Uterine cancer

Uterine (or endometrial) cancer is the most common gynecological malignancy, and the fourth most common cancer among Canadian women. Unfortunately, the death rate from endometrial cancer is rising, suggesting that endometrial cancer may be becoming more deadly or that it is not being diagnosed or treated adequately.

What are the risk factors for uterine cancer?

The risk for uterine cancer increases with:

  • age
  • higher socioeconomic status
  • obesity
  • irregular menstrual periods
  • diabetes
  • polycystic ovarian syndrome
  • endometrial hyperplasia (overgrowth of uterine lining)
  • Lynch syndrome
  • never having been pregnant
  • the use of tamoxifen to treat breast cancer
  • the use of estrogen replacement therapy (ERT) for menopause
  • previous radiation therapy
  • ovarian tumors that secrete estrogen
  • started menstruating before 12 years old, or menopause after age 55

Note: Adding progesterone to the hormone replacement therapy greatly reduces the risk of uterine cancer, which is why postmenopausal women who still have their uteruses should nearly always take progesterone with estrogen. Also, the type of uterine cancer associated with the use of ERT seems to be a more easily treated form of this malignancy.

What can you do to protect yourself against uterine cancer?

There is some evidence that long-term use of ASA lowers the risk of uterine cancer, and the higher the dose of ASA, the lower the risk, leading to the theory that part of the reason cancer develops in the uterus is through inflammation, which is suppressed by ASA.

Art Hister, MD 
with updates by the MediResource Clinical Team