Epidemiology
Etiology
Type I endometrial cancer
- Directly related to long-term exposure to increased estrogen levels
- Some genetic mutations (e.g., in the PTEN gene or mismatch repair genes) are also associated with this type of cancer.
Type II endometrial cancer
- Mostly estrogen-independent
- Associated with endometrial atrophy (especially in postmenopausal women)
- Strongly associated with a genetic predisposition
Risk factors for estrogen-dependent tumors
- Nulliparity
- Early menarche and late menopause
- Polycystic ovary syndrome
- Metabolic syndrome (esp. obesity and diabetes mellitus type 2)
- Fat cells contain the enzyme aromatase and produce extra-ovarian estrogen, while anabolic insulin stimulates the production of extra-ovarian estrogen and also the proliferation of endometrial cells via IGF-1.
- Hypertension
- Unopposed estrogen replacement therapy (e.g., for menopausal symptoms)
- History of breast cancer and tamoxifen treatment
- Lynch syndrome (hereditary nonpolyposis colorectal cancer)
Pathophysiology
Clinical features
Diagnostics
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Treatment
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