Etiologies of Endometrial Cancer

All etiologies (except radiation) result in chronic elevations in circulating levels of estrogen:

■ Ovarian failure (i.e., polycystic ovarian disease [PCOD])

■ Exogenous estrogens

■ Estrogen-producing tumors (i.e., granulosa cell tumors)

■ Liver disease (a healthy liver metabolizes estrogen)

■ Previous radiation (leading to sarcomas)

Postmenopausal bleeding always requires an endometrial biopsy as the first step in the workup.

Any agent/factor that raises the level or time of exposure to estrogen is a risk factor for endometrial cancer.


Early menarche/late menopause



Diabetes mellitus Hypertension Endometrial hyperplasia

Tamoxifen treatment for breast cancer (increases risk two to three times)

Any agent/behavior that lowers the level or time of exposure to estrogen decreases the risk of endometrial cancer.

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