Abstract
Endometrial cancer is the most common gynecologic cancer and is predominantly endocrine-related. The role of unopposed estrogen in the development of endometrial cancer has been investigated in numerous studies. Different reproductive factors such as younger age at menarche, late age at menopause, infertility, nulliparity, age of birth of the first child, and long-term use of unopposed estrogens during hormone replacement therapy have been associated with an increased risk of endometrial cancer. In contrast, there is a growing body of evidence for a protective role of oral contraceptives. Most of the published data on the association between infertility and polycystic ovary syndrome are inconclusive, whereas the effect of tamoxifen on the risk of endometrial cancer has been well established. With this review, we aim to summarize the evidence on the association between infertility, polycystic ovary syndrome, oral contraceptives, and tamoxifen and the development of endometrial cancer.
Highlights
Endometrial cancer is the most common gynecologic cancer [1]
The aim of this review is to investigate the relationship between infertility, polycystic ovary syndrome (PCOS), oral contraceptives (OC), and tamoxifen (TAM) and the risk of endometrial cancer
The hormonal imbalance caused by anovulation in patients with PCOS is associated with unopposed estrogen action [2]
Summary
Endometrial cancer is the most common gynecologic cancer [1]. There are two different types of endometrial cancer: estrogen-related type I, comprising about 80% of the diagnosed endometrial cancers and a smaller group of non-estrogen-related type II cancer. Estrogen stimulates the proliferation and growth of type I endometrial cancer cells, whereas progesterone and synthetic derivatives have the opposite effect. Several pathophysiological conditions, associated with increased estrogen levels, might increase the risk of type I endometrial cancer. In this regard, medication influencing the estrogen/progesterone ratio might influence the incidence of endometrial cancer. Medication influencing the estrogen/progesterone ratio might influence the incidence of endometrial cancer Various reproductive factors such as younger age at menarche and late age at menopause, infertility, nulliparity, age at first delivery, and long-term use of unopposed estrogens during hormone replacement therapy has been associated with a significantly increased risk of developing endometrial cancer [2]. The aim of this review is to investigate the relationship between infertility, polycystic ovary syndrome (PCOS), OCs, and tamoxifen (TAM) and the risk of endometrial cancer
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