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Understanding Endometrial Cancer -- the Basics

What Is Endometrial Cancer?

Various conditions both benign and cancerous (malignant) can affect the uterus, the hollow, pear-shaped organ where a baby grows. Fibroid tumors on the uterine wall are benign (not cancerous), and women who have them are not at increased risk for uterine cancer. Abnormal growth of cells in the uterus' lining -- called the endometrium -- is known as endometrial hyperplasia. It is the most serious benign uterine condition, and in some women it evolves into uterine cancer.

Female Reproductive System

Most uterine cancers arise in the endometrium and are called endometrial cancer. The more aggressive uterine sarcoma arises in the wall of the uterus and accounts for less than 5% of all cases.

If left untreated, endometrial cancer can penetrate the wall of the uterus and invade the bladder or rectum, or it can spread to the vagina, fallopian tubes, ovaries and more distant organs. Fortunately, endometrial cancer grows slowly and, with regular checkups, is usually detected before spreading very far.

What Causes Endometrial Cancer?

Endometrial cancer is a disease of older (usually post-menopausal) women. More than 95% of these cancers occur in those over the age of 40 with an average age of 63 at the time of diagnosis. Post-menopausal women are at high risk for endometrial cancer if they:

Began menstruating early
Went through menopause late
Are obese
Have diabetes or high blood pressure
Have a family history of colorectal cancer
Have few or no children
Have a history of infertility, irregular menstrual periods, or endometrial hyperplasia
Have a family history of endometrial, colon, or breast cancer

Women taking the drug tamoxifen to treat or prevent breast cancer are at a slightly increased risk. But women who have taken birth control pills are only half as likely to develop the disease after menopause as those who have not.

Risk for endometrial cancer is linked to the amount of the female hormone estrogen that the endometrium has been exposed to during the woman's lifetime, since estrogen stimulates cell formation. Women who have had a long span of menstruation have a higher risk of endometrial cancer.

Modern post-menopausal hormone therapy (HT or HRT) has very low doses of estrogen and progesterone, another female hormone that suppresses cell formation. The new HTs do not increase a women's risk of getting endometrial cancer. Nonetheless, women on HT should get regular exams. Women using estrogen only (without progesterone) have an increased risk of developing endometrial cancer.

Rare ovarian tumors can produce estrogen and increase a woman’s chance of developing cancer of the uterus.

Recent research has focused on the findings that high-fat diets, especially containing red meat, can increase the risk of developing cancers, including endometrial and colon cancer. It has been suggested that fatty foods with high fat and caloric content leads to obesity, which is well known to be linked to an increased risk of developing endometrial cancer. Obesity also has been linked to breast cancer; thus, women who have had breast cancer may have a higher risk for endometrial cancer.

Hormone replacement therapy can be given to women with treated endometrial cancer, as it is not associated with an increased risk of recurrence of endometrial cancer or death resulting from it. It is also not linked to the development of new cancers.

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