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Risk factors for endometrial cancer

Relative risk (RR)

Risk factor
(other statistics are noted when used)

Increasing age 1 to 2% cumulative incidence of endometrial cancer in

females age 50 to 70 years

Unopposed estrogen therapy 2 to 10

Tamoxifen therapy 2

Early menarche NA

Late menopause (after age 55) 2

Nulliparity 2

Polycystic ovary syndrome (chronic anovulation) 3

Obesity For type I endometrial cancer: OR 1.5 for overweight

(BMI 25.0 to <30 kg/m 2 ), 2.5 for class 1 obesity (30.0 to
<35 kg/m 2 ), 4.5 for class 2 obesity (35.0 to 39.9
kg/m 2 ), and 7.1 for class 3 obesity (≥40.0 kg/m 2 ).

For type II: OR 1.2 for overweight (BMI 25.0 to <30

kg/m 2 ), 1.7 for class 1 obesity (30.0 to <35 kg/m 2 ), 2.2
for class 2 obesity (35.0 to 39.9 kg/m 2 ), and 3.1 for
class 3 obesity (≥40.0 kg/m 2 ).

Diabetes mellitus 2

Estrogen-secreting tumor NA

Lynch syndrome (hereditary nonpolyposis colorectal 13 to 71% lifetime risk

cancer)

Cowden syndrome 13 to 28% lifetime risk

Family history of endometrial, ovarian, breast, or colon NA

cancer

NA: RR not available; OR: odds ratio; BMI: body mass index.

Data from:
1. Heald B, Mester J, Rybicki L, et al. Frequent gastrointestinal polyps and colorectal adenocarcinomas in a prospective series of PTEN
mutation carriers. Gastroenterology 2010; 139:1927.
 2. Pilarski R, Stephens JA, Noss R, et al. Predicting PTEN mutations: an evaluation of Cowden syndrome and Bannayan-Riley-Ruvalcaba
syndrome clinical features. J Med Genet 2011; 48:505.
3. Ramsoekh D, Wagner A, van Leerdam ME, et al. Cancer risk in MLH1, MSH2 and MSH6 mutation carriers; different risk profiles may
influence clinical management. Hered Cancer Clin Pract 2009; 7:17.
4. Riegert-Johnson DL, Gleeson FC, Roberts M, et al. Cancer and Lhermitte-Duclos disease are common in Cowden syndrome patients.
Hered Cancer Clin Pract 2010; 8:6.
5. Setiawan VW, Yang HP, Pike MC, et al. Type I and II endometrial cancers: have they different risk factors? J Clin Oncol 2013; 31:2607.
6. Smith RA, von Eschenbach AC, Wender R, et al. American Cancer Society guidelines for the early detection of cancer: Update of early
detection guidelines for prostate, colorectal, and endometrial cancers. CA Cancer J Clin 2001; 51:38.
7. Tan MH, Mester JL, Ngeow J, et al. Lifetime cancer risks in individuals with germline PTEN mutations. Clin Cancer Res 2012; 18:400.
8. Ten Broeke SW, van der Klift HM, Tops CMJ, et al. Cancer risks for PMS2-associated Lynch syndrome. J Clin Oncol 2018; 36:2961.

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