Endometrial (Uterine) Cancer

What Increases Your Risk

The biggest risk factor for endometrial cancer is having too much estrogen and not enough progesterone. This is called "unopposed estrogen." (Your body makes progesterone. Man-made progesterone, as in birth control pills or hormone therapy, is called a progestin.)

Long-term exposure to unopposed estrogen may occur as a result of:

• Being obese.¹ Fat cells make extra estrogen, but your body doesn't make extra progesterone to balance it out.
• Taking estrogen without taking a progestin.
• Polycystic ovary syndrome.
• Beginning your menstrual cycle before age 12 or starting menopause after age 55.
• Not ever being pregnant or not ever completing a full-term pregnancy (nulliparity).
• Not ever breast-feeding.

Additional factors that increase your risk include:

• Being older than 50. Endometrial cancer is most common in women older than 50.
• Having a history of breast, ovarian, or colon cancer.
• Taking tamoxifen, a breast cancer treatment that acts like estrogen in the uterus.¹ If you are taking tamoxifen for breast cancer, keep taking it as directed by your doctor. But be sure to have a pelvic exam each year. The risk of endometrial cancer is small compared to the risk of getting breast cancer again.⁵ If you are worried about endometrial cancer risk, talk to you doctor. You might be able to use another medicine, instead of tamoxifen, for breast cancer.
• Having endometrial hyperplasia.
• Having diabetes.
• Having hypertension.
• Having polycystic ovary syndrome (PCOS).
• Having previous radiation therapy to the pelvis.

A less common type II endometrial cancer has been linked to hereditary nonpolyposis colon cancer (HNPCC). In women, this cancer often starts in the uterus and ovaries before it grows in the colon. The American Cancer Society recommends that a woman with a family history of HNPCC talk to her doctor about annual screenings with endometrial biopsy, starting at age 35.⁶

Reducing your risk

There are some measures that can lower your risk for developing endometrial cancer.

• Taking birth control pills that contain both estrogen and progestin for longer than 1 year. Similarly, taking estrogen with progestin for menopausal symptoms lowers your endometrial cancer risk. (You have no risk for endometrial cancer if you have had your uterus removed, or hysterectomy.)
• Staying at a healthy body weight.
• Being physically active.
• Eating a diet rich in fruits, vegetables, and fiber.
• Lowering the amount of animal fats you eat.

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Author:	Kathe Gallagher, MSW	Last Updated: November 27, 2006
Medical Review:	Joy Melnikow, MD, MPH - Family Medicine Ross Berkowitz, MD - Obstetrics and Gynecology
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