Materiały źródłowe

• #1 Recent Advances in Endometrial Cancer Prevention, Early Diagnosis and Treatment

  https://www.mdpi.com/2072-6694/16/5/1028

  Recent Advances in Endometrial Cancer Prevention, Early Diagnosis and Treatment […] Endometrial cancer is the fourth most common female malignancy in high socioeconomic index nations and the sixth most common cancer in women worldwide. […] The disease incidence has increased by 132% over the last 30 years and is set to continue to rise in response to an ageing population and increasing global rates of obesity and diabetes. […] A greater understanding of the mechanisms driving endometrial carcinogenesis has led to the identification of potential strategies for primary disease prevention, although prospective evaluation of their efficacy within clinical trials is still awaited. […] Given the strong association with modifiable risk factors, endometrial cancer appears eminently suited to primary disease prevention, with modelling suggesting that up to 60% of endometrial cancer cases could be potentially prevented. […] An increased understanding of the mechanisms driving endometrial carcinogenesis, namely unopposed oestrogen, insulin resistance and chronic inflammation, has led to the proposal of a number of interventions designed to reduce endometrial cancer incidence, albeit with data on their efficacy largely limited to retrospective observational studies.

• #1 Endometrial Cancer Prevention (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65758/

  Endometrial Cancer Prevention (PDQ) Patient Version […] This PDQ cancer information summary has current information about endometrial cancer prevention. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care. […] Cancer prevention is action taken to lower the chance of getting cancer. By preventing cancer, the number of new cases of cancer in a group or population is lowered. Hopefully, this will lower the number of deaths caused by cancer. […] Avoiding risk factors and increasing protective factors may help prevent cancer. The following risk factors increase the risk of endometrial cancer: Endometrial hyperplasia, Estrogen, Tamoxifen, Obesity, weight gain, metabolic syndrome, and diabetes, Genetic factors. The following protective factors decrease the risk of endometrial cancer: Pregnancy and breast-feeding, Hormonal contraceptives, Weight loss, Physical activity.

• #1 Endometrial Cancer Prevention (PDQ®) – NCI

  https://www.cancer.gov/types/uterine/hp/endometrial-prevention-pdq

  Endometrial cancer occurs in postmenopausal women, with an average age at diagnosis of 60 years. Estrogen, both endogenous and exogenous, is associated with endometrial proliferation, hyperplasia, and cancer. Thus, risk factors include endometrial hyperplasia, reproductive factors (nulliparity, early menarche and late menopause), polycystic ovary syndrome, postmenopausal estrogen therapy, obesity with adult weight gain, and tamoxifen use. Women with Lynch syndrome have an increased risk of endometrial cancer, as do women who have a first-degree relative with endometrial cancer. […] Based on solid evidence, increased parity and duration of lactation are associated with a decreased risk of endometrial cancer. Parous women have a 35% decreased risk of endometrial cancer (hazard ratio [HR], 0.65; 95% CI, 0.540.77) compared with nulliparous women.

• #1 Endometrial Cancer Prevention (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65758/

  Tamoxifen is one of a group of drugs called selective estrogen receptor modulators, or SERMs. Tamoxifen acts like estrogen on some tissues in the body, such as the uterus, but blocks the effects of estrogen on other tissues, such as the breast. Tamoxifen is used to prevent breast cancer in women who are at high risk for the disease. However, using tamoxifen for more than 2 years increases the risk of endometrial cancer. This risk is greater in postmenopausal women. […] Obesity, gaining weight as an adult, or having metabolic syndrome increases the risk of endometrial cancer. Having type 2 diabetes may increase the risk of endometrial cancer. […] Based on solid evidence, women with certain genetic conditions have an increased risk of developing endometrial cancer. Women who have Lynch syndrome have a much higher risk of developing endometrial cancer than women who do not have Lynch syndrome.

