All are the precipitating factors of endometrial cancer except -

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Explanation

High parity (having multiple pregnancies) is a protective factor against endometrial cancer, not a risk factor.
Pregnancy is a high-progesterone state, which counteracts the proliferative (growth) effects of estrogen on the uterine lining (endometrium).
Each pregnancy provides a 'break' from continuous estrogen exposure, thereby reducing the cumulative lifetime risk of developing endometrial cancer.
In contrast, nulliparity (never having been pregnant) is a well-established risk factor for endometrial cancer.

Option A: A history of uterine polyps is considered a risk factor. Polyps are often associated with conditions of high estrogen and can sometimes contain precancerous or cancerous cells.
Option B: Polycystic ovary disease (PCOS) is a major risk factor. It is characterized by chronic anovulation (not releasing an egg), which leads to continuous estrogen production without the opposing effect of progesterone that normally follows ovulation.
Option D: Late menopause (e.g., after age 55) is a significant risk factor. It prolongs the total number of years the endometrium is exposed to estrogen over a woman's lifetime, thereby increasing the risk of malignant changes.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Risk factors for endometrial cancer as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in patient education regarding endometrial cancer risks. This includes counseling on the importance of maintaining a healthy weight, as obesity is a primary modifiable risk factor.
A key nursing responsibility is to teach patients to recognize and report cardinal symptoms, especially any postmenopausal bleeding, which should always be investigated.
Nurses should be aware of high-risk populations, such as women with PCOS or Lynch syndrome, who may require more vigilant monitoring.

How to Approach the Question

First, identify the keywords in the question. The key terms are 'endometrial cancer', 'precipitating factors', and the negative lead-in 'except'.
This 'except' format means you are looking for the option that is NOT a risk factor. Three options will be risk factors, and one will be either neutral or protective.
Recall the main cause of endometrial cancer: prolonged, unopposed estrogen exposure.
Evaluate each option in the context of estrogen exposure:
History of uterine polyps: Associated with high estrogen.
Polycystic ovary disease: Causes unopposed estrogen.

Concept Tested & Keywords

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E6 Gynecology Williams pp. 285-349, 284-348

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