From the Guidelines
Leiomyomas (uterine fibroids) do not directly cause an inflamed uterus that increases endometrial cancer risk, as the primary risk factors for endometrial cancer are related to excess estrogen exposure, obesity, and other metabolic factors, as noted in the 2024 study 1 and the 2016 consensus conference on endometrial cancer 1.
Key Points to Consider
- Fibroids are benign smooth muscle tumors that rarely undergo malignant transformation, and inflammation from fibroids is typically localized, as discussed in the 2024 study 1.
- Endometrial cancer is more strongly linked to excess estrogen exposure without adequate progesterone, as seen in conditions like obesity, polycystic ovary syndrome, and certain hormone therapies, as outlined in the 2016 consensus conference on endometrial cancer 1.
- Some studies suggest that certain inflammatory pathways may be activated in both conditions, but a direct causal relationship between fibroid-induced inflammation and endometrial cancer has not been established, as noted in the 2016 consensus conference on endometrial cancer 1.
- Women with fibroids should still be monitored for abnormal bleeding, as this symptom can occur in both conditions but requires different treatment approaches, as discussed in the 2024 study 1.
- Regular gynecological check-ups are important for women with fibroids to monitor any changes that might warrant further investigation, as recommended in the 2024 study 1.
Risk Factors for Endometrial Cancer
- Excess estrogen exposure without adequate progesterone, as seen in conditions like obesity, polycystic ovary syndrome, and certain hormone therapies, as outlined in the 2016 consensus conference on endometrial cancer 1.
- Obesity, with a relative risk of 2.21, as reported in the 2016 consensus conference on endometrial cancer 1.
- Metabolic syndrome, with a relative risk of 1.89, as reported in the 2016 consensus conference on endometrial cancer 1.
- Nulliparity and infertility, with polycystic ovarian syndrome (PCOS) being a significant risk factor, as discussed in the 2016 consensus conference on endometrial cancer 1.
- Unopposed estrogen therapy, estrogen-producing tumors, and early menarche/late menopause, as outlined in the 2016 consensus conference on endometrial cancer 1.
From the Research
Uterine Leiomyomas and Endometrial Cancer
- There is no direct evidence in the provided studies to suggest that leiomyomas can engender an inflamed uterus susceptible to endometrial cancer 2, 3, 4, 5, 6.
- Uterine leiomyomas are common benign gynecologic tumors that can cause symptoms such as menstrual irregularities, pain, and fertility difficulties, but many women remain asymptomatic 3.
- The presence of uterine fibroids can lead to a variety of clinical challenges, but there is no mention of an increased risk of endometrial cancer 4.
- The management of symptomatic uterine leiomyomas includes medical, procedural, and surgical options, but the primary focus is on alleviating symptoms and improving quality of life, rather than preventing endometrial cancer 4, 6.
- Ultrasonography is the first-line imaging examination for suspected fibroids, and it can help differentiate between leiomyomas and other pathologies, including adenomyosis, solid tumors of the adnexa, and endometrial polyps 5.