There is no way to predict whether an individual woman will get endometrial cancer, and there is no way to screen for this disease. It is possible to develop endometrial cancer without being at high risk, and it is possible to be at high risk and not develop it. However, women who fall into the following groups may be more likely to develop endometrial cancer:
- Women between the ages of 50 and 70 are at increased risk. The chance of being diagnosed with endometrial cancer increases with age. More than half of women with endometrial cancer are diagnosed after age 55.
- Women who are overweight or obese. Women who are obese are two to four times more likely to develop endometrial cancer than women of normal weight. This is because fat in the body can change other hormones into estrogen. The higher a woman’s estrogen levels, the greater her risk is of developing endometrial cancer, especially if she is more than 50 pounds overweight.
- Women who use “unopposed estrogen” hormone therapy. Using unopposed estrogen means taking an estrogen-containing pill or supplement that does not contain the estrogen-balancing hormone, progesterone. Additionally, non-hormonal medications, such as tamoxifen, used for breast cancer patients, can increase the risk of endometrial cancer.
- Women who have complex atypical hyperplasia. This is an abnormal tissue in the uterus that is likely to turn into cancer if not treated.
- Women who began menstruating early, before age 12. Estrogen is a key component in menstrual cycles, so early menstruation means that a woman’s lifetime exposure to levels of estrogen are higher.
- Women who undergo menopause after the age of 50. Menopause leads to loss of estrogen when the ovaries stop working, resulting in symptoms such as hot flashes. If menstrual cycles continue after the age of 50, there is continued estrogen production by the ovaries and elevated lifetime levels of estrogen.
- Women with a history of infertility
- Women who have infrequent periods or a history of polycystic ovarian syndrome (PCOS), a metabolism disorder that causes ovulation irregularities
- Women who have never been pregnant
- Women with diabetes
- Women with hypertension
- Women who have had colon cancer before the age of 50
- Women with a gene inherited at birth that increases their risk. This can include women who have three or more family members, of whom at least one is a parent, sibling (brother or sister) or child, with one of the following diagnoses:
- colon cancer
- hepatobiliary cancer (cancer in the liver or gallbladder)
- ovarian cancer
- stomach cancer
- small intestine cancer
- brain cancer
- some forms of skin cancer
Family history does not necessarily increase a woman’s risk of endometrial cancer unless an abnormal gene is present. Women who have an abnormality in any one of several genes that protect against colon and uterine cancer are at risk. This disorder is commonly known as hereditary non-polyposis colorectal cancer (HNPCC) or Lynch II syndrome. If your family history is worrisome for this condition, screening for these genetic mutations is recommended. Screening involves a blood test. The best person to test is the family member with the cancer diagnosis. Your doctor will discuss with you if they think testing for an inherited gene is right for you. Sometimes a genetic counselor will work with your doctor to decide if testing is recommended.