A
risk factor is anything that changes your chance of getting a disease such as
cancer. Different cancers have different risk factors. For example, unprotected
exposure to strong sunlight is a risk factor for skin cancer. Smoking is a risk
factor for many cancers.
There
are different kinds of risk factors. Some, such as your age or race, can't be
changed. Others are related to personal choices such as smoking, exercising,
body weight, drinking, or diet. Some factors influence risk more than others.
Although certain factors increase a woman's risk for developing endometrial
cancer, they do not always cause the disease. Many women with one or more risk
factors never develop endometrial cancer. Some women with endometrial cancer do
not have any known risk factors. Even if a woman with endometrial cancer has
one or more risk factors, there is no way to know which, if any, of these
factors was responsible for her cancer.
Hormone factors
A
woman's hormone balance plays a part in the development of most endometrial
cancers. Many of the risk factors for endometrial cancer affect estrogen
levels. Before menopause, the ovaries are the main source of the 2 main types
of female hormones -- estrogen and progesterone. The balance between these
hormones changes during a woman's menstrual cycle each month. This produces a
woman's monthly periods and keeps the endometrium healthy. A shift in the
balance of these two hormones toward more estrogen increases a woman's risk for
developing endometrial cancer.
After menopause, the ovaries stop making these
hormones, but a small amount of estrogen is still made naturally in fat tissue.
This estrogen has a bigger impact after menopause than it does before menopause.
Female hormones are also available to take (as a medicine) in birth control
pills to prevent pregnancy and as hormone therapy to treat symptoms of
menopause.
Estrogen therapy
Treating
the symptoms of menopause with estrogen is known as estrogen therapy or menopausal
hormone therapy. Estrogen is available in many different forms such as
pills, skin patches, creams, shots, and vaginal rings to treat the symptoms of
menopause. Estrogen treatment can reduce hot flashes, improve vaginal dryness,
and help prevent the weakening of the bones (osteoporosis) that can occur with
menopause. Doctors have found, however, that using estrogen alone (without
progesterone) can lead to endometrial cancer in women who still have a uterus.
Progesterone-like drugs must be given along with estrogen to reduce the
increased risk of endometrial cancer. This approach is called combination
hormone therapy.
Giving
progesterone along with estrogen does not cause endometrial cancer, but it does
still have risks. Studies have shown that this combination increases a woman's
chance of developing breast cancer and also increases the risk of serious blood
clots.
Birth control pills
Using
birth control pills (oral contraceptives) lowers the risk of endometrial
cancer. The risk is lowest in women who take the pill for a long time, and this
protection continues for at least ten years after a woman stops taking this
form of birth control. However, it is important to look at all of the risks and
benefits when choosing a contraceptive method; endometrial cancer risk is only
one factor to be considered. It's a good idea to discuss the pros and cons of
different types of birth control with your doctor.
Total number of menstrual cycles
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Having
more menstrual cycles during a woman's lifetime raises her risk of endometrial
cancer. Starting menstrual periods (menarche) before age 12 and/or going
through menopause later in life raises the risk. Starting periods early is less
a risk factor for women with early menopause. Likewise, late menopause may not
lead to a higher risk in women whose periods began later in their teens.
Obesity
Most
of a woman's estrogen is produced by her ovaries, but fat tissue can change
some other hormones into estrogens. Having more fat tissue can increase a
woman's estrogen levels, which increases her endometrial cancer risk. In
comparison with women who maintain a healthy weight, endometrial cancer is
twice as common in overweight women, and more than three times as common in
obese women.
Ovarian tumors
A certain type of ovarian tumor,
the granulosa-theca cell tumor, often makes estrogen. Estrogen release
by one of these tumors is not controlled the way hormone release from the
ovaries is, which can sometimes lead to high estrogen levels. The resulting
hormone imbalance can stimulate the endometrium and even lead to endometrial
cancer. In fact, sometimes vaginal bleeding from endometrial cancer is the
first symptom of one of these tumors.
Polycystic
ovarian syndrome
Women with a condition called
polycystic ovarian syndrome (PCOS) have abnormal hormone levels, such as higher
androgen (male hormones) and estrogen levels and lower levels of progesterone.
The increase in estrogen relative to progesterone can increase a woman's chance
of getting endometrial cancer.
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