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What are the risk factors for gynaecological cancers?

Risk factors are characteristics that increase the likelihood of developing a disease, such as a cancer. There are different types of risk factors; some can be modified (diet, physical activity) while others can’t (age, genetic factors). Sometimes, risk factors can be modified by some people but not others (e.g., the number of children).

Although certain factors can increase a woman's risk for developing gynaecological cancer, they do not always cause the cancer. Many women carry at least one risk factor but still will not develop gynaecological cancer. Even if a woman with a gynaecological cancer carries a risk factor, it is difficult to know how much that risk factor contributed to the development of cancer.

Risk factors also look to explain cancer incidence of larger populations but sometimes it will be impossible to attribute “fault” to a risk factor. For example, cervical cancer is caused by Human Papilloma Virus (HPV), which is a sexually transmitted virus. However, the vast majority of women will have sexual intercourse at least once in their lives without developing cervical cancer. It remains unknown why some women develop cancer and others don’t.

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While the causes of some gynaecological cancers are not fully understood some known risk factors include:

  • Increasing age. The risk of a woman being diagnosed with gynaecological cancer increases beyond the age of 65 years.
  • Family history or identified gene mutations. These mutations can include BRCA1, BRCA2 and Lynch Syndrome.
  • Reproductive history such as child-bearing. Women who have never given birth, who had infertility issues, never breastfed or had their first child after the age of 30 are at increased risk for ovarian cancer.
  • Exposure to hormones produced by the body or taken as medication. For e.g, estrogen-only hormone replacement therapy (HRT) taken as tablets after menopause may be associated with an increased risk of uterine cancer.
  • Previously diagnosed with cancer. A woman who has had any previous cancer diagnosis may have an increased risk of developing any type of cancer in the future. For example, women who developed breast cancer are at a significantly higher risk of developing uterine and ovarian cancer.
  • Exposure to diethylstilbestrol (DES) in the womb. DES is a synthetic form of the hormone estrogen. Doctors prescribed DES to help some pregnant women to prevent miscarriage between the 1940s and 1970s in Australia. Women whose mothers were given DES during pregnancy may be at increased risk of cervical and vaginal cancer.
  • Viral infection such as Human Papilloma Virus (HPV). Certain types of HPV have been linked to the development of cervical cancer.
  • The oral contraceptive pill. Long-term use of the oral contraceptive pill is associated with a small increased risk of cervical cancer. However, the pill has a substantial (50%) and long-lasting protective effect against ovarian and endometrial cancer.
  • Smoking. I discussed this in a previous blog ‘Does smoking cause gynaecological cancer?’ Smoking can increase your risk of ovarian, cervical and vulval cancer.
  • Being overweight. Increased caloric intake and obesity is strongly linked to an increased risk of endometrial cancer. Regarding ovarian cancer and cervical cancer, the evidence is less consistent.
  • Diet. A diet low in fruit, vegetables and grains, and high in saturated fat may increase ovarian cancer risk.

It is important for women to know their risk factors and talk about them with health professionals if concerned. Knowing cancer risk factors can prompt an individual to make lifestyle choices that may decrease cancer risk and improve overall health. Knowing risk factors could also aid in deciding if genetic testing may be an option. 

Source: Cancer Australia

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