Risk factors and
Epidemiology of Endometrial
and Ovarian Cancer
By: Tammy, Merissa, and Heather
For: Nursing 519 Unit 6
• Endometrial cancer and ovarian
cancer share many risk factors,
however there are a few
differences.
Endometrial Cancer - Epidemiology
• Endometrial cancer is the most common
cancer of the pelvic region and accounts
of 6% of all cancers in women (McCance
& Huether, 2006).
• There is a higher incidence in white
women, but higher mortality rates (nearly
double) in black women (McCance &
Huether, 2006).
Risk Factors for Endometrial
Cancer
• Chronic exposure to estrogen, which can
be caused by…
• Early menarche (beginning menstruation
before age 12)
• Hormone replacement therapy (HRT) with
exogenous estrogen (i.e., without
progesterone)
• Late menopause (after age 52)
Risk factors for Endometrial Cancer
• Presence of an estrogen-secreting (tumour (e.g.,
some types of breast cancer)
• Nulliparity (having never given birth) or low
parity (Swierzewski, 1999)
• Women with hereditary nonpolyposis colorectal
cancer, caused by a genetic abnormality, have
an increased risk of developing a variety of
cancers, including endometrial cancer
(Mayoclinic, 2008).
Risk factors for Endometrial Cancer
• Age (more common after age 50)
• Family history of uterine cancer
• Personal history of breast, colorectal, or ovarian
cancer
• Prior pelvic radiation therapy
• Race (endometrial cancer is more common in
Caucasian women and uterine sarcoma is more
common in African American women)
• Obesity (Swierzewski, 1999).
Protection against Endometrial
Cancer
• The birth control pill, controlling obesity,
managing hypertension, and controlling
diabetes have proven to have protective
benefits against endometrial cancer
(Copstead & Banasik, 2000;
Mayoclinic.com, 2008; McCance &
Huether, 2006).
Challenges in detecting
Endometrial Cancer
• Endometrial cancer can be difficult to
detect as it is largely asymptomatic,
however vaginal bleeding is a common
sign. This can be misleading as the
majority of the population of women with
endometrial cancer are in the menopausal
age group and may consider this a normal
sign to completing menarche.
Ovarian Cancer - Epidemiology
• Ovarian cancer accounts for 3% of all cancers in
women and has the greatest mortality rate
(66%) of all female reproductive cancers, likely
due to being difficult to detect in the early stages
of the disease (Copstead & Banasik, 2000;
McCance & Huether, 2006).
• Ovarian cancer has a 5-10% familial inheritance,
often associated with the breast cancer gene 1
or 2 (McCance & Huether, 2006).
Risk factors for Ovarian Cancer
• Family History (mother or sister with the
disease, usually developed early)
• Age (over 55)
• Obesity
• Never pregnant
• Hormonal therapy (MedicineNet.com,
2009).
Risk Factors for Ovarian Cancer
• Early menarche
• Late menopause
• Use of fertility drugs (McCance & Huether,
2006)
Protection against Ovarian Cancer
• Factors providing protective benefits
against ovarian cancer include multiple
pregnancies, prolonged lactation, and use
of birth control pills (Mayoclinic.com, 2008;
McCance & Huether, 2006).
To Recap…
• Common risk factors for Endometrial and
Ovarian Cancers…
• Early menarche
• Late menopause
• Familial (genetic) predisposition to cancer
• Obesity (McCance & Huether, 2006; Mayoclinic,
2008; MedicineNet.com, 2009; Swierzewski,
1999).
To Recap…
• Common protective factors against
Endometrial and Ovarian Cancers…
• Oral contraceptive (birth control pill) use
• Controlling obesity
• Having babies! (McCance & Huether,
2006)
A question to ponder...
• As a NP, what test(s) would you order if
you suspected a patient had endometrial
cancer? Ovarian cancer?
• Thank you for your participation!
References:
• Copstead, L. C., & Banasik, J. (2000).
Pathophysiology: Biological and behavioral
perspectives. (2nd ed.). Philadelphia, PA: W.B.
Saunders Company.
• Mayoclinic.com (2008). Endometrial
cancer. Retrieved February 9, 2009 from
http://www.mayoclinic.com/health/endometrialcancer/DS00306/DSECTION=risk%2Dfactors
• Mayoclinic.com (2008). Ovarian
cancer. Retrieved February 9, 2009 from
• http://www.mayoclinic.com/health/ovariancancer/DS00293/DSECTION=risk%2Dfactors
References:
• McCance, K., & Huether, S. (2006).
Pathophysiology: The biologic basis for disease
in adults and children. (5th ed.). St. Louis, MI:
Elsevier Mosby.
• MedicineNet.com. (2009). Ovarian Cancer.
Retrieved February 9, 2009 from:
http://www.medicinenet.com/ovarian_cancer/pag
e2.htm
• Swierzewski, S. (1999). Endometrial Cancer:
Causes and risk factors, signs and symptoms.
Retrieved February 9, 2009 from:
http://www.oncologychannel.com/endometrialca
ncer/riskfactors.shtml