II. Prevention: Protective Factors
- High Parity
- Normal body weight (BMI 20-24)
-
Oral Contraceptive use for one or more years
- Avoid Unopposed Estrogen
- Estrogen Replacement Therapy should be accompanied by Progesterone
III. Risk Factors
- Menstrual History
- Early Menarche (under age 12): 1.5 to 2 fold Relative Risk
- Nulliparity: 2 to 3 fold Relative Risk
- Late Menopause (over age 52): 2.4 fold Relative Risk
- Bloody Menopause: 4 fold Relative Risk
-
Obesity
- Obese women account for 70% of early stage Endometrial Cancer
- Endometrial Cancer mortality increases with Body Mass Index
- Overweight 21-50 pounds: 3.0 fold Relative Risk
- Overweight more than 50 pounds: 10 fold Relative Risk
- Increased BMI compared to women with BMI 20 to 24
- BMI 30-34: 1.7 Relative Risk
- BMI 35-39: 4.3 Relative Risk
- BMI >40: 6.4 Relative Risk
-
Anovulation or PCOS and related conditions
- Polycystic Ovary Syndrome (Stein Leventhal Syndrome)
- Chronic Anovulation
- Hirsutism: 2 fold Relative Risk
- Exogenous Hormones
- Unopposed Estrogen: 9.5 fold Relative Risk
- Tamoxifen: 2.3 fold Relative Risk
- Familial history of cancer
- Hereditary Nonpolyposis Colorectal Cancer (HNPCC, Lynch Syndrome): High risk
- Family history Endometrial Cancer
- Age related risks
- Risk roughly doubles every 5 years after age 30
- Ages 15 to 18 years: rare
- Ages 30 to 34 years: 2.8 cases per 100,000
- Ages 35 to 39 years: 6.1 cases per 100,000
- Ages 40 to 44 years: 12.5 cases per 100,000
- Ages 45 to 49 years: 24.0 cases per 100,000
- Ages 50 to 54 years: 47.9 cases per 100,000
- Ages 55 to 59 years: 68.4 cases per 100,000
- Ages 60 to 64 years: 86.5 cases per 100,000
- Ages 65 to 69 years: 94.4 cases per 100,000
- Ages 70 to 74 years: 101.9 cases per 100,000
- SEER Cancer statistics
- Other risks
- Diabetes Mellitus: 2.8 fold Relative Risk
- Hypertension: 1.5 fold Relative Risk
- Liver disease
- Hypothyroidism
- Alcohol Abuse
- History of pelvic irradiation