• #1 Recent Advances in Endometrial Cancer Prevention, Early Diagnosis and Treatment

  https://www.mdpi.com/2072-6694/16/5/1028

  Obesity has the strongest link with endometrial cancer of the twenty most common tumour types and is plausibly implicated in 34% of diagnoses. […] Conversely, weight loss, by reducing adiposity and the aromatase-induced conversion of androgens into oestrogen, improving insulin sensitivity and lowering the levels of inflammation, is associated with a reduction in the endometrial cancer risk. […] The focus has, therefore, shifted to the new anti-obesity medications (AOMs) that have been developed in recent years and which appear to lead to more significant and sustained weight loss in comparison with lifestyle interventions and older AOMs such as orlistat. […] Bariatric surgery alters the anatomy of the digestive system to restrict the capacity of the stomach, reduce nutrient absorption and induce early satiety. […] It is the most effective intervention for obesity identified to date, leading to the long-term weight loss of up to 29 kg depending upon the exact procedure performed. […] Wilson et al. demonstrated in their meta-analysis that bariatric surgery is effective in reducing the risk of subsequent endometrial cancer by 62%.

• #1 Recent Advances in Endometrial Cancer Prevention, Early Diagnosis and Treatment

  https://www.mdpi.com/2072-6694/16/5/1028

  Identifying high-risk individuals for targeted endometrial cancer prevention is imperative in order to maximise the benefits and minimise the risk of harm from long-term intervention. […] Women with Lynch syndrome represent the highest-risk group, with a 40–60% lifetime risk of endometrial cancer depending upon the underlying genetic variant. […] The widespread adoption of reflex immunohistochemistry for mismatch repair genes (MLH1, MSH2, MSH6 and PMS2) on endometrial cancers prompts the identification of affected individuals, who will, themselves, benefit from surveillance for colorectal malignancies and whose affected female relatives should be offered a risk-reducing hysterectomy from the age of 40 years. […] To date, four risk prediction models have been developed with the aim of stratifying the endometrial cancer risk within the general population, of which three models have been externally validated.

• #1 Endometrial Cancer Prevention (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65758/

  Estrogen levels are lower during pregnancy and when breast-feeding. The risk of endometrial cancer is lower in women who have had children. Breastfeeding also decreases the risk of endometrial cancer. […] Taking hormonal contraceptives (birth control pills) that combine estrogen and progestin (combined oral contraceptives) decreases the risk of endometrial cancer. The protective effect of this type of birth control increases with the length of time they are used, and can last for many years after oral contraceptive use has been stopped. […] It is not known if losing weight decreases the risk of endometrial cancer. However, having bariatric surgery (a surgery that changes how your digestive system works so you will lose weight) decreases the risk of endometrial cancer. […] Physical activity (exercise) may lower the risk of endometrial cancer. This includes any physical activity you do at your job or at home.

• #1 Endometrial Cancer | Nutrition Guide for Clinicians

  https://nutritionguide.pcrm.org/nutritionguide/view/Nutrition_Guide_for_Clinicians/1342025/all/Endometrial_Cancer

  Oral contraceptive use. Contraceptive pills containing progestin reduce the risk of endometrial cancer by about 50%. […] Exercise. Regular physical activity is associated with a 20-30% reduction in risk. […] Limiting high-energy-dense foods and high salt (or foods high in sodium), exercising regularly, and maintaining a healthy weight may reduce cancer risk. Following a plant-based diet helps achieve a healthy weight and provides a higher diet quality compared with other eating patterns. […] Some evidence suggests that following a low-fat, plant-based diet, maintaining a healthy weight, and getting regular exercise may reduce the risk of this disease.

• #1 Uterine (Endometrial) Cancer – UChicago Medicine

  https://www.uchicagomedicine.org/cancer/types-treatments/uterine-cancer

  Obesity is an important risk factor for uterine cancer that can be modified. Extra stored fat in a body increases estrogen levels, causes inflammation and can promote cancer development. Most common endometrial endometrioid cancers are estrogen dependent. Women who are 50 pounds overweight are 10 times more likely to develop endometrial cancer. Managing weight through appropriate diet and increasing physical activity can potentially decrease risk for this cancer. […] Our cancer prevention experts provide comprehensive and personalized care for women at elevated risk for endometrial (uterine) cancer and ovarian cancer.

• #1 Reducing Risk for Uterine Cancer | Uterine Cancer | CDC

  https://www.cdc.gov/uterine-cancer/prevention/index.html

  There is no known way to prevent uterine cancer. […] But some things may lower your chance of getting uterine cancer. […] Keeping a healthy weight and being physically active may lower your chance of getting uterine cancer. […] Using birth control pills that contain estrogen and progesterone. […] Maintaining a healthy weight and being physically active. […] Taking progesterone, if you are taking estrogen. […] While these things may help reduce the chance of getting uterine cancer, they are not recommended for everybody, and risks and benefits are associated with each.

