Endometrial cancer risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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

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.

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.

3.Early menopause

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.

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.[1]

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.[2]

6. Genetic disorders
  • 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.[3]
  • 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.[4][5]
7. Polycystic ovary syndrome

Women who have polycystic ovary syndrome have an increased risk of endometrial cancer.

8. 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.[6]

9. High blood pressure is also a risk factor.
10. Prior pelvic radiation therapy: Radiation can increase the risk of endometrial cancer by damaging the DNA of cells.
11. Diabetes: Epidemiological data shows that endometrial cancer may be as much as four times more common in women with diabetes.
12. Ovarian tumors: The granulosa-theca cell tumor, one type of ovarian tumor, can produce estrogen and increase the risk of endometrial cancer.

References

  1. 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.
  2. 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.
  3. Ma J, Ledbetter N, Glenn L (2013). "Testing women with endometrial cancer for lynch syndrome: should we test all?". J Adv Pract Oncol. 4 (5): 322–30. PMC 4093445. PMID 25032011 : 25032011 Check |pmid= value (help).
  4. Kumar (2009). Robbins and Cotran Pathologic Basis of DiseaseProfessional Edition, 8th ed. Saunders, An Imprint of Elsevier.
  5. Cotran, Robbins (2009). Pathologic Basis of Disease. Jacksonville, FL, U.S.A: Saunders//Elsevier. ISBN 978-1-4160-3121-5.
  6. 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.


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