What are the causes and risk factors for endometrial cancer ?
The risk factors for endometrial cancer are multiple. As with many cancers, one of the risk factors is age. The older a woman gets, the higher her risk of endometrial cancer. Another important factor is obesity.
💡 DID YOU KNOW ?
Compared to all other cancers, endometrial cancer is the most strongly associated with obesity . For example, in the United States, 75% of all endometrial cancers are attributable to obesity.
While the risk of endometrial cancer is about 3% in a person with a normal weight, the risk can reach 50% when obesity is severe (Source: New England Journal of Medicine).
Type 2 diabetes (non-insulin-dependent diabetes) is also a risk factor: a woman with diabetes is about twice as likely to develop endometrial cancer as a woman who is not diabetic (Source: Canadian Cancer Society).
A longer or greater exposure to estrogen, the ovarian hormones, also increases the risk of endometrial cancer. This includes women who experienced early puberty(before 12 years old), late menopause (after 55 years old), or who have never been pregnant.
It also includes women who have undergone estrogen-based hormone replacement therapy. Tamoxifen, which is a hormonal treatment for breast cancer, increases the risk of uterine cancer when taken for two years or more. Polycystic ovary syndrome is also a risk factor for endometrial cancer.
Expert perspective
Polycystic ovary syndrome (PCOS) is the most common hormonal disorder among women of reproductive age. It affects about 10% of women, but the symptoms vary widely from one patient to another (Source: INSERM).
These symptoms can worsen with weight gain. PCOS can lead to fertility issues, excessive hair growth ( hirsutism ), and diabetes. It is caused by a hormonal imbalance with an excessive production of male hormones ( androgens ), particularly testosterone , which are usually produced in small amounts in the female body.
Among other factors, heredity may play a role. These hereditary forms are caused by genetic mutations that are passed down from generation to generation and are involved in the development of cancer. Due to these mutations, some women may have a genetic predisposition to develop cancer.
💡 DID YOU KNOW ?
DNA is a collection of 3 billion molecules located in the nucleus of each of the 30 trillion cells that make up our body. This DNA consists of a sequence of 4 different elements named A, T, G, and C, after the first letter of their full names. It forms a double helix and contains all the information necessary for the functioning of each cell. This information is contained in small fragments of DNA called " genes ". There are about 21,000 genes that determine the functioning of a cell and the production of proteins, which are essential components of cells.
Mutations can occur in the DNA, changing one element for another within one or more genes. These mutations can be passed down from a parent to a child ( hereditary genetic mutations ) or occur spontaneously in an individual during their lifetime ( sporadic mutations ). Some mutations can increase the risk of developing cancers.
UA genetic predisposition to endometrial cancer is primarily observed in patients with Lynch syndrome.
Expert perspective
Lynch syndrome is a genetic disorder that primarily affects the colon-rectum and the endometrium. Patients with Lynch syndrome have a higher risk of developing colorectal cancer, with onset typically around the age of 45. They also have an increased risk of developing cancer of the endometrium, ovaries, stomach, small intestine, or biliary and urinary tracts.
Additionally, there is a familial predisposition to developing endometrial cancer in some women. This familial predisposition may be due to genetic factors, a family lifestyle, chance, or a combination of these factors. The risk of developing endometrial cancer during one's lifetime is doubled when a first-degree relative (mother, sister, child) has endometrial cancer (Source: The Lancet).
Several factors reduce the risk of endometrial cancer. The first is maintaining a normal weight or losing weight in cases of obesity. Pregnancy and breastfeeding also reduce the risk. Finally, exposure to a female hormone, progesterone, also lowers the risk. This exposure can occur during regular menstrual cycles, with prolonged (more than 5 years) use of an oral contraceptive containing a progestin (a hormone with similar action to progesterone), a progestin-releasing intrauterine device (IUD), or menopausal hormone replacement therapy containing a progestin.
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Article updated on Jan 23, 2025
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