Define Type I and II endometrial cancer.
Type I endometrial cancer: endometrioid adenocarcinomas (grade 1 and 2) derived from atypical endometrial hyperplasia
Type II endometrial cancer: endometrioid adenocarcinomas (grade 3) and tumors of nonendometrioid histology (serous, clear cell, mucinous, squamous, transitional, and undifferentiated cells)
List causes of type I endometrial cancer.
Directly related to long-term exposure to increased estrogen levels
Some genetic mutations (e.g., in the PTEN gene or mismatch repair genes) are also associated with this type of cancer.
List causes of type II endometrial cancer.
Associated with endometrial atrophy (especially in postmenopausal women)
Strongly associated with a genetic predisposition
List risk factors for estrogen-dependent tumors.
Early menarche and late menopause
Polycystic ovary syndrome
Metabolic syndrome (esp. obesity and diabetes mellitus type 2 )
Unopposed estrogen replacement therapy (e.g., for menopausal symptoms)
History of breast cancer and tamoxifen treatment
Lynch syndrome (hereditary nonpolyposis colorectal cancer)
List protective factors.
Low estrogen and high progestin or progesterone levels have a protective effect.
Combination oral contraceptive pills
Regular physical exercise
Lifelong soy-rich diet