Endometrial cancer

Endometrial cancer is the most common type of gynecological cancer in developed countries. It originates in the endometrium, which is the mucous layer that lines the inside of the uterus, where cells begin to grow uncontrollably. Its prevalence is low (8.4 cases/100,000 inhabitants) and, in general, it has a good prognosis due to early symptoms that allow for early detection.

The exact cause of endometrial cancer is unknown, but certain risk factors that increase the likelihood of its occurrence have been identified. These include:

• Hormonal imbalances. Abnormal fluctuations in estrogen and progesterone levels cause changes in the endometrium, especially if it involves an increase in estrogen levels and a decrease in progesterone. This can occur in polycystic ovary syndrome and in obese women.
• More years of menstruation. Women with early menarche and/or later menopause have a higher risk of developing this type of neoplasia.
• Pregnancies: Women who have had at least one pregnancy have a lower risk of developing endometrial cancer.
• Use of contraceptive pills. Women who take contraceptive treatment for a long time have a lower risk of developing endometrial cancer.
• More than 90% of endometrial cancer cases are diagnosed in women over 50 years old.
• Hereditary cancer syndromes, such as Lynch syndrome or hereditary non-polyposis colorectal cancer, increase the risk of developing this type of cancer. Having mutations in the BRCA1/2 genes also increases the predisposition.

Endometrial cancer usually presents symptoms even in its early stages, which facilitates early detection. Among the symptoms, the most common are:

• Unusual vaginal bleeding, spotting, or discharge: Approximately 90% of patients diagnosed with endometrial cancer experience abnormal vaginal bleeding, such as a change in their menstrual periods or bleeding between periods or after menopause.
• Pelvic pain and/or mass and weight loss: Pelvic pain, feeling a mass (tumor), and/or unexpected weight loss can also be symptoms of endometrial cancer. These symptoms are more common in the later stages of the disease.

Although any of these can be caused by conditions other than cancer, it is important to consult a doctor if you experience any of these symptoms.

Most cases of endometrial cancer cannot be prevented, but there are some actions that can reduce the risk of developing this disease. The best way to reduce the risk is to try to avoid or minimize risk factors. General recommendations would be:

• Healthy lifestyle, with a balanced diet, regular physical exercise, and promoting weight loss in obese or overweight women.
• Combine the intake of estrogen with progesterone to treat menopause symptoms. This combination may increase the risk of breast cancer, so it is recommended to consult with a doctor.
• Use of contraceptive pills. The use of this type of medication reduces the risk of uterine neoplasia and can be useful in women at high risk.
• In the case of hereditary predisposition syndromes such as those mentioned above (Lynch syndrome, etc.) where patients have a very high risk of endometrial cancer, hysterectomy may be considered as a preventive measure.