 | HUMAN FERTILITY AND REPRODUCTION: THE OOCYTE, THE EMBRYO, AND THE UTERUS
Copyright © 2001 by the New York Academy of Sciences
description
Annals of the New York Academy of Sciences 943:296-315 (2001)
© 2001 New York Academy of Sciences
Role of Exogenous and Endogenous Hormones in Endometrial Cancer
Review of the Evidence and Research Perspectives
ARSLAN AKHMEDKHANOVa,b,
ANNE ZELENIUCH-JACQUOTTEb AND
PAOLO TONIOLOa,b
aDepartment of Obstetrics and Gynecology and bDepartment of Environmental Medicine, New York University School of Medicine, New York, New York 10016, USA
Address for correspondence: Dr. Arslan Akhmedkhanov, Department of Obstetrics and Gynecology, New York University School of Medicine, 550 First Avenue, NB 9E2, New York, NY 10016. Voice: 212-263-7763; fax: 212-263-8887.
akhmea01{at}med.nyu.edu
Endometrial carcinoma is the most common cancer of the female reproductive organs in the United States. International comparisons reveal that the incidence of endometrial cancer vary widely between different countries with the highest rates observed in North America and Northern Europe, intermediate rates in Eastern Europe and Latin America, and lowest rates in Asia and Africa. International variation in endometrial cancer rates may represent differences in the distribution of known risk factors, which include obesity, postmenopausal estrogen replacement, ovarian dysfunction, diabetes mellitus, infertility, nulliparity, and tamoxifen use. Most of the risk factors for endometrial cancer can be explained within the framework of the unopposed estrogen hypothesis, which proposes that exposure to estrogens unopposed by progesterone or synthetic progestins leads to increased mitotic activity of endometrial cells, increased number of DNA replication errors, and somatic mutations resulting in malignant phenotype. Although the impact of exogenous hormone replacement was intensively studied during the last two decades, less is known about the effects of endogenous hormones in endometrial cancer. A review of available experimental, clinical, and epidemiologic data suggests that in addition to estrogens, other endogenous hormones, including progesterone, androgens, gonadotropins, prolactin, insulin, and insulin-like growth factors, may play a role in the pathogenesis of different histopathologic types of endometrial cancer.
Key Words: androgens • cancer • endogenous hormones • endometrial cancer • exogenous hormones • hormones • progesterone
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