Endometrial cancer is a cancer that begins in the lining of the uterus and accounts for more than 80% of uterine cancers. Endometrial cancer is the most diagnosed gynecologic cancer.1,2,3,4
In the United States, the average risk for a woman to develop uterine cancer is approximately 3.1%.5 Most cases are diagnosed after age 55, with the median age of diagnosis being 63.5 Some hereditary cancer syndromes are associated with an increased risk for endometrial cancer.1,2,3,4
General Risk Factors
- Beginning menstruation at an early age (before age 12)
- Never being pregnant
- A late age of menopause (after age 55)
- Estrogen-only hormone replacement therapy after menopause
- Type II Diabetes
- Tamoxifen use (a drug used to treat breast cancer or to reduce the risk for breast cancer; the benefits of using tamoxifen outweigh the risks of use in some women)
- Polycystic ovarian syndrome (PCOS) – this condition is associated with higher levels of androgen and estrogen hormones and lower levels of progesterone and can result in the failure of the ovaries to release an egg during the menstrual cycle
- Endometrial hyperplasia (increased growth of the endometrium) – the risk is much higher for endometrial cancer if atypical hyperplasia is present
- Prior radiation therapy to the pelvis for treatment of a previous cancer
- Family history of cancer – having family members with endometrial cancer raises the risk of endometrial cancer, even in absence of a known hereditary cause
- Diagnosis of a genetic endometrial cancer predisposition syndrome
As with the vast majority of cancers, there is no confirmed way to completely prevent the development of endometrial cancer. Maintaining a healthy weight through a healthy diet and exercise may decrease the risk for endometrial cancer. Women who use birth control pills as a form of contraception (birth control) are thought to have a lower risk for endometrial cancer. This is especially true for women who use birth control pills for longer periods of time. Some progesterone-containing intrauterine devices (IUDs) used for contraception may also reduce the risk for endometrial cancer. Women who have had multiple pregnancies are also thought to have a lower risk for endometrial cancer. Women who are done having children and who have a high risk for endometrial cancer due to a genetic change that increases the risk for endometrial cancer or medical findings that greatly increase their risk may be offered a risk-reducing hysterectomy to help prevent the formation of endometrial cancer. A hysterectomy is a surgery to remove the uterus.
Symptoms of endometrial cancer can include vaginal bleeding, spotting, or discharge. These symptoms may also be due to medical conditions other than endometrial cancer. Any vaginal bleeding occurring after menopause should be further evaluated to rule out endometrial cancer.
Currently in the United States, there is no standard or routine screening test for women at average risk for endometrial cancer. If your doctor considers you to be at a higher risk than the average person for endometrial cancer due to any of the risk factors mentioned above or if you are experiencing any of the symptoms mentioned above, he or she may recommend that you undergo certain screening or diagnostic tests, which can include some combination of a pelvic exam, endometrial biopsies (removal of tissue samples from the inner lining of the uterus), transvaginal ultrasound, and/or dilatation and curettage, also called a D&C (a procedure that uses a surgical tool to remove endometrial tissue.)
If endometrial cancer is diagnosed following any of the tests above, treatment will depend on the stage of the cancer (how far the cancer has grown or spread). Treatment can include some combination of surgery, chemotherapy, radiation, and hormone therapy.
AVOID THE FOLLOWING
- A diet high in animal fat
- Being very overweight; having too much body fat
- American Society of Clinical Oncology: Endometrial Cancer (http://www.cancer.net/cancer-types/uterine-cancer)
- American Cancer Society: Endometrial Cancer (http://www.cancer.org/cancer/endometrialcancer/index)
- National Cancer Institute: Endometrial Cancer treatment (http://www.cancer.gov/cancertopics/pdq/treatment/endometrial/Patient)
- ACOG Practice Bulletin No. 149. Endometrial Cancer. Obstet Gynecol 2015 April;125(4):1006-26.
- SEER Cancer Stat Facts: Uterine Cancer. National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/statfacts/html/corp.html
- Hendriks YM, et al. Cancer risk in hereditary nonpolyposis colorectal cancer due to MSH6 mutations: impact on counseling and surveillance. Gastroenterology. 2004 127:17-25.