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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