Uterine Cancer Prevention

Uterine cancer, also known as endometrial cancer, develops when cells in the uterus grow out of control. There are two types of uterine cancer: adenocarcinoma and sarcoma. Adenocarcinoma originates in the inner lining of the uterus called the endometrium and is often referred to as endometrial cancer. Endometrial cancer accounts for more than 90% of all uterine cancers. Sarcoma, which develops in the walls of the uterus is much less common.

It’s unclear exactly what causes uterine cancer. Still, researchers have been able to outline uterine cancer risk factors that can affect your chances of developing the disease.

• Age. Most uterine cancers occur in women 50 and older, and the average age at diagnosis is 60.
• Obesity. It’s estimated that seven out of 10 uterine cancers are linked to excess fatty tissue. Women with BMIs between 25 and 29.9, which is classified as overweight, are at double the risk of uterine cancer than women with BMIs in the “normal” range. Women with BMIs of 30 or above have three times the risk.
• Type 2 diabetes. Women who have type 2 diabetes are at increased risk of uterine cancer, which is likely because type 2 diabetes typically affects people who are overweight.
• Hormone therapy. Risk of uterine cancer is increased in women who use estrogen therapy after menopause.
• More menstrual periods. Uterine cancer is more common in women who begin menstruating before age 12, go through menopause later in life or never become pregnant. This is likely because such women are exposed to more estrogen in their lifetime.
• Ovarian dysfunction. Polycystic ovarian syndrome (PCOS) and other forms of ovarian dysfunction may cause higher than normal levels of estrogen, which can, in turn, trigger the formation of cancerous cells.
• Tamofixen. This nonsteroidal agent used widely in treating metastatic breast cancer has been linked in studies to increased risks of developing uterine cancer.
• Hereditary condition, such as Lynch syndrome and Cowden syndrome.

Certain inherited genetic mutations, such as hereditary nonpolyposis colon cancer (Lynch syndrome), elevate an individual’s risk of several types of cancer, including uterine cancer. Women with this hereditary syndrome should discuss with their gynecologist the benefits and risks of screening with ultrasound and endometrial biopsy. Due to the significantly high likelihood of developing uterine cancer in this population (up to a 70% lifetime risk), it is recommended that women with Lynch syndrome undergo hysterectomy once they have completed childbearing. Additionally, because women with Lynch syndrome also face an increased risk of ovarian cancer, it is common to remove the ovaries and fallopian tubes concurrently with the hysterectomy.

Inheritable genetic mutations account for only about 5% of all uterine cancers, indicating that the vast majority of cases are sporadic.

While there’s no reliable way to prevent uterine cancer, the following uterine cancer prevention recommendations may help women at average risk reduce their chances of developing the disease:

• Maintain a body mass index below 25.
• Be physically active every day.
• Discuss the benefits and risks of hormone therapy with your gynecologist.
• Seek treatment for any abnormal bleeding, which can be a sign of endometrial hyperplasia (precancer).