|Anatomy of Uterus, Cervix and Ovary|
1.Human pappiloma virus infection. Especially oncogenic subtypes type 16 and 18.
2.Coitarche at a younger age
3.Time gap between the menarche and the coitarche is less.
4.Multiple sexual partners
6.Immunosuppression eg. HIV infection, post-transplant
8.Lower socioeconomic group.
Risk factors for the carcinoma of the endometrium
1.Age highest incidence in the postmenopausal age group in the 6th decade.
2.Increased exposure to the endogenous estrogens- early menarche, late menopause,nullipartiy, obesity, cirrhosis
3.Oestrogen secreting ovarian tumors- granulosa cell tumour.
4.Polycystic ovarian syndrome
5.Hypertension, diabetes mellitus
6.Endometrial hyperplasia with atypical changes
7.Exposure to unopposed oestrogen therapy as hormone replacement therapy.
8.Tamoxifen therapy- (in breast carcinoma treatment)
Risk factors for the carcinoma of the ovary
1.Ovulation induction therapy used in the treatment of subfertiliy due to anovulatory cycles.- eg. clomiphene
2.Family history of ovarian, breast or colonic cancers. Associated with BRCA 1 and BRCA 2 gene mutations and hereditary non polyposis colorectal cancer syndrome
3.Personal history of breast cacinoma. ( around 10% of ovarian cancers are familial and 90% sporadic)
4.Nulliparity, early menarche, late menopause, having the first child after 30. ( all share increased life time exposure to ovulatory cycles)
Breast feeding and consumption of combine hormonal contraception have a protective effect.