Question

Which are risk factors for endometrial cancer? (Select all that apply.) a. Anovulation b. Abnormal uterine bleeding c. History of atypical endometrial hyperplasia d. Multiparity e. Polycystic ovarian syndrome f. Obesity g. Diabetes

Short answer

a, c, e, f, g

Step-by-step solution

Identifying the risk factors for endometrial cancer

Endometrial cancer risk factors are medical or lifestyle conditions that increase the likelihood of developing the disease. The correct options must be considered with known medical research and biological reasoning.

Evaluating anovulation

Anovulation is a condition where ovulation does not occur. This can affect hormone levels, leading to increased estrogen exposure without progesterone balance, raising the risk of endometrial cancer. Therefore, (a) Anovulation is a risk factor.

Assessing abnormal uterine bleeding

While abnormal uterine bleeding can be a symptom of endometrial cancer, it is not a direct risk factor. Therefore, (b) Abnormal uterine bleeding is not a risk factor.

Considering history of atypical endometrial hyperplasia

Atypical endometrial hyperplasia is a precancerous condition, significantly increasing the risk of developing endometrial cancer. Thus, (c) History of atypical endometrial hyperplasia is a risk factor.

Evaluating multiparity

Multiparity (having multiple pregnancies) generally lowers the risk of endometrial cancer due to the protective effects of progesterone during pregnancy. So, (d) Multiparity is not a risk factor.

Assessing polycystic ovarian syndrome (PCOS)

PCOS often leads to anovulation and increases estrogen exposure, which is associated with a higher risk of endometrial cancer. Therefore, (e) Polycystic ovarian syndrome is a risk factor.

Considering obesity

Obesity results in higher levels of estrogen, which increases the risk of endometrial cancer. Hence, (f) Obesity is a risk factor.

Assessing diabetes

Diabetes, particularly Type 2, is associated with increased risk due to associated factors such as obesity and altered insulin levels. Therefore, (g) Diabetes is a risk factor.

Key concepts

Anovulation

Anovulation is a medical condition in which a woman does not ovulate, meaning her ovaries do not release an egg during her menstrual cycle. This disruption can lead to hormone imbalances, particularly an increase in estrogen without the balancing effect of progesterone.

Anovulation can result from conditions like polycystic ovarian syndrome (PCOS) and can lead to prolonged estrogen exposure, increasing the risk of endometrial cancer.

This is because the endometrium (lining of the uterus) can grow excessively without the regulatory effect of progesterone.

Atypical Endometrial Hyperplasia

Atypical endometrial hyperplasia refers to the abnormal thickening of the endometrial lining, coupled with cellular changes that can be precancerous. This condition is considered a significant risk factor for developing endometrial cancer.

Women with atypical endometrial hyperplasia have a higher chance of progressing to malignancy if left untreated.

Detecting and managing this early can be crucial. Regular monitoring and, in some cases, surgical intervention, like a hysterectomy, may be recommended to prevent cancer development.

Polycystic Ovarian Syndrome (PCOS)

PCOS is a hormonal disorder common among women of reproductive age. It is characterized by irregular menstrual periods, excess androgen levels, and polycystic ovaries.

Women with PCOS often experience anovulation, leading to prolonged estrogen exposure.

This hormonal imbalance can increase the risk of developing endometrial cancer. Managing PCOS often involves regulating menstrual cycles through medication and lifestyle changes.

Obesity

Obesity is a significant risk factor for endometrial cancer due to the higher levels of estrogen produced in body fat.

Excess weight leads to increased estrogen levels, which can stimulate the growth of the endometrial lining.

Additionally, obesity is often associated with other risk factors such as diabetes and hypertension. Weight management through diet, exercise, and medical intervention can help reduce the risk.

Diabetes

Diabetes, particularly Type 2, is linked with an increased risk of endometrial cancer.

Patients with diabetes often have obesity and insulin resistance, both of which contribute to higher estrogen levels in the body.

Maintaining good glycemic control and addressing associated risk factors through lifestyle and medical management can help mitigate the increased risk.