Table 1.
Summary table of the main risk factors for endometrial cancer and existing and potential prevention strategies to minimise this risk
| Risk factor | Effect on endometrial cancer risk | Proposed mechanism | Proven methods of prevention | Potential methods of prevention |
|---|---|---|---|---|
| Lynch syndrome | Lifetime risk 70%, cf. 2–3% in general population | Mutations in DNA mismatch repair genes | Risk-reducing surgery | Aspirin |
| Tamoxifen | Postmenopausal RR 4.01 (95% CI 1.7–10.9) | Oestrogenic effects on endometrium | Low threshold to investigate abnormal bleeding | LNG-IUS |
| PCOS | Lifetime risk 9% OR 2.89 |
Insulin resistance Anovulatory cycles |
Induce regular withdrawal bleeds | Weight reduction Metformin hormonal contraception |
| Obesity | RR 1.59 per 5 kg/m2 increase in BMI | Activation of pro-proliferative pathways (Fig. 1) Anovulatory cycles |
Bariatric surgery Physical activity |
Non-surgical weight loss LNG-IUS |
| Diabetes | RR 1.42–4.1 | Activation of pro-proliferative pathways | Bariatric surgery | Modulation of insulin resistance |