012 | volume= 8 | issue= | pages= CD003915 | pmid=22895938 | doi=10.1002/14651858.CD003915.pub4 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22895938 }} </ref> | |||
:5. '''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.<ref name="pmid23076938">{{cite journal| author=Staley H, McCallum I, Bruce J| title=Postoperative tamoxifen for ductal carcinoma in situ. | journal=Cochrane Database Syst Rev | year= 2012 | volume= 10 | issue= | pages= CD007847 | pmid=23076938 | doi=10.1002/14651858.CD007847.pub2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23076938 }} </ref> | ||
Hereditary nonpolyposis colon cancer (HNPCC) syndrome | :6. '''Family history''' | ||
:* ''Hereditary nonpolyposis colon cancer (HNPCC) syndrome (Lynch syndrome)'': Women with Lynch syndrome have a 40–60% risk of developing endometrial cancer, higher than their risk of developing colorectal (bowel) or ovarian cancer.<ref>{{cite book | last = Hoffman | first = Barbara | title = Williams gynecology | publisher = McGraw-Hill Medical | location = New York | year = 2012 | isbn = 9780071716727. }}</ref> [[Carcinogenesis]] in Lynch syndrome comes from a mutation in ''[[MLH1]]'' and/or ''MLH2'': genes that participate in the process of [[mismatch repair]], which allows a cell to correct mistakes in the DNA.<ref>{{cite book | last = Hoffman | first = Barbara | title = Williams gynecology | publisher = McGraw-Hill Medical | location = New York | year = 2012 | isbn = 9780071716727. }}</ref> Other genes mutated in Lynch syndrome include ''[[MSH2]]'', ''[[MSH6]]'', and ''[[PMS2]]'', which are also mismatch repair genes. | |||
:* ''Cowden syndrome'': Women with Cowden syndrome have a 5–10% lifetime risk of developing endometrial cancer, compared to the 2–3% risk for unaffected women.<ref>Kumar (2009). Robbins and Cotran Pathologic Basis of DiseaseProfessional Edition, 8th ed. Saunders, An Imprint of Elsevier.</ref><ref>{{cite book | last = Cotran | first = Robbins | title = Pathologic Basis of Disease | publisher = Saunders//Elsevier | location = Jacksonville, FL, U.S.A | year = 2009 | isbn = 978-1-4160-3121-5 }}</ref> Cowden syndrome is associated with mutations in ''PTEN'', a tumor suppressor gene, that cause the ''PTEN'' protein not to work properly leading to hyperactivity of the mTOR pathway. | |||
:7. '''Polycystic ovary syndrome''' | |||
Women who have polycystic ovary syndrome | :* Women who have polycystic [[ovary]] syndrome have an increased risk of endometrial cancer. | ||
:8. '''Obesity''' | |||
* | :* [[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]].<ref name="pmid24905773">{{cite journal| author=SGO Clinical Practice Endometrial Cancer Working Group. Burke WM, Orr J, Leitao M, Salom E, Gehrig P et al.| title=Endometrial cancer: a review and current management strategies: part I. | journal=Gynecol Oncol | year= 2014 | volume= 134 | issue= 2 | pages= 385-92 | pmid=24905773 | doi=10.1016/j.ygyno.2014.05.018 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24905773 }} </ref> | ||
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. | :11. '''Diabetes and hypertension''' | ||
:* Women suffering from hypertension or diabetes are at increased risk for developing endometrial cancer.<ref name="pmid12640672">{{cite journal| author=Furberg AS, Thune I| title=Metabolic abnormalities (hypertension, hyperglycemia and overweight), lifestyle (high energy intake and physical inactivity) and endometrial cancer risk in a Norwegian cohort. | journal=Int J Cancer | year= 2003 | volume= 104 | issue= 6 | pages= 669-76 | pmid=12640672 | doi=10.1002/ijc.10974 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12640672 }} </ref> | |||
* | |||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Roukoz A. Karam, M.D.[2]
Overview
Common risk factors in the development of endometrial cancer are estrogen exposure, tamoxifen use, obesity, diabetes, high blood pressure and genetic disorders.
