How one in three women with endometrial cancer could avoid it

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The strongest modifiable risk factor is being overweight and obese. One in four endometrial cancers are linked to having a body mass index (BMI) above a healthy weight range, according to the review. Roughly 6 per cent was linked to insufficient exercise and 11 per cent to diabetes.

Endometrial cancer by the numbers

  • The cancer that develops in the lining of the uterus is the fifth most commonly diagnosed cancer in women
  • In 2019 more than 3000 Australian women will be diagnosed and more than 500 will die
  • The five-year survival rate is 83 per cent
  • Roughly 33 per cent of endometrial cancers diagnosed every year are attributed to modifiable conditions, particularly overweight and obesity. 

The breast cancer drug tamoxifen is also in the convincing risk factor category and is associated with a slightly increased risk of endometrial cancer, as well as oestrogen-only hormone replacement therapy (oral or transdermal), which is only recommended for women after hysterectomy.

However, oral contraception is convincingly protective, while breastfeeding, having babies, physical activity and coffee “probably” lowers the risk.

Green tea, hormonal intrauterine devices, weight loss, non-steroidal anti-inflammatory drugs and bisphosphonates (drugs to treat osteoporosis) could also be protective.

The evidence was inconclusive when it came to the effects of endometriosis, polycystic ovary syndrome, stress, hormonal fertility treatments, alcohol, black tea and diets high in fat.

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Paracetamol and breast cancer drug raloxifene had no link to the cancers, dispelling earlier suggestions that the common pain killer and cancer treatment may raise risks.

Lesley McQuire was diagnosed with endometrial cancer on her 52nd birthday in 2002.

She had two tumours in her uterus and a risk factor trifecta: her mother had been diagnosed, she carried the genetic mutation Lynch Syndrome and she had gained weight after going through early menopause.

“I won the lottery for endometrial cancer,” she said. “I could have died early, as some women do. I am very grateful to my doctors.”

Lesley McQuire was diagnosed with endometrial cancer on her 52nd birthday.

Lesley McQuire was diagnosed with endometrial cancer on her 52nd birthday.Credit:James Brickwood

Professor Dorothy Keefe, the chief executive of Cancer Australia, said the aim of the website was to empower women to be aware of risk factors.

“The evidence is building that obesity is a problem for many cancers … but there is a lot more to developing obesity than just choices. There are huge societal issues involved,” Professor Keefe said.

“We are just providing the evidence base that if you can live a healthier lifestyle and be more mobile it does bring that risk down.”

Similarly, having children and breastfeeding is not always a choice.

“It isn’t about insisting every woman breastfeed, but if you can then the evidence says it could have long term health benefits,” she said.

In some cases it’s a balancing act of risk and benefit.

For instance, tamoxifen might incrementally raise the risk of endometrial cancer, but it can be lifesaving for breast cancer patients.

“You just need to be aware of the slightly increased risk so that if you develop symptoms – such as vaginal bleeding – then you need to take it seriously,” Professor Keefe said.

Now disease-free, Ms McQuire urged women with a family history of cancer to talk to their doctors.

“Don’t dilly-dally,” she said.

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