Only a proportion of obese, diabetic and hypertensive women develop endometrial cancer and similarly only a proportion of women with endometrial cancer are obese diabetic or hypertensive. The question remains whether estrogen is a causal agent or is acting in its normal capacity as a growth factor and is really to be regarded as a co-carcinogen. 2003-10-27 Carcinoma of the endometrium
2003-10-27 Carcinoma of the Endometrium 6 Only a proportion of obese，diabetic and hypertensive women develop endometrial cancer and similarly only a proportion of women with endometrial cancer are obese， diabetic or hypertensive．The question remains whether estrogen is a causal agent， or is acting in its normal capacity as a growth factor and is really to be regarded as a co－carcinogen．
Risk Factors for Endometrial Hyperplasia and Carcinoma Factor Discussion Relative Risk Menopause 2. 4 times more likely for women undergoing menopause after age 52 than between 49 and 52 Unopposed Estrogen replacement without progestins; risk 4-8 estrogen increased with dosage and duration of use rapy Nulla Obesity 3 times more likely at 20-50 pounds overweight 3-10 10 times if more than 50 pound overweight; associated with aromatization of adrenally produced androstenedione estrone in fat cells Tamoxifen therapy 2-3 Diabetes mellitus 2003-10-27 Carcinoma of the endometrium
2003-10-27 Carcinoma of the Endometrium 7
Oral contraception, especially after long term use, reduces the incidence of both endometrial and ovarian carcinomas 2003-10-27 Carcinoma of the endometrium
2003-10-27 Carcinoma of the Endometrium 8 Oral contraception，especially after long term use，reduces the incidence of both endometrial and ovarian carcinomas．
The endometrial hyperplasia induced by tamoxifen produces endometrial polyps. A report in the Lancet in 1999 suggested a four-fold increase in endometrial carcinoma 2003-10-27 Carcinoma of the endometrium 9
2003-10-27 Carcinoma of the Endometrium 9 The endometrial hyperplasia induced by Tamoxifen produces endometrial polyps．A report in the Lancet in 1999 suggested a four-fold increase in endometrial carcinoma．．
Symptomatology The usual presenting symptom of endometrial carcinoma is postmenopausal bleeding which carries a 10% risk of associated malignancy in the absence of hormone replacement therapy. Curettage,or endometrial sampling is mandatory Postmenopausal discharge from pyometra carries a 50% risk of associated malignancy. Pain may occur with pyometra or metastatic spread 2003-10-27 Carcinoma of the endometrium
2003-10-27 Carcinoma of the Endometrium 10 Symptomatology The usual presenting symptom of endometrial carcinoma is postmenopausal bleeding which carries a 10％ risk of associated malignancy in the absence of hormone replacement therapy. Curettage，or endometrial sampling is mandatory. Postmenopausal discharge from pyometra carries a 50％ risk of associated malignancy. Pain may occur with pyometra or metastatic spread．