• #1

  https://link.springer.com/article/10.1007/s11912-018-0747-1

  There is now convincing evidence that women with higher physical activity levels have a lower risk of endometrial cancer than women with the lowest activity levels. […] Long-term follow-up data provides convincing evidence that use of combined oral contraceptives (COC) is associated with a significant and enduring reduction in the lifetime risk of endometrial cancer. […] Oral, injectable and intrauterine progestin use has been shown to reduce the risk of endometrial cancer. […] Recent years have seen the emergence of the first oestrogen-based, progestin-free oral menopausal HRT for non-hysterectomised women. […] A meta-analysis of cohort and case control studies demonstrated a statistically significant endometrial cancer risk reduction with 13 years of bisphosphonate use. […] Continued efforts to promote breastfeeding may help to reduce endometrial cancer risk in the general population.

• #1 Endometrial Cancer Prevention (PDQ®) – NCI

  https://www.cancer.gov/types/uterine/hp/endometrial-prevention-pdq

  Based on solid evidence, at least 1-year use of oral contraceptives containing estrogen and progesterone decreases endometrial cancer risk, proportionate to duration of use. The lower risk may persist for more than 30 years after the last use of oral contraceptives. […] The evidence is insufficient to conclude whether weight loss is associated with a decreased incidence of endometrial cancer. Bariatric surgery is associated with a decreased risk of developing endometrial cancer. […] Based on solid evidence, increased physical exercise is associated with a decreased risk of endometrial cancer. Regular exercise may be associated with a 38% to 46% relative decrease in risk. […] Based on solid evidence, cigarette smoking is associated with a decreased risk of endometrial cancer. Smokers have a reduced risk of endometrial cancer of approximately 20% among prospective studies.

• #1

  https://link.springer.com/article/10.1007/s11912-018-0747-1

  Biomarker studies have shown that combined oral contraceptives and synthetic progestin reduce endometrial proliferation, in women with Lynch syndrome. […] The World Cancer Research Fund has concluded that the risk of endometrial cancer is reduced by moderate physical activity and maintaining a healthy weight. […] Lifestyle modification can result in 46% weight reduction over 2 to 4 years, and anti-obesity drugs can lead to 7-10% weight reduction; however, only bariatric surgery produces significant and, crucially, durable results. […] Bariatric surgery has been shown to reduce cancer risk in women, particularly postmenopausal breast and endometrial cancers. […] Studies continue to show that as well as excess body weight being a risk factor for endometrial cancer, so too is adult weight gain, weight cycling, the duration of overweight/obesity and possibly being overweight in childhood/at age 18.

• #1 Prevention Strategies in Endometrial Carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6244901/

  To assess the most recent high-quality evidence for endometrial cancer prevention strategies. […] Obesity is an established risk factor for endometrial cancer. […] Weight cycling and weight gain in middle age are risk factors for endometrial cancer. […] Bariatric surgery reduces the risk of endometrial cancer by up to 81% in obese women who attain and maintain a normal weight. […] Combined oral contraceptives provide durable protection against endometrial cancer for 30 years or more. […] Ever use of the levonorgestrel intrauterine system (LNG-IUS) and inert intrauterine devices reduce endometrial cancer risk. […] The first oestrogen-based non-progestin HRT for non-hysterectomised women that contains estradiol and bazedoxifene has an effective protective effect on endometrium. […] Bisphosphonates reduce endometrial cancer risk.

• #1 Recent Advances in Endometrial Cancer Prevention, Early Diagnosis and Treatment

  https://www.mdpi.com/2072-6694/16/5/1028

  The beneficial effects of oral contraceptives on endometrial cancer risk have been known for the last 20 years, with every five years of use associated with a 24% reduction in the disease risk. […] Importantly, this effect appears to persist for up to 30 years after the discontinuation of use. […] The levonorgestrel-releasing intra-uterine system (LNG-IUS) may well be the most effective endometrial cancer prevention measure, with large-scale observational studies describing up to a 78% reduction in endometrial cancer risk among the users, particularly if used long-term. […] Aspirin, a cyclooxygenase-2 inhibitor, has anti-inflammatory effects and acts to reduce the aromatase and oestrogen levels and increase apoptosis. […] While women within the general population may benefit from only a small reduction in endometrial cancer risk from long-term aspirin use (8–11%), this may prove to be a more effective strategy in women with obesity (relative risk reduction 20–44%).

