Prevention

Recommendations for reducing the risk of developing endometrial cancer include:

• maintaining a healthy weight
• taking birth control pills (especially over an extended period)
• having progesterone therapy as part of hormone replacement therapy for women with an intact uterus.

Risk factors

• Age
• Obesity
• Diabetes
• Endometrial hyperplasia
• Lynch syndrome (40–60 per cent lifetime risk of endometrial cancer)
• Family history of endometrial cancer in a first-degree relative
• PTEN gene mutations
• Unopposed postmenopausal oestrogen therapy
• Endometrial hyperplasia
• Nulliparity
• Anovulation
• Early menarche and late menopause
• Tamoxifen use in postmenopausal women
• Hormone secreting tumour of the ovary (granulosa cell tumour)

Risk-reducing surgery

Risk-reducing surgery may be considered for women with:

• non-genetic conditions where there is an increased risk of endometrial cancer such as atypical hyperplasia
• genetic conditions (e.g. Lynch syndrome or PTEN mutation).

Women considering risk-reducing surgery should have a thorough family history taken, including male relatives, and consider referral to a familial cancer service to try to define the actual risk, not only for the individual but also for other family members.

Screening recommendations

Screening in asymptomatic women is not appropriate for the early detection of endometrial cancer.

Checklist