Am I At Risk for Endometrial Cancer?

There is really no way to know for sure if you’re going to get endometrial cancer. It occurs in about 1 out of 37 women. Certain factors can make you more likely to get this cancer than another woman. However, just because you have one or more risk factors does not necessarily mean you will get endometrial cancer. In fact, you can have all the risk factors and still not get it. Or you can have no known risk factors and still get it.

Most of the risks linked to endometrial cancer come from too much exposure to the hormone estrogen. Estrogen and progesterone are the two main types of female hormones. The balance between these two hormones in your uterus changes every month during your menstrual cycle. These two hormones need to be in the right balance for your uterus to be healthy.

If you agree with any of the following bolded statements, you may be at an increased risk for endometrial cancer. Many of these risk factors may be out of your control, such as your age or family history. Some risk factors, such as the types of food you eat, are factors you can control. Ask your health care team and your loved ones to help you think of ways that you can lower your risk for endometrial cancer.

I am obese

Obese women (BMI over 30) are more likely to develop endometrial cancer. Each increase in BMI further increases the risk. This may be related to having higher estrogen levels in fat tissue. 

Uterine cancer or colon cancer runs in my family 

If several of your family members have had uterine, endometrial, or colon cancer, you are at greater risk for getting endometrial cancer. You may have inherited a genetic problem called nonpolyposis colorectal cancer or Lynch syndrome. Endometrial carcinoma is the type of uterine cancer that is seen in Lynch syndrome. Other uterine cancers, such as sarcomas, are not related to Lynch syndrome. If you have a strong family history of these cancers, talk with your doctor about having genetic counseling and testing. This may help show you if you have a high risk for endometrial cancer.

I have had breast or ovarian cancer  

Many of the risks for these two types of cancer are the same as the risks for endometrial cancer. 

I have used tamoxifen

Tamoxifen is a drug that is used to treat women with breast cancer. Tamoxifen can affect the endometrium, and using it can increase the risk of endometrial cancer. If you have used tamoxifen for treating or preventing breast cancer, be sure to get your yearly pelvic exams and tell your doctor right away if you have any unusual vaginal bleeding or discharge. 

I use estrogen replacement therapy

If you take the hormone estrogen alone to help deal with the effects of menopause, your chance of getting endometrial cancer is increased. If you need estrogen replacement therapy, discuss using a combination of estrogen and progesterone with your doctor. This combination helps protect your uterus from developing cancer. So the risk of endometrial cancer is not increased when both hormones are used for hormone replacement therapy.  Keep in mind, though, that taking estrogen and progesterone together can increase your risk for breast cancer, heart attack, stroke, and blood clots. If you use hormone replacement therapy, see your doctor regularly for follow-up care. Also, use the lowest dose of hormones for the shortest time needed to control your symptoms.  

I have been exposed to a lot of estrogen over the years

Exposure to excess estrogen raises your risk for endometrial cancer. You could be exposed to too much estrogen for any of these reasons:

• I am very overweight. Fat cells change other hormones into estrogen. So having more fat can increase your estrogen level.

• My periods started before I was age 12. If you started menstruating at an early age, your uterus has been exposed to estrogen for longer than average. The total number of years you have menstruated matters, too. If your periods started early, but you went through menopause early as well, your risk of getting endometrial cancer is not increased.

• I went through menopause late. If you went through menopause late in life, your uterus has been exposed to estrogen for longer than average. The total number of years you menstruated matters, too. If you went through menopause late, but your periods started later in your teens as well, your risk of getting endometrial cancer is not increased.

• I have never been pregnant. During pregnancy, more progesterone is present. This helps protect the uterus from too much estrogen. If you’ve never been pregnant, your uterus may have been exposed to higher levels of estrogen.

I have polycystic ovarian syndrome (PCOS)

Women with PCOS have abnormal hormone levels. They may have higher androgen (male hormones) and estrogen levels, and lower levels of progesterone. These changes in hormone balance can increase the risk of endometrial cancer.  

I have diabetes

If you have diabetes, you have a greater risk of getting endometrial cancer. The reason for this is not totally known, but it's likely related to obesity. Obesity and one type of diabetes are linked. But even women with diabetes who are not overweight still have higher rates of endometrial cancer.

I eat a diet high in fat

A high-fat diet increases your risk for several cancers, including endometrial cancer. Eating fatty foods is also a quick route to obesity, which is known to increase your risk for endometrial cancer.

I am older than age 50

As you get older, your risk of getting endometrial cancer increases. Most cases of it occur after menopause.