How does endometrial cancer arise?

The main risk factors for endometrial cancer are:

Age.
Endometrial cancer is rare before menopause. Type II cancers occur in older women than type I cancers.

Hyperestrogenism.
This mainly concerns type I cancers

This excess estrogen can have several possible causes:
- Obesity*.
It is the most common cause of endogenous hyperestrogenism today. Androgens are converted to estrogen in adipose (fat) tissue. The amount of estrogen produced is proportional to the abundance of adipose tissue.

The geographic distribution of endometrial cancer overlaps with that of obesity.

- Diabetes *.
It is often associated with obesity, but is a risk factor in its own right.

- High blood pressure*.
It is also associated with obesity.

- Exogenous estrogen intakes*.
Hormone therapy for menopause that does not include progestins was an important cause in the 1960s. However, this type of regimen has not been used for more than 40 years.

Tamoxifen, prescribed in the treatment of breast cancer, has also been implicated. However, the risk is low in absolute terms. But any bleeding that occurs in a woman treated with tamoxifen or who has been treated should be investigated.
- Polycystic ovary syndrome
- Alcoholism is also a contributing factor, through induced hyper-estrogenism.

Heredity.
The main hereditary predisposition to endometrial cancer is Lynch syndrome (see specific tab).
Cowden syndrome, due to the mutation of the gene coding for the PTEN protein, is a rarer cause of hereditary endometrial cancer.

We also mention the history of pelvic radiotherapy.

The risk factors marked with an * are those on which it is possible to act to limit the individual or collective risk of developing endometrial cancer. We can also act on these factors after treatment to limit the risk of recurrence.