Endometrial cancer risk factors: Difference between revisions

Jump to navigation Jump to search
 
(28 intermediate revisions by 4 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Endometrial cancer}}
{{Endometrial cancer}}
{{CMG}}
{{CMG}} {{AE}}{{RAK}}
==Overview==
==Overview==
Common risk factors in the development of endometrial cancer are [[Estrogen]] exposure, [[Tamoxifen]] use, obesity, [[diabetes]], [[high blood pressure]] and genetic disorders.
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'''
:1. '''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.  
:* 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>
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.
: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.<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>
:* 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'''
:2. '''Tamoxifen'''
:* 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.<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>
: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>
:3. '''Genetic disorders'''
:5. '''Tamoxifen'''
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.<ref name="pmid: 25032011">{{cite journal| author=Ma J, Ledbetter N, Glenn L| title=Testing women with endometrial cancer for lynch syndrome: should we test all? | journal=J Adv Pract Oncol | year= 2013 | volume= 4 | issue= 5 | pages= 322-30 | pmid=: 25032011 | doi= | pmc=PMC4093445 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25032011  }} </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.<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>
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.
:6. '''Family history'''
 
:* ''Hereditary nonpolyposis colon cancer (HNPCC) syndrome (Lynch syndrome)'': Women with Lynch syndrome have a 40–60%&nbsp;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.
:4. '''Polycystic ovary syndrome'''
:* ''Cowden syndrome'': Women with Cowden syndrome have a 5–10%&nbsp;lifetime risk of developing endometrial cancer, compared to the 2–3%&nbsp;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.
Women who have polycystic [[ovary]] syndrome (a disorder of the hormones made by the ovaries) have an increased risk of endometrial cancer.
:7. '''Polycystic ovary syndrome'''
 
:* Women who have polycystic [[ovary]] syndrome have an increased risk of endometrial cancer.
:5. '''Body fat'''
: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]].<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>
 
:11. '''Diabetes and hypertension'''
:6. '''[[High blood pressure]]''' is also a risk factor.
:* 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>
 
:7. '''Prior pelvic radiation therapy''': [[Radiation]] can increase the risk of endometrial cancer by damaging the [[DNA]] of cells.
 
:8. '''[[Diabetes]]''': Epidemiological data shows that endometrial cancer may be as much as four times more common in women with diabetes.
 
:9. '''Ovarian tumors''': The granulosa-theca cell tumor, one type of ovarian tumor, can produce estrogen and increase the risk of endometrial cancer.


==References==
==References==
Line 42: Line 36:
{{WikiDoc Help Menu}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
{{WikiDoc Sources}}
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Gynecology]]
[[Category:Surgery]]

Latest revision as of 13:57, 29 November 2018

Endometrial cancer Microchapters

Home

Patient Information

Overview

Historical perspective

Classification

Pathophysiology

Causes

Differentiating Endometrial cancer from other Diseases

Epidemiology and Demographics

Risk factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

MRI

Ultrasound

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Future or Investigational Therapies

Case Studies

Case #1

Endometrial cancer risk factors On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Endometrial cancer risk factors

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Endometrial cancer risk factors

CDC on Endometrial cancer risk factors

Endometrial cancer risk factors in the news

Blogs on Endometrial cancer risk factors

Directions to Hospitals Treating Endometrial cancer

Risk calculators and risk factors for Endometrial cancer risk factors

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
  • Women who have received higher doses or longer periods of estrogen therapy have higher risks of endometrial cancer.[1]
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
  • Women who reach menopause at an older age are exposed to estrogen for a longer time and have an increased risk of endometrial cancer.[2]
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.[3]
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
  • 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.[9]
11. Diabetes and hypertension
  • Women suffering from hypertension or diabetes are at increased risk for developing endometrial cancer.[10]

References

  1. Vern L. Katz, Gretchen M. Lentz (2012). Comprehensive gynecology. Philadelphia, PA, USA: Elsevier/ Mosby. ISBN 978-0-323-06986-1.
  2. 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.
  3. 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.
  4. 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.
  5. Hoffman, Barbara (2012). Williams gynecology. New York: McGraw-Hill Medical. ISBN 9780071716727. Check |isbn= value: invalid character (help).
  6. Hoffman, Barbara (2012). Williams gynecology. New York: McGraw-Hill Medical. ISBN 9780071716727. Check |isbn= value: invalid character (help).
  7. Kumar (2009). Robbins and Cotran Pathologic Basis of DiseaseProfessional Edition, 8th ed. Saunders, An Imprint of Elsevier.
  8. Cotran, Robbins (2009). Pathologic Basis of Disease. Jacksonville, FL, U.S.A: Saunders//Elsevier. ISBN 978-1-4160-3121-5.
  9. 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.
  10. 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.


Template:WikiDoc Sources