What Are the Risk Factors for Endometrial Cancer?

by Sheila M. Eldred Health Writer

Worried about whether you are at risk of endometrial cancer? This cancer is on the rise, according to the American Cancer Society. Before you panic, it’s important to know that having one or even a few of the risk factors does not mean you will definitely develop endometrial cancer.

Read on to learn about the most common risk factors for this cancer.

Three generations of women using a tablet.

Age is a risk factor

Unfortunately, the risk of endometrial cancer appears to rise as you age. Some set the age of risk as over 50; other research has found that this cancer is more common after menopause.

Woman using an insulin pump.

Diabetes and endometrial cancer

Endometrial cancer is also much more widespread in women with diabetes — possibly four times as common, according to the American Cancer Society. That includes women with diabetes who are not overweight.


Hormones, the drug tamoxifen, and cancer

Hormones play a big role in endometrial cancer, with more estrogen increasing the risk.

Although the breast cancer drug tamoxifen acts as an anti-estrogen in breast tissue, it has the opposite effect in the uterus. Its use has been linked to an increased risk of endometrial cancer. Still, the likelihood of getting endometrial cancer while using it is low enough that breast cancer-related benefits likely outweigh the risks. If you’re considering this drug, discuss the risks with your doctor.

Woman before weight loss surgery with nurse and family member.

Obesity increases endometrial cancer risk

Extra fat tissue can cause estrogen levels to rise, which, in turn, ups the risk of endometrial cancer. In fact, the cancer is twice as common in overweight women than women of a healthy weight, according to the American Cancer Society — and more than three times as common in women with obesity.

Menstrual cycle calendar and menstruation supplies.

More lifetime menstrual cycles increases risk

There’s a link between the number of menstrual cycles a woman goes through over a lifetime and developing endometrial cancer: The more periods you have, the higher the risk. So women who started menstruating early or stopped menstruating late and were exposed to more estrogen appear to have an increased risk of endometrial cancer.

Pregnant woman standing in front of a window.

Women who have been pregnant have lower risk

Yet another factor that shifts the hormonal balance is pregnancy. Pregnancy means more progesterone, so if you’ve never been pregnant, you’re likely at a higher risk of endometrial cancer. In fact, women who weren’t able to get pregnant may have an even higher risk of developing the cancer, although the reasons for this are unclear.

Hormone replacement therapy.

Estrogen therapy can raise your risk

You’ve guessed it by now: Taking estrogen without progesterone during menopause increases the risk of endometrial cancer. But here’s where it gets tricky: Taking a combination hormone therapy ups the risk of breast cancer and blood clots. Using hormones at the lowest dose and for the shortest period possible can curtail these risks; regardless, it’s a decision best made with your doctor.

Mother and daughter embracing while sitting on a bench.

Family history’s impact on endometrial cancer

A family history of Lynch syndrome could mean you’re more at risk of endometrial cancer, research indicates. An abnormal copy of one of at least seven different genes can cause this syndrome. Women with the syndrome have a 40-60 percent chance of developing endometrial cancer, and it’s also associated with a very high risk of colon cancer.

Researchers also suspect another yet-to-be-determined genetic disorder could account for families with high rates of endometrial, but not colon, cancer.

Woman DNA strand.

Other conditions linked to endometrial cancer

Polycystic ovary syndrome (PCOS) and Cowden syndrome, both inherited conditions, are associated with a higher risk of endometrial cancer.

Endometrial hyperplasia, a precancerous condition that causes the growth of the lining of the uterus, doesn’t usually become cancerous if it’s mild. But if it’s atypical and untreated, it turns into cancer in 8 to 29 percent of cases, depending on whether it’s simple or complex. Doctors usually recommend treating complex atypical hyperplasia.

Using dumbells.

Next steps: Reduce your risk of endometrial cancer

There’s good news, too: There may be things you can do to help reduce your risk of endometrial cancer because there are protective factors for this cancer in addition to risk factors. These include using birth control pills or an intrauterine device (IUD), breastfeeding for more than 18 months, and being physically active. Talk to your doctor to learn more about your individual risk and how to stay as healthy as possible.

Sheila M. Eldred
Meet Our Writer
Sheila M. Eldred

Sheila Mulrooney Eldred is a graduate of Columbia’s School of Journalism and a former newspaper reporter. As a freelance health journalist, she writes about everything from life-threatening diseases to elite athletes. Her stories have appeared in The New York Times, Nature, FiveThirtyEight, Pacific Standard, STAT News, and other publications. In her spare time, she and her family love running, cross-country skiing, and mountain biking in Minneapolis.