• #1 Endometrial Cancer Prevention (PDQ®): Prevention – Health Professional Information [NCI] – Skin Center

  https://www.skincenter.com/patient-education/healthwise?DOCHWID=ncicdr0000062823

  Data suggest that use of levonorgestrel-releasing intrauterine systems (LNG-IUS) is associated with a statistically significant reduction in the risk of developing endometrial cancer. […] Bariatric surgery is associated with more sustained weight loss compared with nonsurgical intentional weight loss. Evidence suggests an association between bariatric surgery and a decreased risk of endometrial cancer. […] Based on solid evidence, increased physical exercise is associated with a decreased risk of endometrial cancer. […] Based on solid evidence, cigarette smoking is associated with a decreased risk of endometrial cancer.

• #1 Endometrial Cancer Risk Factors | American Cancer Society

  https://www.cancer.org/cancer/types/endometrial-cancer/causes-risks-prevention/risk-factors.html

  Oral contraceptives pills (OCP) including both estrogen-progestin contraceptives as well as progestin-only contraceptives. The risk is lowest when they are taken long-term, and this protection lasts for at least 10 years after the pills are stopped. […] Both progesterone-containing IUDs and copper IUDs decrease the risk of endometrial cancer. […] If you use hormone therapy after menopause, use of a medication that contains both estrogen and progesterone will help reduce risk. […] During pregnancy, the level of progesterone is high, which protects against endometrial cancer. Multiple pregnancies decrease the risk even more. Breastfeeding also is associated with a decrease in a mother’s uterine cancer risk. […] An increase in physical activity can help maintain a healthy weight and lower your risk of endometrial cancer.

• #1 Endometrial Cancer Prevention with Levonorgestrel-Releasing Intrauterine System | IntechOpen

  https://www.intechopen.com/chapters/47603

  Endometrial cancer is a potentially preventable disease but still many new cases occur each year. […] Understanding the causative role of these conditions constitutes the basis for prevention strategies. […] The primary role of progestin in postmenopausal estrogen therapy is endometrial protection to prevent hyperplasia. […] Progestins should, therefore, be added to ET in all postmenopausal women with an intact uterus. […] Intrauterine-administered progestin, such as levonorgestrel (LNG), delivered directly to the target cells of the endometrium, has a profound suppressive effect on endometrial growth rendering the endometrium inactive and simultaneously eliminating uterine bleeding. […] The rationale of the development of LNG-IUSs specifically for postmenopausal women is to minimize the potential adverse systemic effects.

• #1 Endometrial Cancer Prevention (PDQ®): Prevention – Patient Information [NCI] | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/endometrial-cancer-prevention-ncicdr0000258009

  The use of HT that contains only estrogen increases the risk of endometrial cancer, and the risk grows higher the longer the estrogen is used. […] Women who reach menopause at an older age are exposed to estrogen for a longer time and have an increased risk of endometrial cancer. […] This increases the risk of endometrial cancer. […] Tamoxifen is used to prevent breast cancer in women who are at high risk for the disease. However, using tamoxifen for more than 2 years increases the risk of endometrial cancer. […] Obesity, gaining weight as an adult, or having metabolic syndrome increases the risk of endometrial cancer. […] Having metabolic syndrome increases the risk of endometrial cancer. […] Based on solid evidence, women with certain genetic conditions have an increased risk of developing endometrial cancer.

• #1 Diagnosis and Management of Endometrial Cancer | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0315/p468.html

  Endometrial cancer is the most common gynecologic malignancy. […] Controlling risk factors such as obesity, diabetes, and hypertension could play a role in the prevention of endometrial cancer. […] The ACS recommends that all women older than 65 years be informed of the risks and symptoms of endometrial cancer and advised to seek evaluation if symptoms occur. […] There is no evidence to support the screening of asymptomatic women, with the exception of those who have or are at increased risk of Lynch syndrome. […] Management of risk factors such as obesity, diabetes, and hypertension could play a role in the prevention of endometrial cancer. […] For women on hormone therapy, the addition of progesterone has been shown to decrease the risk of endometrial cancer. […] Patients with Lynch syndrome should be advised to keep a menstrual calendar and report abnormal bleeding. […] Women older than 40 years who have the mutation and do not wish to become pregnant in the future can consider a prophylactic hysterectomy.

