Uterine cancer: What’s your risk?

Almost 62,000 women are diagnosed with uterine cancer each year in the United States. It is also known as endometrial cancer and it is the most common gynecologic cancer.

Uterine cancer is on the rise, particularly among women under 50. Experts believe this is because obesity is on the rise. Being overweight or obese sharply increases a woman's risk for the disease.

Uterine cancer happens when tumors grow in a woman’s uterus. The uterus is where a fetus grows when a woman is pregnant.

In most cases, the disease starts in the lining of the uterus, or endometrium. Uterine cancer may also begin in the wall of the uterus.

Weight and your risk for uterine cancer

Experts believe that six out of every 10 cases of uterine cancer are caused by being overweight or obese.

You can find out if you are overweight or obese by calculating your body mass index, or BMI. A BMI of 25 or more generally means you are overweight. A BMI of 30 or higher is considered obese.

Extra weight is a big problem for the uterus because fats cells create more estrogen.

The uterus is extremely sensitive to estrogen. It is one of the hormones that plays a big part in a woman’s menstrual cycle. It controls the growth and regrowth of the lining of the uterus.

Extra estrogen causes the lining of the uterus to grow too much. The extra growth increases the risk of tumors developing.

“The connection between weight and uterine cancer is very profound,” says Shannon Westin, M.D., associate professor Gynecologic Oncology and Reproductive Medicine.

Research shows that women who are overweight or obese are four times more likely to get uterine cancer. Women who are extremely obese are seven times more likely to get uterine cancer.

Other hormonal risk factors

Exposure to estrogen in any form is a key risk factor for uterine cancer. This means that some types of hormone replacement therapy can increase your risk.

Ovarian conditions like polycystic ovarian syndrome (PCOS) can also increase estrogen production and raise your risk of uterine cancer.

Some things that affect your estrogen exposure cannot be controlled. For example, the number of years you have a menstrual period. If you start your periods early, or if you start menopause later, your risk for uterine cancer is higher.

Your risk also is higher if you have never been pregnant.

Medical conditions

In general, women who have breast cancer or ovarian cancer are at higher risk of uterine cancer.  So are women who have had pelvic radiation. The breast cancer drug tamoxifen can make the uterus lining grow, raising your risk for uterine cancer.

Diabetes is also associated with increased risk of uterine cancer.

The precancerous condition endometrial hyperplasia can progress to uterine cancer if left untreated.

Family history and race

Your risk for uterine cancer is higher if other members of your family have been diagnosed with uterine or colorectal cancer.

Some people develop these cancers because of a hereditary genetic mutation known as Lynch syndrome. Lynch syndrome also puts you at higher risk for kidney, ovarian and brain cancer.

If you are concerned about your family history of cancer, talk to a genetic counselor.

Your race does not have an impact on your risk for uterine cancer, but it does affect survival rates for those who develop the disease.

African-American women who get uterine cancer are more likely to be diagnosed with more aggressive types of the disease, which are harder to treat.

How to reduce your risk

There are several ways to reduce your risk of uterine cancer.

Maintain a healthy weight. The best way to do this is by exercising and eating a plant-based diet. Fill two-thirds of your plate with vegetables, fruits and whole grains. Fill the final third or less with lean protein like chicken or fish. Plant proteins like tofu are even better.

Know your family history. Talk to family members about their history of breast, uterine, colorectal and other cancers.

Think twice about hormone replacement therapy. If your doctor recommends HRT, make sure you ask how it will affect your cancer risk. Consider alternative treatments for menopause symptoms.

Uterine cancer symptoms

There is no screening exam for uterine cancer.  It's important to be aware of changes in your body and look out for symptoms.

The most common symptoms of uterine cancer are:

• Unusual bleeding, such as between periods, heavier flow, or bleeding after menopause
• Abnormal vaginal discharge
• Pelvic pain or pressure
• Weight loss that cannot be explained

“The good news is the majority of patients present early because they have bleeding. Early stage uterine cancer can often be cured,” says Westin.