Risk Factors
Some of the risk factors for endometrial cancer are:
- 1. Estrogen exposure
- 2. Early menarche
- Women who 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.[2]
- 3.Late menopause
- 4. Nulliparity
- 5. 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.[4]
- 6. Family history
- Hereditary nonpolyposis colon cancer (HNPCC) syndrome (Lynch syndrome): Women with Lynch syndrome have a 40–60% risk of developing endometrial cancer, higher than their risk of developing colorectal (bowel) or ovarian cancer.[5] Carcinogenesis in Lynch syndrome comes from a mutation in MLH1 and/or MLH2: genes that participate in the process of mismatch repair, which allows a cell to correct mistakes in the DNA.[6] Other genes mutated in Lynch syndrome include MSH2, MSH6, and PMS2, which are also mismatch repair genes.
- Cowden syndrome: Women with Cowden syndrome have a 5–10% lifetime risk of developing endometrial cancer, compared to the 2–3% risk for unaffected women.[7][8] Cowden syndrome is associated with mutations in PTEN, a tumor suppressor gene, that cause the PTEN protein not to work properly leading to hyperactivity of the mTOR pathway.
- 7. Polycystic ovary syndrome
- Women who have polycystic ovary syndrome have an increased risk of endometrial cancer.
- 8. Obesity
- 11. Diabetes and hypertension
- Women suffering from hypertension or diabetes are at increased risk for developing endometrial cancer.[10]
References
- ↑ Vern L. Katz, Gretchen M. Lentz (2012). Comprehensive gynecology. Philadelphia, PA, USA: Elsevier/ Mosby. ISBN 978-0-323-06986-1.
- ↑ 2.0 2.1 Brinton LA, Berman ML, Mortel R, Twiggs LB, Barrett RJ, Wilbanks GD; et al. (1992). "Reproductive, menstrual, and medical risk factors for endometrial cancer: results from a case-control study". Am J Obstet Gynecol. 167 (5): 1317–25. PMID 1442985.
- ↑ Vale CL, Tierney J, Bull SJ, Symonds PR (2012). "Chemotherapy for advanced, recurrent or metastatic endometrial carcinoma". Cochrane Database Syst Rev. 8: CD003915. doi:10.1002/14651858.CD003915.pub4. PMID 22895938.
- ↑ Staley H, McCallum I, Bruce J (2012). "Postoperative tamoxifen for ductal carcinoma in situ". Cochrane Database Syst Rev. 10: CD007847. doi:10.1002/14651858.CD007847.pub2. PMID 23076938.
- ↑ Hoffman, Barbara (2012). Williams gynecology. New York: McGraw-Hill Medical. ISBN 9780071716727. Check
|isbn=value: invalid character (help). - ↑ Hoffman, Barbara (2012). Williams gynecology. New York: McGraw-Hill Medical. ISBN 9780071716727. Check
|isbn=value: invalid character (help). - ↑ Kumar (2009). Robbins and Cotran Pathologic Basis of DiseaseProfessional Edition, 8th ed. Saunders, An Imprint of Elsevier.
- ↑ Cotran, Robbins (2009). Pathologic Basis of Disease. Jacksonville, FL, U.S.A: Saunders//Elsevier. ISBN 978-1-4160-3121-5.
- ↑ SGO Clinical Practice Endometrial Cancer Working Group. Burke WM, Orr J, Leitao M, Salom E, Gehrig P; et al. (2014). "Endometrial cancer: a review and current management strategies: part I." Gynecol Oncol. 134 (2): 385–92. doi:10.1016/j.ygyno.2014.05.018. PMID 24905773.
- ↑ Furberg AS, Thune I (2003). "Metabolic abnormalities (hypertension, hyperglycemia and overweight), lifestyle (high energy intake and physical inactivity) and endometrial cancer risk in a Norwegian cohort". Int J Cancer. 104 (6): 669–76. doi:10.1002/ijc.10974. PMID 12640672.