We know that around 15% of endometrial cancers occur in women less than 50 years of age, and 5% in women less than 40. These women may not yet have had a family and likely have not entered menopause. Thus they may not be ready to have their uterus and ovaries removed, which is the usual surgical step when endometrial cancer is diagnosed.
It is very challenging to advise these women as to what to do . . . balancing our desire to support them in having children but also worrying that they cancer could spread and put their life at risk.
We identified that in addition to women with inherited risks for endometrial cancer (genetic mutations passed down from their parents) and the risks associated with being obese (heavy women have extra estrogen in their systems that stimulates the uterus), in approximately one third of young women with endometrial cancer, we could not identify a reason for them to develop the disease.
We are now studying the molecular features of endometrial cancers in young women in the hopes of being able to guide them. Molecular analysis is one way we could determine the likelihood of them having a ‘good outcome’ vs. ‘bad’ disease.