• #1 Prevention Strategies in Endometrial Carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6244901/

  Recent years have seen the emergence of the first oestrogen-based, progestin-free oral menopausal HRT for non-hysterectomised women. […] A meta-analysis of cohort and case control studies demonstrated a statistically significant endometrial cancer risk reduction with 13 years of bisphosphonate use. […] A 2016 meta-analysis of cohort and case control studies did suggest a small-to-modest protective effect with aspirin use. […] Continued efforts to promote breastfeeding may help to reduce endometrial cancer risk in the general population. […] A meta-analysis of 13 studies demonstrated a weak inverse relationship between high isoflavone (soy) consumption and endometrial cancer risk. […] The largest meta-analysis in the literature concluded there was a dose-dependent reduction in endometrial cancer risk with coffee intake.

• #1 Prevention Strategies in Endometrial Carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6244901/

  A meta-analysis by Zhou et al. found a reduced risk of endometrial cancer with higher intake of green tea. […] For now, it would seem that prevention strategies should focus on minimising risk through weight reduction and/or stability, improving access to bariatric surgery, and by educating women and healthcare professionals about the importance of weight and activity levels on their risk of type 1 endometrial cancer. […] Future research may provide us with the justification to use aspirin, metformin or bisphosphonates for chemoprevention but at present the evidence for either their efficacy or their long-term safety in high-risk women is lacking.

• #1 Can Endometrial Cancer Be Prevented? | American Cancer Society

  https://www.cancer.org/cancer/types/endometrial-cancer/causes-risks-prevention/prevention.html

  There’s no sure way to prevent endometrial cancer. But there are things you can do that may help lower your risk of developing this disease. They’re based on changing your risk factors whenever possible. […] Having excess weight makes a person up to 3 times more likely to get endometrial cancer compared with someone at a healthy weight. Getting to and staying at a healthy weight is one way to lower the risk of this cancer. […] Studies have linked higher levels of physical activity to lower risks of endometrial cancer, so getting regular physical activity (exercise) may also be a way to help lower endometrial cancer risk. […] Getting proper treatment of pre-cancer disorders of the endometrium is another way to lower the risk of endometrial cancer. […] Someone with hereditary nonpolyposis colon cancer (HNPCC or Lynch syndrome) has a very high risk of endometrial cancer. Most experts recommend that those with HNPCC have their uterus, ovaries, and fallopian tubes removed (a hysterectomy and bilateral salpingo-oophorectomy) after they are finished having children to prevent endometrial cancer.

• #1 Prevention Strategies in Endometrial Carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6244901/

  Weight loss and LNG-IUS would seem to be an effective strategy for preventing the development of obesity-driven endometrial cancer in the highest risk women. […] Risk-reducing surgery, in the form of hysterectomy and bilateral salpingo-oophorectomy when family complete, is well established in the primary prevention of Lynch syndrome-associated endometrial and ovarian cancers. […] The levonorgestrel intrauterine system (LNG-IUS) has been shown to reduce the development of endometrial polyps in tamoxifen users but no convincing effect on endometrial cancer risk has yet been demonstrated. […] A crucial aspect of PCOS management is induction of regular withdrawal bleeds, in an attempt to reduce the risk of developing endometrial hyperplasia and cancer. […] The World Cancer Research Fund has concluded that the risk of endometrial cancer is reduced by moderate physical activity and maintaining a healthy weight.

• #1

  https://link.springer.com/article/10.1007/s11912-018-0747-1

  To assess the most recent high-quality evidence for endometrial cancer prevention strategies. […] Obesity is an established risk factor for endometrial cancer. […] Bariatric surgery reduces the risk of endometrial cancer by up to 81% in obese women who attain and maintain a normal weight. […] Combined oral contraceptives provide durable protection against endometrial cancer for 30 years or more. […] Ever use of the levonorgestrel intrauterine system (LNG-IUS) and inert intrauterine devices reduce endometrial cancer risk. […] Weight loss and LNG-IUS would seem to be an effective strategy for preventing the development of obesity-driven endometrial cancer in the highest risk women. […] Risk-reducing surgery, in the form of hysterectomy and bilateral salpingo-oophorectomy when family complete, is well established in the primary prevention of Lynch syndrome-associated endometrial and ovarian cancers.

