Are You at Risk for Endometrial Cancer?

Endometrial cancer is the most common gynecological cancer in women over 45, and the fourth most common cancer in women. In 2008, about 40,000 women were diagnosed with endometrial cancer. When detected and treated early, however, endometrial cancer patients have extremely good survival odds.

What is Endometrial Cancer?

The uterus has two layers, the myomelium, which is the outer layer, and the endometrium, the inner layer. Most uterine cancers begin in the endometrium; so the term endometrial cancer is used interchangeably with uterine cancer.

Throughout a woman's monthly menstrual cycle, the endometrium changes in response to her ovaries producing estrogen and progesterone. When the balance shifts and there is an excess of estrogen, it stimulates the growth of the endometrium and increases a woman's risk for endometrial cancer.

Risk Factors for Endometrial Cancer

Age. Most endometrial cancers strike women in their 50s or older.

Race. White women are more likely to develop endometrial cancer, although black women are more likely to die from the disease.

Tamoxifen. Women who take Tamoxifen to prevent or treat breast cancer are at greater risk for endometrial cancer.

Hormone replacement therapy (HRT). HRT of just estrogen, without progesterone, increases women's risk for endometrial cancer. HRT with progesterone lowers risk.

Endometrial hyperplasia. Hyperplasia is an increase in the number of cells in the lining of the uterus. It's most common in women 40 or older. Endometrial hyperplasia may or may not develop into cancer. There are three types of endometrial hyperplasia: atypical, simple, and complex. Women with atypical endometrial hyperplasia are at greater for endometrial cancer.

Genetic predisposition. Scientists have identified a particular genetic mutation they believe accounts for about 20 percent of endometrial cancers. This mutation responds to a group of drugs called rapalogs. While it's currently not possible to predict which women have this altered gene, we may someday be able to screen for this mutation.

Obesity and obesity-related conditions. The fatty tissue in women's body produces estrogen, which can disrupt the normal balance of estrogen and progesterone. This excess of estrogen increases a woman's risk for endometrial cancer. In fact, 40 percent of endometrial cancers are now attributed to obesity, and physicians are diagnosing women with endometrial cancer at younger ages due to the increasing incidence of obesity.

Other risk factors. Women who have never had children, who began menstruating before 12, or who entered menopause at an advanced age are at greater risk for endometrial cancer. Ovarian tumors, irregular ovulation, and a inherited form of colorectal cancer are also risk factors.

Sources

National Cancer Institute. "What you need to know about cancer of the uterus." Web.

http://www.cancer.gov/cancertopics/wyntk/uterus

Kim, Julie J. Ph.D., and Chapma-Davis, Eloise, MD. "Role of Progesterone in Endometrial Cancer." Seminars in Reproductive Medicine 28(1) (2010): 81-90. Medscape Medical News. Web. 30 March 2010.

http://www.medscape.com/viewarticle/716315

Thomas CC, Wingo PA, Dolan MS, Lee NC, Richardson LC.
 "Endometrial Cancer Risk Among Younger, Overweight Women." Obstetrics and Gynecology 114 (2009): 22-27. Medscape Medical News. Web.

http://www.medscape.com/viewarticle/708584

Rizzo, Michelle. "Serum Triglyceride Levels Linked to Endometrial Cancer Risk." International Journal of Cancer 124 (2009): 2938-2941. Medscape Medical News. Web. 17 June 2009.

http://www.medscape.com/viewarticle/706113

Rizzo, Michelle. "Atypical Hyperplasia Carries High Long-Term Risk of Endometrial Cancer." Medscape Medical News. Web. 2 February 2010.

http://www.medscape.com/viewarticle/716333

UT Southwestern Medical Center. "Single gene mutation induces endometrial cancer, researchers find." Web. 10 February 2010.

http://www.utsouthwestern.edu/utsw/cda/dept353744/files/576015.html

Mayo Clinic. "Endometrial cancer." Web. 6 December 2008.

http://www.mayoclinic.com/health/endometrial-cancer/DS00306