Those factors that increase the risk of developing endometrial cancer are referred to as endometrial cancer risk factors. Having these risk factors does not guarantee an endometrial cancer diagnosis; however, they increase one’s chances of developing this cancer.
Speaking of endometrial cancer prevention, it is not possible to prevent this cancer completely. However, making certain modifications to your lifestyle can help reduce the risk of endometrial cancer.
Most Common Endometrial Cancer Risk Factors
Endometrial cancer risk factors are categorized as modifiable or lifestyle-related factors and non-modifiable or non-lifestyle-related factors. Lifestyle-related factors are those that can be controlled and modified, and non-lifestyle-related factors are those that cannot be controlled. The most common endometrial cancer risk factors include:
Age
Age is a non-modifiable risk factor for endometrial cancer. Endometrial cancer most commonly occurs in postmenopausal women and women over the age of 45. However, it may also occur in premenopausal women, especially when other risk factors, such as diabetes, obesity, and polycystic ovarian syndrome are associated.
Excess Estrogen
Exposure to excess estrogen is also an endometrial adenocarcinoma risk factor. It may occur due to several underlying medical conditions, such as ovarian dysfunction and polycystic ovary syndrome. Women on estrogen-based hormone therapy also have a higher risk of developing endometrial cancer.
Early Menstruation and Late Menopause
The uterus is exposed to estrogen during the menstrual cycle. In cases where the menstrual cycle starts early, and menopause is attained late, women have more number of menstrual cycles and therefore, higher exposure to estrogen. These women have a higher risk of developing endometrial cancer.
Never Attaining Pregnancy
Women who have never attained pregnancy have a higher chance of getting endometrial cancer than women with at least one pregnancy. Getting pregnant reduces the period of uterine exposure to estrogen, thereby lowering the risk of endometrial cancer.
Radiation Therapy for Pelvic Cancer
Some types of pelvic cancer require radiation therapy for their management. Radiation therapy uses high-energy radiation to kill cancer cells. However, in some cases, the healthy cells of the endometrium may also undergo mutations due to radiation therapy and may change into malignant cells.
Obesity
Obesity is among the strongest risk factors for endometrial cancer. There are several mechanisms through which obesity causes endometrial cancer. Fat tissues may alter the levels of estrogen by converting androgens to estrogens, releasing excess estrogen into the bloodstream, and causing insulin resistance that can increase estrogen production.
It has been reported that overweight women have a two times higher risk and obese women have a three times higher risk of endometrial cancer than women with a healthy weight.
Endometrial Hyperplasia
It is a condition characterized by the growth of endometrial tissues. Those with atypical hyperplasia have a higher risk of developing endometrial cancer. Studies have found that simple atypical hyperplasia progresses into endometrial cancer in about 8% of the cases, while complex atypical hyperplasia progresses into endometrial cancer in 29% of the cases.
Family History
Women with a family history of endometrial cancer may have an increased risk of developing this condition.
Tamoxifen
Tamoxifen is a medication used for the prevention and management of breast cancer. It mimics the action of estrogen on the uterine wall. In women with menopause, it stimulates the growth of the uterine lining, thereby increasing the risk of endometrial cancer. Although the risk of endometrial cancer with tamoxifen is low, women who are prescribed this drug should discuss this issue with their healthcare providers.
Lynch Syndrome
It is an inherited condition that increases the risk of several cancers, including endometrial cancer. It also enhances the risk of colon cancer. If a person has a family history of Lynch syndrome, the other family members should be screened for it and their risk of developing colon and endometrial cancers should be thoroughly assessed.
Diabetes
Women with diabetes have twice the risk of endometrial cancer than those without diabetes. Insulin resistance can cause increased estrogen levels, which is a risk factor for endometrial cancer.
Endometrial Cancer Prevention Measures
It is not possible to prevent endometrial cancer as its exact cause is unknown. However, certain measures can help in reducing its risk. The following are the most important endometrial cancer prevention measures:
Maintain a Healthy Weight
Maintaining a healthy weight significantly lowers the risk of endometrial cancer. Those women who are overweight or obese may consider losing weight and maintaining a healthy weight by reducing their calorie intake and enhancing their physical activity.
Regular Exercise
Opting for regular exercise can increase the chances of endometrial cancer prevention. Studies have reported that women who engage in regular physical activity have a 20–40% reduced risk of endometrial cancer.
Healthy Diet
Consuming a healthy diet comprising fruits and vegetables reduces the risk of endometrial cancer. Further, a diet that enhances obesity, such as a high-fat diet containing processed foods, should be avoided to lower the risk of endometrial cancer.
Limit Estrogen Exposure
Limiting exposure to estrogen also lowers the risk of endometrial cancer. If the women are on hormone replacement therapy, they may discuss the risks and benefits of therapy with their healthcare providers. Further, estrogen-alone therapy may be replaced with a combination of estrogen-progestin therapy.
Manage Chronic Conditions
Several underlying medical conditions, such as obesity, diabetes, and polycystic ovarian syndrome, increase endometrial cancer risk. Managing these conditions lowers the risk of endometrial cancer.
Use Birth Control
Using birth control pills for at least one year may lower the risk of endometrial cancer. The reduction in risk may last for a few years after the drug is withdrawn. These drugs have side effects and should be taken after consultation with healthcare providers.
Pregnancy and Breastfeeding
Getting pregnant at least once and breastfeeding lowers the risk of endometrial cancer due to reduced exposure to estrogen.
Regular Check-ups
Regular check-ups for endometrial cancer may result in early diagnosis and management, especially in women with increased risk for hyperplasia and endometrial cancer.
Conclusion
The endometrial cancer risk factors include advanced age, obesity, diabetes, polycystic ovary syndrome, never getting pregnant, radiation therapy for pelvic cancer, hormone therapy for breast cancer, early menstruation and late menopause, endometrial hyperplasia, and Lynch syndrome. Endometrial cancer prevention measures include a healthy diet, regular physical activity, pregnancy and breastfeeding, and a reduction in estrogen exposure.
Frequently Asked Questions
It is not possible to completely prevent endometrial cancer. However, with the right measures, one can reduce its risk. The following endometrial cancer prevention measures help in mitigating the risk:
- Maintaining a healthy weight
- Opting for balanced nutrition and regular exercise
- Being mindful of estrogen exposure
- Managing chronic health conditions effectively
- Opting for regular health checkups
Infertility may result in an imbalance between estrogen and progesterone. Women with infertility may be exposed to estrogen for relatively longer periods, increasing their risk of endometrial cancer.
PCOS results in anovulation and increased exposure of the uterine lining to estrogen. It may cause endometrial hyperplasia and an increased risk of endometrial cancer.
Foods containing vitamins C and E and carotenoids reduce the risk of endometrial cancer by scavenging free radicals.
Foods such as whole grains and plant-based proteins may lower the risk of endometrial cancer.
It is normal for one to wonder how to prevent endometrial cancer through diet. Doctors recommend a balanced diet to reduce endometrial cancer risk. A diet containing fresh fruits and vegetables, whole grains, and plant-based proteins protects the body against various health conditions that may lead to endometrial cancer. It is important to avoid processed meat and lower the consumption of red meat. Further, limit the consumption of alcohol and salt.
