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Etiology of uterine cancer

Risk factors

  • Long-term separate estrogen stimulation increases the incidence of endometrial hyperplasia and cancer (1-2). This is observed with long-term unopposed estrogen replacement, estrogen-producing tumors, and obesity leading to increased peripheral production of estrogen from steroid hormones and disturbances of ovulation (3).
  • Tamoxifen treatment for breast cancer increases the risk for endometrial cancer due to its stimulating effect on the endometrium (4).
  • Women with the inherited mutation for DNA repair genes in families with HNPCC (Hereditary non-polyposis colorerectal cancer or Lynch syndrome) have an increased risk for developing endometrial cancer (5). 
  • Use of combination birth control pills reduces the risk significantly for development of endometrial cancer (6).
  • Carcinosarcomas have similar risk factors including obesity, nulliparity, and exogenous estrogen therapy (7).
  • Radiation treatment slightly increases the risk for later development of sarcoma in the treated area (8).

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