• #1 Endometrial Carcinoma Guidelines: Guidelines Summary, Prevention, Diagnosis

  https://emedicine.medscape.com/article/254083-guidelines

  Women who are undergoing surgery for colorectal cancer and who do not wish to preserve fertility should be offered prophylactic hysterectomy and/or oophorectomy. […] The NCCN guidelines include the following recommendations for surveillance and risk reduction in women with Lynch syndrome: Hysterectomy and bilateral salpingo-oophorectomy should be offered to women who have completed child bearing and carry MLH1, MSH2, or MSH6 mutations; Annual endometrial sampling for carriers of MLH1 or MSH2; Annual colonoscopy (to decrease risk of colorectal cancer); Routine transvaginal ultrasound and serum CA-125 testing are not recommended. […] In women with Lynch syndrome, the SEOM and the GEICO recommend screening for endometrial cancer with annual endometrial sampling, transvaginal ultrasound (TVUS), and CA125 measurement, beginning at age 30-35, or 5-10 years prior to the earliest age of first diagnosis of Lynch-associated cancer of any kind.

• #1 Tamoxifen and Uterine Cancer | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2014/06/tamoxifen-and-uterine-cancer

  Tamoxifen use may be extended to 10 years based on new data demonstrating additional benefit. […] Women taking tamoxifen should be informed about the risks of endometrial proliferation, endometrial hyperplasia, endometrial cancer, and uterine sarcomas. They should be encouraged to promptly report any abnormal vaginal symptoms, including bloody discharge, spotting, staining, or leukorrhea. […] Any abnormal vaginal bleeding, bloody vaginal discharge, staining, or spotting should be investigated. […] Postmenopausal women taking tamoxifen should be closely monitored for symptoms of endometrial hyperplasia or cancer. […] Premenopausal women treated with tamoxifen have no known increased risk of uterine cancer and as such require no additional monitoring beyond routine gynecologic care. […] Unless the patient has been identified to be at high risk of endometrial cancer, routine endometrial surveillance has not proved to be effective in increasing the early detection of endometrial cancer in women using tamoxifen. Such surveillance may lead to more invasive and costly diagnostic procedures and, therefore, is not recommended.

• #1 Tamoxifen and Uterine Cancer | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2014/06/tamoxifen-and-uterine-cancer

  Emerging evidence suggests the presence of high-risk and low-risk groups for development of atypical hyperplasias with tamoxifen treatment in postmenopausal women based on the presence or absence of benign endometrial polyps before therapy. Thus, there may be a role for pretreatment screening of postmenopausal women with transvaginal ultrasonography, and sonohysterography when needed, or office hysteroscopy before initiation of tamoxifen therapy. […] If atypical endometrial hyperplasia develops, appropriate gynecologic management should be instituted, and the use of tamoxifen should be reassessed. If continued use of tamoxifen therapy is advised and the risks are accepted by the patient, hysterectomy should be considered in women with atypical endometrial hyperplasia. Tamoxifen use may be reinstituted following hysterectomy for endometrial carcinoma in consultation with the physician responsible for the woman’s breast care.

• #1 Reducing your risk for uterine cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/uterine/risks/reducing-your-risk

  You may lower your risk of developing uterine cancer by doing the following. […] Research shows that you can lower your risk for uterine cancer by having a healthy body weight. Eating well and being physically active can help you have a healthy body weight. […] Studies show that physical activity may help protect against uterine cancer. […] Some drugs and lifestyle choices may help to protect you from developing uterine cancer. […] Taking birth control pills (oral contraceptives) that have both estrogen and progesterone may help protect women from developing uterine cancer. […] Women who have atypical endometrial hyperplasia usually receive treatment to help prevent the abnormal cells from becoming uterine cancer. […] Women with polycystic ovarian syndrome should take progesterone therapy to control hormone levels and reduce the risk for uterine cancer.

