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Aetiology

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The exact cause of the disease is unknown but the following associations have been identified as risk factors:

  • endogenous risk factors
    • increasing age
    • obesity and physical inactivity
    • early menarche and late menopause
    • low parity or infertility
    • polycystic ovarian syndrome
    • family history
    • lynch syndrome (hereditary nonpolyposis colorectal cancer)
    • oestrogen secreting tumours (granulosa or thecal cell tumours of ovary)
    • diabetes mellitus
    • hypertension
    • history of breast cancer
    • immunodeficiency
  • exogenous risk factors
    • unopposed oestrogen only hormone replacement therapy
    • tamoxifen therapy
    • dietary factors
    • previous radiotherapy

An excess of oestrogen is common to all risk factors:

  • in obese patients, androstenedione is converted to oestrone in adipose tissue
  • a late menopause is preceded by many anovulatory cycles resulting in a lack of progesterone to counter the endometrial proliferation mediated by oestrogens
  • patients with polycystic ovary disease have anovulatory cycles
  • ovarian theca cell tumours produce oestrogens

The following are thought to have a protective effect against endometrial carcinoma:

  • cigarette smoking
  • combined oral contraception for at least one year - reduces the incidence in pre and peri menopausal women
  • grand multiparity

In endometrial hyperplasia (a premalignant condition of endometrial carcinoma), excess unopposed oestrogen acts as a recognized risk factor.

  • in 30-40% of patients with atypical hyperplasia will have a concurrent adenocarcinoma while the rest are at very high risk of developing the cancer.

Reference:


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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