Prevention Strategies in Endometrial Carcinoma

Abstract

Purpose of the Review

To assess the most recent high-quality evidence for endometrial cancer prevention strategies.

Recent Findings

• Obesity is an established risk factor for endometrial cancer.

• Weight cycling and weight gain in middle age are risk factors for endometrial cancer.

• Bariatric surgery reduces the risk of endometrial cancer by up to 81% in obese women who attain and maintain a normal weight.

• Combined oral contraceptives provide durable protection against endometrial cancer for 30 years or more.

• Ever use of the levonorgestrel intrauterine system (LNG-IUS) and inert intrauterine devices reduce endometrial cancer risk.

• The first oestrogen-based non-progestin HRT for non-hysterectomised women that contains estradiol and bazedoxifene has an effective protective effect on endometrium.

• Bisphosphonates reduce endometrial cancer risk.

Summary

Weight loss and LNG-IUS would seem to be an effective strategy for preventing the development of obesity-driven endometrial cancer in the highest risk women. Future research may identify other safe and effective chemoprevention interventions, such as aspirin, bisphosphonates or metformin.

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