• #1 Uterine/Endometrial Cancer | Condition | UAMS Health

  https://uamshealth.com/condition/uterus-cancer/

  Endometrial cancer prevention strategies include avoiding risk factors when possible and increasing protective factors that may help prevent cancer. […] Obesity, certain inherited conditions, and taking estrogen alone (without progesterone) can increase the risk of endometrial cancer. […] Endometrial cancer screening is currently not recommended because no standard or routine screening test has been shown to be effective.

• #1 Endometrial Carcinoma Guidelines: Guidelines Summary, Prevention, Diagnosis

  https://emedicine.medscape.com/article/254083-guidelines

  The NCIs PDQ cancer information summary notes that the use of oral contraceptives containing estrogen and progesterone for at least 1 year reduces the risk for developing endometrial cancer. The decreased risk is proportionate to duration of use, and the benefit persists for at least 15 years after cessation. However, use of oral contraceptives is also associated with increased risk for blood clots, stroke, and myocardial infarction, particularly in women who smoke and are older than 35 years. […] The ACS recommends the following measures to reduce the risk of developing endometrial cancer: Asymptomatic women who have Lynch syndrome or a family history of colon cancer should be tested annually with endometrial biopsy beginning at age 35; Progestin should be added to estrogen in hormone replacement therapy.

• #1 Uterine and Endometrial Cancer Prevention | Roswell Park Comprehensive Cancer Center – Buffalo, NY

  https://www.roswellpark.org/cancer/uterine-endometrial/prevention-screening

  If you have Lynch Syndrome, you should consider the following steps for early detection and prevention of endometrial cancer: Endometrial biopsy, yearly starting at age 35. […] Preventive surgery, such as hysterectomy to remove your uterus and bilateral salpingo-oophorectomy to remove your fallopian tubes and ovaries after childbearing is complete. These surgeries can be performed in a single operation.

• #1 Endometrial (Uterine) Cancer Screening Guidelines | Mays Cancer Center

  https://cancer.uthscsa.edu/cancer-care/cancer-prevention-screenings/endometrial-cancer-screening-guidelines

  South Texans experience higher gynecological cancer rates than many other places in the U.S. Endometrial cancer screening helps doctors detect disease, often before it causes symptoms. […] At Mays Cancer Center, home to UT Health San Antonio MD Anderson Cancer Center, we provide endometrial cancer screening for women who have Lynch syndrome in their family. […] Women who have a high risk of endometrial cancer may benefit from yearly testing, even without symptoms. Screening helps doctors detect cancer soon after it develops, which may lead to treatment benefits. […] Based on current scientific evidence, we recommend only women at high risk for endometrial cancer get screened regularly. You are considered to have a high risk if you have (or a family member has) Lynch syndrome. […] If you have an increased endometrial cancer risk, we recommend you receive the following screening tests once a year: […] If you have had endometrial cancer, you have unique screening needs. Our gynecologic oncologists can help protect your long-term health by tailoring a screening plan for your situation.

• #1 Lifestyle Changes Women Should Consider to Prevent Cancer | Nutrition and Cancer Prevention | University of Michigan Rogel Cancer Center

  https://www.rogelcancercenter.org/living-with-cancer/practical-matters/lifestyle-changes-women-should-consider-prevent-cancer

  What can you do to reduce your risk of endometrial cancer? Achieve and maintain a healthy weight. […] Exercise most days of the week. […] Avoid sitting for long periods of time. […] Follow a healthy, balanced diet focused on lots of fruits and vegetables complemented with whole grains and lean proteins.

• #1 Endometrial Cancer Prevention (PDQ®): Prevention – Patient Information [NCI] | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/endometrial-cancer-prevention-ncicdr0000258009

  The following protective factors decrease the risk of endometrial cancer: […] Estrogen levels are lower during pregnancy and when breast-feeding. The risk of endometrial cancer is lower in women who have had children. […] Taking hormonal contraceptives (birth control pills) that combine estrogen and progestin (combined oral contraceptives) decreases the risk of endometrial cancer. […] New data suggest that other hormonal contraceptives, such as birth control devices that are inserted into a woman’s uterus, may also decrease the risk of endometrial cancer. […] It is not known if losing weight decreases the risk of endometrial cancer. However, having bariatric surgery (a surgery that changes how your digestive system works so you will lose weight) decreases the risk of endometrial cancer. […] Physical activity (exercise) may lower the risk of endometrial cancer. […] Cancer prevention clinical trials are used to study ways to prevent cancer. […] New ways to prevent endometrial cancer are being studied in clinical trials.

