1.3 Risk reduction

1.3 Risk reduction

Everyone should be encouraged to reduce their modifiable risk factors, including taking the following steps.

Using oral contraceptives, which include both oestrogen and progesterone, for at least one year can reduce the risk of developing endometrial cancer. The reduction in risk is proportional to the time that the oral contraceptive was taken and can persist for up to 30 years after the last use of the pill (NCI 2019).

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 define the actual risk not only for the individual but also for other family members.

Family cancer history assessment is appropriate for women who have:

  • two or more first- or second-degree relatives diagnosed with endometrial or colorectal cancers, if one of the relatives received their diagnosis under the age of 50
  • three or more first- or second-degree relatives with Lynch syndrome–associated cancer, (e.g. adenocarcinoma of the colorectum, endometrium, small intestine, stomach, ovary or pancreas), urothelial carcinoma of the ureter or renal pelvis, cholangiocarcinoma, brain tumour or sebaceous gland tumour (eviQ 2019a).