• #1 Uterine and Endometrial Cancer Prevention | Roswell Park Comprehensive Cancer Center – Buffalo, NY

  https://www.roswellpark.org/cancer/uterine-endometrial/prevention-screening

  Having a healthy lifestyle and seeking routine healthcare is important to protect yourself from many cancer types, including endometrial cancer. […] Seek routine gynecologic care. Even if you’re past your childbearing years, women should see a gynecologist for an annual checkup and exam. Alert your physician to any abnormal bleeding or spotting between periods, bleeding after menopause, or abnormal discharge right away. […] Maintain a healthy weight. Women who are overweight or obese are up to six times more likely to develop uterine cancer. […] Get regular exercise. Women with higher levels of physical activity have lower risk for endometrial cancer. In addition, exercise can lower your risk for other uterine cancer risk factors obesity, high blood pressure and diabetes. […] Consider your family planning choices. Interestingly, the following factors are associated with reduced risk for uterine cancer: Pregnancy, Breastfeeding, Taking oral contraceptives.

• #1

  https://www.healthxchange.sg/cancer/uterine-endometrial-cancer/endometrial-cancer-treatment-prevention

  Endometrial cancer (also known as uterine cancer) is preventable. […] Here are the various ways a woman can reduce her risk of endometrial cancer (also known as uterine cancer): Maintain a healthy weight and lifestyle – Have a nutritious diet (eating foods that are low in fat and cholesterol and high in fibre, such as fruits, vegetables and wholegrain breads and cereals) – Exercise regularly. […] Go for a yearly pelvic examination. […] Consult a doctor early, if you notice any abnormal vaginal bleeding. Most bleeding is not caused by uterine cancer, but your doctor can investigate the cause of the abnormal bleed. […] Do not take chances if you think you have a problem. See your doctor at once. When uterine cancer is found early, the outlook is excellent. Delay in seeking treatment makes this disease much harder to cure.

• #1 Reducing your risk for uterine cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/uterine/risks/reducing-your-risk

  A prophylactic hysterectomy may be an option for some women who have a very high risk of developing uterine cancer, including some women with Lynch syndrome. This is surgery to remove the uterus before cancer develops. The decision to have a prophylactic hysterectomy should be carefully considered. Talk to your doctor about all the risks and benefits of the surgery and if it’s the best choice for you.

• #2 Endometrial Cancer Prevention, Early Diagnosis and Treatment | Encyclopedia MDPI

  https://encyclopedia.pub/entry/55841

  Endometrial cancer appears eminently suited to primary disease prevention, with modelling suggesting that up to 60% of endometrial cancer cases could be potentially prevented. […] An increased understanding of the mechanisms driving endometrial carcinogenesis, namely unopposed oestrogen, insulin resistance and chronic inflammation, has led to the proposal of a number of interventions designed to reduce endometrial cancer incidence. […] Obesity has the strongest link with endometrial cancer of the twenty most common tumour types and is plausibly implicated in 34% of diagnoses. […] Conversely, weight loss, by reducing adiposity and the aromatase-induced conversion of androgens into oestrogen, improving insulin sensitivity and lowering the levels of inflammation, is associated with a reduction in the endometrial cancer risk.

• #2 Endometrial Cancer Prevention, Early Diagnosis and Treatment | Encyclopedia MDPI

  https://encyclopedia.pub/entry/55841

  The focus has, therefore, shifted to the new anti-obesity medications (AOMs) that have been developed in recent years and which appear to lead to more significant and sustained weight loss in comparison with lifestyle interventions. […] Bariatric surgery alters the anatomy of the digestive system to restrict the capacity of the stomach, reduce nutrient absorption and induce early satiety. […] The beneficial effects of oral contraceptives on endometrial cancer risk have been known for the last 20 years, with every five years of use associated with a 24% reduction in the disease risk. […] Importantly, this effect appears to persist for up to 30 years after the discontinuation of use. […] The levonorgestrel-releasing intra-uterine system (LNG-IUS) may well be the most effective endometrial cancer prevention measure, with large-scale observational studies describing up to a 78% reduction in endometrial cancer risk among the users.

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